Consider systemic and socio-cultural issues in a counselling case study Family context and wider socio-cultural influences are widely recognised in counselling and psychology as major contributory factors that help to shape the way people think, perceive and feel about themselves, their relationships and the way things are in their society (Barker, 2010; Vossler, 2010). Importantly, Barker (2010) points out the dichotomous socio-cultural divisions that are prevalent within most modern societies. These divisions can be seen to reflect the dominant ideals that are considered the ‘norm’ or ‘normal’ within a society and what is considered anomalous with the norm; for example, man/woman, cisgender/transgender, straight/gay etc. Furthermore, Barker (2010) suggests that those existing within the norm are generally considered as more privileged which leads to the formation of hierarchies and major inequalities of power. Therefore, those existing outside the cultural norm are often stigmatised and marginalised by society and resultantly, this can often lead to emotional difficulties such as the onset of fear and sadness (Barker, 2010). However, as Barker (2010) points out it is also important to note that many people, such as those of ‘mixed race’ etc, exist between the divisions and thus tend to experience discrimination from ‘both sides’ of the dichotomy. This essay will explore the potential affects of these socio-cultural issues, upon a fictional case study of a bi-sexual transsexual female. In addition, it will do so from a systemic standpoint and outline some possible counselling approaches and methods that may help to moderate any ingrained patterns of negative/problematic behaviour.
Firstly, the details of the fictional case study to be examined for this essay are as follows: Tina is a 43 year old bisexual transsexual female. She was brought up as an only child in rural Lincolnshire. Tina’s father died of cancer when she was very young, leaving her mother to bring her up as a ‘single’ parent. Tina moved to London when she was 18 to ‘escape’ what she calls ‘the narrow-mindedness of village gossips’. At the age of 30 Tina finally underwent surgery to become a ‘real man’. Although this lifted her mood initially she now feels insecure about her identity status. Tina is currently unemployed and living alone on state benefits in an inner city housing estate. She has been referred to counselling by her doctor to whom she presented with symptoms of depression and anxiety. In her first session of counselling Tina explained how she is increasingly frightened to leave her flat for fear of verbal abuse from the people on her estate and also complete strangers. She stated that when she is out, particularly when she sees groups of teenagers, often the anxiety becomes so extreme that she freezes and suffers from panic attacks. Tina also said that her fear of leaving the flat has led her to stay indoors for days at a time making her feeling lonely and distressed.
Tina is also sad because she feels that her bisexuality has been off putting to many potential long-term partners and as such has only ever experienced brief sexual encounters with members of both sexes. Tina really feels as though she has never really ‘fitted in’ and that she has always experienced difficulty in establishing any secure relationships with others. Both men and women are often unsure of her femininity, as despite surgery and hormone therapy, to her distaste she still retains many masculine features. She further described how even as a child her femininity led to her being bullied at school; she also liked to play with dolls and dress up in girls clothes, although her mother was always horrified to find her doing so. Her mother has little to do with her now as she says she feels deeply ashamed of Tina. Her mother also refuses to accept Tina’s new female identity and still continues to call her by her birth name, John.
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