I'm going to focus on the first client seen by the clinician in the video. In this example, the primary defense mechanism employed by the client is rationalization. During her explanation of her referral, she identified the perceived cause as her mother's lack of involvement in her life. While I can sympathize with feelings of empowerment and autonomy this disengagement brings, she evinces some ambivalence about her relationship with her mother. She externalizes her anxiety over her lack of a relationship with her mother on her teacher and administrators who referred her to the clinician. In addition, she minimizes and denies her lack of effort in the class by positing that it puts undue and unwarranted strain upon her ("I have to sleep") and that those around her are overreacting to her lack of effort in the class.

Perhaps those who referred her to the clinician perceive her lack of effort as a form of acting out in which she garners attention from her mother by failing a class. She lends credence to this theory in her reasoning of why she does not attend school. Her reason for not attending is that her mother does not take an involvement in her life and demand that she remain engaged in school. It seems also that she is seeking this understanding and involvement from her boyfriend, whom she describes as "the only one who understands me." I would take this a step further to say that he is the only one who takes the time or makes the effort to understand her.

Her negative emotions regarding her mother find further expression through her statement that "if she doesn't want to be there, I don't want her there." This is an example of "sour grapes" rationalization wherein she does not get what she desires (maternal guidance and interest) and then decides she never wanted it in the first place.

Further emotional content is gleaned from her projection of anger onto the therapist. She perceives the therapist's questions as judging her relationship (a natural defensive reaction to someone exploring a new topic in coerced therapy). The client then erects an emotional boundary, chiding the therapist as a power figure who will judge her life and see if more therapy is warranted. This is designed to show the therapist that her insights matter only on paper, not within her psyche. She confirms her denial and dissociation from her issues by saying that she does not want to think about this kind of stuff.

She does divulge some of her negative emotions towards her mother in her story about cooking. The lack of sympathy from her mother as well as the lack of instruction are demonstrated in her retelling her mother's response to her burning her hand during cooking. Again the ambivalence towards her mother's disengagement is evidenced by her implicit saying that she would not like to have been judged for cooking for herself (an independent, laudable act) and that her mother should just stay out of her business and let her be happy.

Introduction to Austrian

While reading the introduction to Sonia G. Austrian's textbook, I was struck by how much I agreed with the criticisms of the DSM and how it categorizes people. As someone who is sympathetic to both the social work criticisms of holistic evaluation and the Szaszian criticism of pathologizing everyday behavior, I have a healthy disdain for the DSM. I have found it only helpful as a shorthand reference to a constellation of symptoms, but as descriptors for people, it falls woefully short.

I see the focus on medication and short-term treatment every day within my placement. The competing imperatives of legal competence restoration and psychotherapeutic treatment make medication the primary intervention. In treatment plans, I get to see how differently psychiatrists as well as psychologists view the patient. While one offers medication and the other therapy, they both focus on diagnosis rather than the person's environment. For a social worker, it's actually interesting to see differential diagnosis and offer opinions. This is not to say that the other professions are blind to the psychosocial environment. Often, their insights into potential outplacement are valuable since I am new to the DMH system. However, ultimately it comes down to symptom management and liability control, and not a successful transition to the community.