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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