Monday, September 2, 2013


Case Study – A Child Who Suffered PTSD From The Death Of A Care-Giver

Apart from attending school, Winnie had to attend private tuition classes at her tutor’s home. She had been taking tuition classes for the past three years. Each time she was there, the tutor’s husband would play with her or cook for her. He treated her like his own daughter as they do not have a daughter of their own. She had grown very close to him. When she was around 12 years old, he was involved in a car accident and passed away. 

His death had traumatized her very much but she still had to go to the tutor’s house for her tuition. In the tutor’s home, a memorial altar was set up to honour the memories of him. Each time, she would be seeing the memorial altar with a picture of him adorned with flowers and candles. But it was his picture re-traumatizing her giving her a lot of fear. She tried her best to avoid looking at his picture. In her mind, she tried her best to believe that he is still alive and kicking. She even told her mother about her fears of going there, but her explanation was rejected and she was forced to go to the tutor’s home for her tuition. After repeated exposure, Winnie started to have flashbacks whenever she reached the doorstep of her tutor’s home, she would become very depressed and cried a lot. She was very angry at her mother as she felt that her mother didn’t care for her and for accusing her of lying.

Her condition may not have developed into PTSD, but from a very young age, her mother due to her own belief in ghostly manifestations would be talking to her and others, filling her mind with such things. She started to see his ghostly appearance first in the tutor’s home, but as time progresses, she began to see his ghost appearing in her own home as well. Her behaviour started to become very erratic, refusing to go anywhere within the house or even to the toilet if no one accompanies her at all. Her condition caused her mother to panic and her mother started to consult me about it. Before that they even brought Winnie to see some mediums  in the hope that their spiritual powers could exorcise his ghost and restore her back to her sanity. Instead, this was added on to her trauma. Apart from the run-around by her mother,  visitations to mediums . All this made Winnie develop a strong sense of helplessness and added on more impact in PTSD . 

Treatment Plan

Winnie’s treatment started off with some sessions that allowed her to share her story and let out her frustration pent up inside of her. As she was constantly being reminded that she was fabricating the story of seeing the ghost of her tutor’s late husband, these sessions were meant to communicate and build trust. So by listening and accepting her story as she told it demonstrates respect and acceptance of her. As she was over-protected by her parents, she lacked the space and privacy needed for her to grow and it affected her sense of belonging. She needs to feel that she is not going to be stigmatized in the same manner by them and she eventually develop her confidence in me. 

The sessions didn’t involve the use of psychotherapy because she was full of fear, overwhelmed by her negative emotions and pressures from her family. Also what she told me fell outside the purview of our sense of reality, e.g. ghosts or ghostly manifestations. It was better to work on her thought processes and how she could move on. In this case, I used Psychodynamic approach as well as Humanistic approach to help and support her with a lot of empathy. Added on to her treatment was the use of non-verbal therapies or expressive techniques as it allowed her to express her anger, fear, feelings and tears (for the trauma caused her to cry a lot). 

At this moment, she was still at the grief and loss stage. It made her very vulnerable, showing signs of depression and anxiety with the occasional outburst of anger. The non-verbal therapies allowed her to externalize her grief and loss. Slowly she started to feel relieved and then feeling good and regain her confidence towards herself. She eventually accepted the death of her tutor’s late husband. Apart from treating her condition, I had to rebuild her communication and bonding back with her parents because the support from her family is very important.

She eventually moved forward with her life happily, preoccupying herself with a lot of activities. She is much closer to her mother and since her mother’s realization of her trauma she was allowed to stop going to the tutor’s home to end her re-traumatizing herself. Even when she is off her treatment, I’m still giving her support. It is with my support and her re-bonding back to her mother that Winnie can move on ultimately.


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