Vignette:

Jack brings his 23-years-old daughter, Gretchen, to your office because he cannot understand how someone who did
so well in school could “suddenly (his words) be unable to respond to even the simplest instructions to care for
herself.
Gretchen was at college completing her sophomore yare when “she fell apart.” When you question Gretchen, she looks
at you and after a bit of positive commentary on her bravery in coming to your office, she is able to respond to
you with single word sentence. Her father leaves her with you and you again remind her that it must be pretty
scary to be in your office. At this comment she begins to cry. You ask her if she is willing to give you any
information that might give you a sense of how best to support her. Through her tears she makes statements that
indicate she experienced a frightening assault with she was in school.

1. What part of her memory system must your access to help her connect with her trauma?
Limbic system: The hippocampus, amygdale

2. What symptoms tell you that she is dissociating?
a. Difficulties functioning at school
b. Not able to take care of herself: feel overwhelming
c. Lack of response: she replied back by single word sentence
d. Emotionally unstable: Crying

3. How will you help her move her implicit (knowing how) memories in to explicit (knowing what) memory?

Due to her assault incident, her parts of the brain are putting her terror experience to long-tem/explicit memory
and shut down and only encoded in implicit memory. Her terror experience remains in implicit memory such as body
memory triggered by reminders of the trauma. Her case is not clear but she may have sleeplessness, flashbacks.

4. What theorist do you feel will be appropriate to explore in developing a treatment plan for Gretchen?
Through the Cognitive therapy: educate client about common distortions, engage in reality testing and self-talk
designed to counteract negative reflective statements and ease resistance.

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