The Transformation of Kathy (I)

    The Case of Kathy Menu



    The Transformation of Kathy (I)
    by Polly Bloomberg-Fretter (Broitman:Faculty), 2/2/98

    The Transformation of Kathy by Polly Bloomberg-Fretter, Ed.D. (Formerly Polly B. Fretter)

    I am very pleased to welcome Dr. Polly Bloomberg-Fretter to BOL. She is a colleague and close friend in private practice in East Bay Area of Northern CA. My first introduction to Polly was when we were both doing our dissertations on Control Mastery Theory. Should research on this theory be of interest to you, I strongly recommend her papers which are listed below and in the CM bibliography on the CM Forum site. Her dedication to research was the impetus for conducting the following treatment. This psychotherapy treatment was conducted as part of an investigation of long-term, psychodynamic therapies for major depressive disorders carried out by the Berkeley Psychotherapy Research Project at the University of California at Berkeley. Professor Enrico Jones was the principal investigator of this project. Dr. Polly Bloomberg-Fretter treated the patient twice weekly for two and one-half years. Each session was videotaped. The patient was evaluated extensively before, during, and after treatment. All measures of patient change indicated the treatment was very successful. The patient maintained these gains at 6-month and 1-year follow-ups The patient gave her permission for this disguised presentation to be used as a teaching tool.

    Relevant publications: Fretter, P. B. (1995). A Control-Mastery Case Formulation of a Successful Treatment for Major Depression In Session: Psychotherapy in Practice, 1, 2, 3-17. (Requests for reprints should be sent to Polly Bloomberg-Fretter, 1035 San Pablo Avenue, Suite 5, Berkeley, CA 94706-2276.)

    Jones, E. E., Ghannam, J., Nigg, J. T., & Dyer, J. F. P. (1993). A paradigm for single- case research: The time series study of a long-term psychotherapy for depression. Journal of Consulting and Clinical Psychology, 61, 381-394.

    The Transformation of Kathy -The First Hour

    When I first met Kathy I had no idea the creativity she would bring, the richness of metaphor and imagination she would share, nor how hard she would work determined to overcome the crippling beliefs that were ruining her life. I also had no idea how much she would teach me about the powerfully unique ways of healing early wounds. Although she presented herself in that first interview in a colorless and irritable manner I liked her right away. She was a 35-year-old, attractive, petite woman with blonde short hair and light eyes. Her dress, voice, and interaction with me all spoke of a rather efficient, functional , unanimated and annoyed quality. She came to life, for just a few moments, in stating that what brought her to treatment was a wish to move further emotionally from her current level. Although eager to get help with her emotional growth, she spoke with great annoyance about qualifying for the depression study which required that she score in the severely depressed range on a number of objective measures.. All questions by me about her depression were met with skepticism, challenge, and hair-splitting debates that bordered on anger. She did not "feel" depressed but she could describe "events that caused a reaction of depression." I finally said "Fine. Please do."

    She efficiently listed the events that had caused her depression: 3 months previously, her eldest son, 15-years-old, moved to another state to live with his father from whom Kathy had been divorced for many years. She felt sorry her son had such difficult choices to make. He had been longing for his father recently. He was 6-years-old when they divorced so he had grown attached to his father. Currently, she had a new boyfriend - a good man with whom she and the children had been living for a few years. The couple planned to marry in a few months. There was no more to say about that and she asked irritatedly " where should we go next?"

    I asked her if she could talk some about her childhood. Again she recited a succinct list: She was born with an older half-brother, Dan, who was nine years older than she. He was from her mother's previous, brief marriage. Father had a government job and they moved a lot. When Kathy was 7-years-old her brother, Dan, who was 16 then, died in a diving accident. I silently noted that her son was now nearing the age of her brother at the time of his death. Mother and her extended family blamed father. Mother and father fought continually and the entire family never recovered. All family celebrations ceased forever. Everyone was severely depressed. Her mother just left emotionally. She never talked about the accident or any feelings about it. Kathy said, "Mother died inside. She resented me and my father for surviving. There was always a tinge of punishment, maybe just in withholding." Mother became efficient, busy, and completely unavailable. Kathy attempted to cheer her up, but mother rejected all her efforts since she was so devastated by her loss and unable to recover. Father became removed and dove into work. Later he drank and had affairs. Kathy let him know what she thought of him. Kathy suddenly interrupted her recitation, explaining irritatedly to me that she had already told this story recently to the intake interviewer so she could not have much feeling at the moment. I told her that was fine and she continued.

    Kathy described her life after the accident as barren, grim, and lonely, until somehow at age 13, when the family moved to Utah, everything clicked for Kathy. For two years, she was popular, smart, and had everything. Then it all blew up. Her father suddenly decided to send her to boarding school. She had had a boyfriend and father wanted to break it off. So he did and it was awful. No friends, no people. She functioned well in academics and threw herself into school. Father said her choice for the next year was: finish school early or go back to boarding school. She chose to graduate early and attend a local college where she met her ex-husband who was a teacher there. Since she wanted a family more than she wanted anything, she married him her second year in college and had her 3 children. She felt that if she couldn't have a family when she was a child, at least she could have her own children and have the closeness she'd always wanted. The marriage was not good. Her husband filed for divorce and Kathy left with the children, then aged 2, 4, and 6. Her husband didn't fare well. He got depressed, took drugs and alcohol and would go to Kathy's house and argue and yell. Kathy found a job in the Bay Area and left with her children. She currently works out of her home as a secretary doing contract work.

    She continued to say that her parents are in the middle of the "world's worst divorce," have been for years, and that they get her in the middle of it. As a child she was close to father. They were always together before the accident. Then he just dove into work and was gone. Same with mother. Now Kathy talks to mother out of obligation. She talks to father by phone. They were never close after the accident. She doesn't need father now except it's so lonely raising the kids alone. Interestingly, she added, "It's the good things they do that are hard to experience alone. It feels so lonely." Father withdrew so much after the accident. He had a terrible childhood. His father disappeared when father was 2. His mother died of alcoholism when he was 16, so when he withdrew from Kathy, he just did what came naturally - relied on himself and dove into work.

    She had adored and idolized her brother Dan. Of course, he picked on his younger sister and she tattled on him. They moved a lot. They were in Missouri and no one liked it there. Her brother wanted to return to live with the maternal grandmother and family. He talked the parents into it. While there, he dove off some rocks and broke his neck. Mother flew there. Father and Kathy drove. By the time Kathy arrived a few days later, Dan was dead. Mother and grandmother blamed father though it barely made sense. Probably because if he'd been a better father, Dan wouldn't have wanted to leave in the first place.

    As this first hour ended and I reflected on what Kathy had presented, I made a general comment about how this tragic situation and family dynamics had affected her whole life profoundly and really robbed her of having a family. She softened somewhat but protectively added that her parents really had provided all the externals she needed, though emotionally her life had been a stark desert.


      • a cognitive-behavioral view by Jacqueline B. Persons, 2/13/98
        • What _are_ the goals of therapy? by Jim Pretzer, 2/14/98
      • More research on Kathy by Nnamdi Pole, 3/1/98

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