Mentor Assessment #1: Case Study #2

Date: March 23, 2016

Topic: Psychiatry
Preview:
The following Mentor Assessment details the second case study received from Dr.
Arauzo on my fourth mentor visit. During this case study, Dr. Arauzo taught me about keeping a
clear mind and not getting too sucked into a patients story.

Patient Background:
The case study that I was given was the story of a woman in her early 30s, who was
referred to Dr. Arauzo because he was currently treating both of her parents. Her mom had been
treated for depression stemming from a sexual assault incident, and her father was treated for
depression as well. The woman, known as Patient B, suffered from ADD and anxiety. The
womans mother and father both requested her to be treated because they were worried about her
and her mental health and she obliged. However, once patient A began talking about he struggles,
Dr. Arauzo discovered that a lot of her anxiety came from her mother and father who,
respectively, were an alcoholic and a meth binger. Even after confronted about their deeper
issues, both of the parents denied the accusation but confirmed with Dr. Arauzo that the others
problem was true. Dr. Arauzo discovered through patient B a deeper level to the other patients he
was treating, which in turn helped him figure out a better treatment plan for all three of them.

What To Look For:

The parents of patient B had previously portrayed themselves as the victims in their own
lives. They tried everything they could to help their daughter, and to help their own mental
illnesses. However, it was discovered that they really were their own worst enemies and were
only harming themselves by not talking about their deeper issues. Dr. Arauzo explained this as
part of a psychological theory called Karpmans Triangle. Karpmans triangle consists of three
main parts:
In each triangle, there are three main people. The victim who often complains about how
nothing goes their way and they are not to blame, the villain who is the root cause of the
problems the victim complains of, and the rescuer who is the rock for the victim and will help
save the victim from their struggles and issues with the villain.
The triangle comes from human instinct to relay information in a story form. The triangle is not
considered a real part of the persons mind, but is an explanation for the way a story is told by
each person.
The roles of the triangle are often changing. As one gains more knowledge about a story, and
gains different perspectives, the victim often turns into the villain and vice versa.

Lesson:
 In this particular case study, the parents initially gave the impression of the rescuer by
trying to help their daughter to get help via Dr. Arauzo. However, they ended up being the
villains and the victims in their own study. Each of them was victim to their own decisions yet
also played the villain by consciously deciding to continue with their addictions. Dr. Arauzo
avoids the shock of these scenarios by knowing to keep an open mind when dealing with any
patient. He told me that most stories portray the psychiatrist as the rescuer, and one must keep a
clear mind when listening to a persons struggles so that they can remain a neutral and stable
source without getting sucked into the triangle.

Terminology:
Karpmans Triangle- a model of dysfunctional social interaction with each point on the triangle
represents a common and ineffective response to conflict.
ADD- Also known as Attention Deficit Disorder, is a developmental disorder that is marked
especially by persistent symptoms of inattention (such as distractibility, forgetfulness, or
disorganization) or by symptoms of hyperactivity and impulsivity
Depression- a psychotic disorder marked especially by sadness, inactivity, difficulty in thinking
and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings
of dejection and hopelessness, and sometimes suicidal tendencies