Victoria N.

Abstract

Both the initial diagnosis here, which was based on classical symptoms and age of onset, and the highly favorable response to treatment, turned out to be misleading. More than two years into treatment, this patient’s underlying issue suddenly emerged, casting a new light on all that had gone before. When this occurred, the family conflicts first intensified, before beginning to move toward at least a temporary resolution. Team members themselves were divided over the way to approach this issue. Referral and encouragement by the psychiatrist and some team members to attend a specialized outside treatment agency then became essential to the patient’s own resolution of a long-standing inner conflict over it. Ultimately, the patient’s determination and resilience permitted a focus on addressing this conflict directly and, conversely, the resolution of the conflict organized all aspects of this patient’s life.