[[Systemic group supervision]] # 202210031340 Systemic Group Supervision on 3 Oct 2022 [[03-10-2022]] Supervisor: J A, C, JJ, S. Reference: - [[Book - Adolescent Psychiatry in Clinical Practice edited by Simon G Gowers]] - [[Normal Development in Adolescence]] --- C presented a case of a seventeen years old female patient who had been admitted to the hospital for psychosis. The patient got a younger biological brother. Her biological father diagnosed to have Schizophrenia. The patient's biological mother was murdered by her birth father when she was 7. Due to physical abuse, the patient and her biological brother have lived with a foster family since she was 2.5 years old. There is alleged sexual abuse by the foster father to the biological brother, as such, both brother and sister will have to be rehoused elsewhere. She presented with increased self-harm and suicidal behaviour. This young patient has a complex and difficult childhood. The Case Worker seek to increase her understanding of this patient to help her. ## Some of the themes that surfaced during the discussion: - [[Attachment Theory]] figures - [[Sexual abuse]]? - Foster parents and child - #Mental_Illness - [[🏠 Trauma]] - ![[07 Feb 2022 Systemic Group Supervision#^0b8bc6]] - [[Grief and Loss]] - Sense of Security #safety - [[Shame and Guilt MOC]] - Self-Blame. - [[Uncertainty creates anxieties]] - Defence Mechanism [[Rationalisation]] and numbing of emotions. ## Interventions The Case Worker engaged the patient through the activity of folding origami. During the one-hour session, the case worker talked with the patient. The patient became more relaxed as the session progresses. The patient revealed that she feels lonely ( [[On Loneliness MOC]] ), and misses her mother. She has difficulty acknowledging her own emotions and needs by saying "never mind". ## Takeaways - It's a reminder of the effect of #therapist use of self. =="How does the patient experience herself through the case worker?"== - Trusting the process. The worker was initially unsure of what to ask, but she trusted the process. - [[Embodiment]] Self- Experiential. Connection. - [[202102222010 Describe, do not explain. Be curious]] ---- ## Signs of Disorganized Attachment [[Attachment Theory]] Signs of disorganized attachment in children may include: - Attention seeking - Avoidant - Inability to communicate needs - Lack of self-soothing skills - Focused on a task to an extreme - Push-pull dynamic with caregivers - Feeling fearful - Confusion and ambivalence Signs of disorganized attachment in adults may include: - Poor [emotional regulation](https://www.choosingtherapy.com/emotional-regulation/) - Seeking extreme closeness or extreme distance with no in-between - Highly anxious of others intentions - Inconsistency with their own romantic relationships - Fear of abandonment - Fear of getting emotionally intimate - Low self-esteem - Resistance to form secure attachments due to [trust issues](https://www.choosingtherapy.com/trust-issues/)3 ---- "Nevermind" - When they say nevermind, they really mind. "Emotional Ambivalence" - [[07 Feb 2022 Systemic Group Supervision#^9fa564]]