| Helen F. is a dramatic-looking young woman, tall
and willowy, with jet black hair, pale skin, and blue eyes. She
is wearing all black, her top cut low to reveal her cleavage, and
the lace sleeves ending just short of her wrists to show off her
bracelet-shaped tattoos. She presents for cystic acne, primarily
on her cheeks and jaw line, which is worse premenstrually; and for
amenorrhea since going off the birth control pill. (She had to go
off the pill because it was causing side effects, including the
acne and mood swings.)
She had a pregnancy scare when she first had amenorrhea; after
skipping her period for several months, she was sure she was pregnant
because she felt something moving around in her abdomen.
She also wonders if homeopathy can help her with dyslexia. She
has trouble writing term papers because she tends to leave out letters
or words.
Although she is now a graduate student at a local alternative/holistic
university, she paid her undergraduate tuition by working as what
is euphemistically called an “exotic dancer.” She knew
that sleazy old men were watching her strip, but she didn’t
care. The money was good plus she loved dancing, wild and free,
alone in the booth, just her and the music. She describes her life
at the time as “dancing close to the flame,” in other
words, pushing life to the limits.
In her teenage and college years, she enjoyed these extremes; she
used a lot of drugs, hung out with a fast crowd, and had a lot of
one-night stands. Now at the ripe old age of 28, she looks back
on her wild youth and feels she has really settled down. She has
been with the same boyfriend for five years and they are talking
about getting married.
Their relationship is basically good, both emotionally and physically,
however she has an issue with feeling unattractive. The acne really
bothers her; she is extremely self-conscious about it and feels
that “everyone is looking at it.” She wishes she could
hide it but feels frustrated that it is on a conspicuous part of
her face. She reports “low self-esteem” and feeling
“less of a woman” because of the acne. She also considers
herself too fat and feels “disgusted” with her body.
She also believes that somehow “everyone knows” that
she doesn’t get her period and as a result feels “diseased,
something is wrong with my body.”
Her past medical history includes genital warts (frozen off), recurring
vaginitis, and probable candida (diagnosed by a naturopath, for
which she takes probiotics). Her naturopath, who is into Louise
Hay, told her that amenorrhea signifies “dislike of her femininity”;
she disagrees, but admits that her mother was a poor role model.
Her father was alcoholic and physically abusive, her mother weak
and dependent and non-protective of Helen. Her father was also verbally
and emotionally abusive, telling Helen when she was a teenager that
she was “only fit to be a streetwalker.)
Her main fear is of loss of control. She weeps easily when she
feels helpless. On a day-to-day level she worries about finances,
whether people are talking about her behind her back, and whether
her hair is falling out. She likes tidiness because messiness makes
her feel chaotic and agitated. She feels jealous when she sees a
“beautiful woman who seems to have it together.” She
has been treated in the past for depression, anxiety and insomnia.
She also reports disliking damp weather; drinking lots of tea as
her favorite beverage; weepiness and irritability with PMS; constant
burning vaginal discharge and postnasal drip.
In sum, she says ,”I would like to feel attractive and womanly
and in control of my body.”
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Case-Solving Contest Guidelines” for how to enter.
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