Assume the perspective of a Gestalt therapist, and show how you would proceed with Karen, a 27-year-old Asian American who is struggling with value conflicts pertaining to her religion, culture, and sex-role expectations. Here is what she has related to you during the first session.

Throughout her life Karen has identified herself as a “good Catholic” who has not questioned much of her upbringing. She has never really seen herself as an independent woman; in many ways she feels like a child, one who is strongly seeking approval and directions from those whom she considers authorities. Karen tells you that in her culture she was taught to respect and honor her parents, teachers, priests, and other elders. Whenever she tries to assert her own will, if it differs from the expectations of any authority figure, she experiences guilt and self-doubt. She went to Catholic schools, including college, and she has followed the morals and teachings of her church very closely. She has not been married, nor has she even had a long-term relationship with a man. Karen has not had sexual intercourse, not because she has not wanted to but because she is afraid that she could not live with herself and her guilt. She feels veryrestricted by the codes she lives by, and in many ways she sees them as rigid and unrealistic. Yet she is frightened of breaking away from what she was taught, even though she is seriously questioning much of its validity and is aware that her views on morality are growing more and more divergent from those that she at one time accepted. Basically, Karen asks: “What if I am wrong? Who am I to decide what is moral and immoral? I’ve always been taught that morals are clear-cut and do not allow for individual conveniences. I find it difficult to accept many of the teachings of my church, but I’m not able to really leave behind those notions that I don’t accept. What if there is a hell, and I’ll be damned forever if I follow my own path? What if I discover that I ‘go wild’ and thus lose any measure of self-respect? Will I be able to live with my guilt if I don’t follow the morality I’ve been taught?”

Karen is also struggling with the impact of cultural restraints on her view of what it means to be a woman. Generally, she sees herself as being dependent, unassertive, fearful of those in authority, emotionally reserved, socially inhibited, and unable to make decisions about her life. Although she thinks that she would like to be more assertive and would like to feel freer to be herself around people, she is highly self-conscious and “hears voices in her head” that tell her how she should and should not be. She wishes she could be different in some important respects, but she wonders if she is strong enough to swim against what she has learned from her culture, her parents, and her church.

Assume that Karen is coming for a series of counseling sessions in a community clinic. You know the above information about her, and what she wants from you is help in sorting out what she really believes about living a moral life versus what she has been told is the moral way to be. She says that she would like to learn how to trust herself and, in essence, have the courage to know her convictions and live by them. At the same time, she feels unable to act on her values, for fear that she will be wrong. How would you proceed with her?

Answer the following questions related to the case study:

1. What do you see as Karen’s basic conflict? 

2. In which stage of growth is Karen currently? What is the evidence?

a. Discovery – realizing something new or looking at something different

b. Accommodation – Recognize there is a choice; Try new behaviors in a safe space; Experiment

c. Assimilation – Capable of dealing with environment

Evidence:

3. What do you notice as you focus on the language?

4. Which two Contact Boundary Disturbances is Karen most likely experiencing?