What mental disorders beyond those described in this chapter are prominent in middle adulthood? How will you approach the treatment of mental illness in older adults differently from adolescents and young adults?
Question: When attempting to conceptualize what a midlife crisis looks like, many think of a middle-aged man who suddenly wants to change careers or runs away with a younger woman. Now imagine your views of a midlife crisis for a woman. These examples raise the question: midlife crisis or normative crisis? Does gender play a role in the way you think about midlife crises?
Question: If everyone has a “different” personality (i.e., if no two are alike), then how can we say that someone has a “disordered” or “sick” personality? What truly makes a personality pathological?
Question: Read the following vignette.
Craig enters therapy because he believes he needs help with his relationship. As he describes his current girlfriend, he says, “I don’t know if I want to marry her. I need someone with the same IQ as mine, and frankly, I am just smarter than she is.” As he continues to discuss the negative aspects of his girlfriend, he further states, “I don’t know. I think I can do better. She’s not as smart as me, she’s not as motivated as me, she went to a decently good school – but nothing impressive. I honestly worry that our children won’t be as smart as they could be because of her.”
When Craig describes his childhood, he says that he spent most of his life in extremely competitive private schools. His father and mother divorced when he was age 6, and he rarely saw his father as a child. His mother was sweet to him, however, school, academia and being the “best” was the most important thing in his household.
When the therapist asks what Craig wishes for himself, he says, “I want to be wealthy. Really, really, wealthy. I honestly am terrified of being ordinary.”
As best you can, describe what you believe are important elements to the case, and what you would focus on if you were the treating clinician. Finally, if you had to pick a diagnosis for this client, what would it be and why?
