Vignette Analysis Essay

Sara is a 38-year old woman who was referred by primary care physician for cycling moods, emotional instability and body image distortion. She presents as markedly underweight, in baggy clothing. It is obvious that Sara does not want to be there. Sara is currently taking anti-psychotic medication and mood stabilizers. When you ask her why, she tells you that “my doctor thinks I’m nuts. OK, I admit that sometimes things come out of my mouth that I regret. But people just have to get over it and accept me for who I am. And OK, sometimes I have weird ideas and rituals, but I don’t hurt anyone.” She also admits to loving excitement and risk taking. “I love it when my mind races and I just hop in the car and go. Messes with my job sometimes, but who cares”.

During your psychosocial assessment, you learn that Sara was born in Japan. Her father was a Native American spirit-seeker. He came to Japan to study Eastern Religions where he met her mother, who she describes as, “a meek and quiet little Japanese woman”. When Sara was 8 years old, they left Japan and moved to the United States, living with her father’s family. She appears nervous talking about this time of her life, but does admit it was a dark and fearful time, except for her grandmother, who she loved deeply, but died when Sara was age 14.

At age 15, she began seeing spirits of her deceased grandmother. She wondered if this was a spiritual sign. It saddened her so much, that she began strict dieting to purify her body and soul. She believes that her grandmother’s death, “was all my fault. I deserve to suffer”. Her guilt and self-loathing have prevented her from committing to a relationship.