This case study can be found in the preface of the book, On Being Normal and Other Disorders by Paul Vergaehe.
This is a good example of how delinquent behavior can sometimes be a symptom of very understandable everyday circumstances. In this case, what we see as a behavioral problem in a teenager, has much to do with his family situation, and his personality development.
The client is a 15 year old male who is in consultation for having been arrested for car theft.
Symptoms: The client steals only “Mercedes” cars. In the driver’s seat, he drives aimlessly around, then leaves the car in a particular part of the country. He leaves the cars unharmed. He then hitchhikes back home.
Diagnosis: The client is the only child, whose parents are undergoing marital crisis. The mother is from a privileged background, and the father is from working class background who worked himself up the social ladder. The parents fell in love with the other’s differences. Now they reproach each other for it. The father works himself to death and retreats from confrontation. The mother has found another lover. And somewhat coincidentally, the town where the client leaves the car, is where the mother was born and is where her name still holds prestige.
From this case presentation, one can see that the symptom is not the isolated symptom of the client. This case displays the symptom of the family. The child has taken on the job of glueing the family together. When this looks like a hopeless scenario, he acts unconsciously in a symbolic way to communicate this his distress.From a psychoanalytic perspective one would say that his behavior provides an answer to the desire of the Other, that is, his parents, with the proviso, however, that the boy himself is not, or is only barely aware of it. “The unconscious is the discourse of the Other” (Lacan). Systemic theory would say that the boy shoulders the symptoms of his family. A cognitive behavioral approach would see his behavior as learned, which leads us to the following question: From whom does one learn what, and why? (p.5)
Gestalt Therapy Perspective on this Case-study
This are my comments using Gestalt therapy theory:
Gestalt therapy theory would say that the client exists and acts in a field. This field encompasses the family — the family’s present, past and future combined– it includes also the society in which the client lives in, the client’s character development / education and influences.
In this case, the client has lost his self in this field, and is only able to cope in a reactive unconscious manner. This is an example of his creative adjustment to a situation that had gone out of hand for him. The client does things systematically with a certain degree of passion, but lost contact with his conscience and self-preservation instinct. i.e. he was doing something that potentially subjected himself (and others) to harm.
The therapy process is one that would have to deal with the client’s sense of who he is and defining his present needs. Gestalt therapy works in the here & now. The client is guided to experience his present existence, in order to experience his present needs. This is what was evidently “missing”, by studying his symptoms.
Psychoanalysis of the situation points to this: that the boy reacts unconsciously as a distress reaction to his parents’ potential separation. The client is, however, already 15 years old. In reality, the separation of the parents does not pose a life-threat to the patient, although this was the client’s experience when he was a dependent baby.
This situation describes the client’s dilemma: there is unfinished businesses (open gestalts) experienced by the client as a young child, that is not settled. It could be something like: “I am dependent on my parents/ it is dangerous to me if they separate…” What the story really is, has to be uncovered by the client during therapy.
The second part of the therapy has to involve experiencing the needs of the present, as mentioned earlier.
Whatever approach one takes, a common factor emerges: the diagnosis cannot be limited just to the boy. The impact of the Other is fundamental. This is the first major difference between medical diagnostics and psychodiagnostics: clinical psychodiagnostics cannot be restricted to the individual. Psychic identity, with its potential psychopathology and aberrant behaviors, must be conceived in such a way that it grants the other a place equally important as the individual’s. (p.5)
Verhaeghe, P. (2008). On being normal and other disorders: A manual for clinical psychodiagnostics. Karnac Books. P. 4.