Integrated Services Project
SUE
Personal History
Sue is the sixth child of eleven siblings, she has 8 sisters and 2 brothers, and the family is of Lebanese descent
Sue experienced significant physical and sexual abuse from both her father and her brother during her childhood, beginning when she was 12 years old. Sue’s sisters were also sexually abused by their father and brother during their childhood. Sue continued to be sexually abused by her brother when she moved out of the family home at the age of 23 years.
Sue reports that her father was eventually incarcerated due to the sexual abuse he perpetrated towards one of her sisters. After completing a 4 year sentence Sue’s father was accepted back into the family home by her mother.
Sue reports being angry that her father was never incarcerated for the abuse he perpetrated towards her. She feels he ‘got away with it’, and often talks about pursuing her own legal action against him.Sue, herself has a history of violent behaviour toward herparents and she is subject to a court order prohibiting her contacting them or returning to the family home.
Sue is in contact with several of her sisters. However, some of her sisters have a history of exploiting her financially and these relationships have been quite destructive. As a result Sue reports experiencing significant internal conflict between wanting to have contact with her sisters and being part of a ‘family’ while knowing that they are taking advantage of her.
Living Environments
Sue left the family home at the age of 23 years and moved into public housing. However her living
situation broke-down when she set fire to her residence. A second housing placement was acquired for Sue, to which she also set fire. There is inconsistent information relating to how long Sue stayed in each of these placements, or what led to the incidents of fire setting.
Sue spent some time in a refuge before moving to a third community housing placement. Her lease in this location had experienced and she was not being offered a new lease due to incidents of fire lighting and property destruction. It is from this tenuous living situation that Sue was nominated to the ISP.
Intellectual Functioning and Mental Health
Sue been diagnosed with a Borderline Personality Disorder and has been assessed as functioning in the borderline range with an IQ of 73.She has shown difficulty with introspection, impulse control and regulating her emotions and distress.
Sue has extremely low self-esteem and very little in her life that provides her with a feeling of self-worth. Sue has unrealistic expectations of the interpersonal relationships she has with others and very high expectations of the support they will provide to her. She develops strong attachments to the people and services that support her.
She has a tendency to exhaust services and individuals by ‘smothering’ them, wanting to spend all her time with individuals and phoning them constantly. Sue has a fear of abandonment, and will view a cancelled appointment or person not answering their phone as rejection.
She has $3000 in unpaid phone bills due to excessive use of the telephone.
Self-Harm and Hospital Presentations
Sue has a long history of self-harming behaviour, typically involving burning herself with a cigarette and superficial cutting of her wristwith a razor or metal from soft-drink cans for example. Sue’s main motivation to engage in self harm seems to be related to an urge to reduce high physiological arousal from overwhelming turbulent emotions, as well as a way of expressing emotions / feelings and thoughts that she is unable to express verbally.
Suecalls emergency services and or presents to the Emergency Department of hospitals almost daily, reporting suicidal ideation and urges to self-harm. She also at times presents after self-harming. Sue has lit numerous fires, and threatens to do so frequently in order to be admitted to psychiatric units. These fires tend to be lit at her place of residence, but recently she threatened to light a fire in a public place.
Reports suggest that Sue’s frequent presenting behaviours may in part be driven by loneliness, lack of independent living skills and a desire for a secure and more nurturing environment.
While in the community,Sue would also often ‘take in’ people and allow them to live at her residence (usually men), as she did not like to be alone.
Previous Therapeutic Support
Prior to entry to the ISP, Sue received support from a Clinical Psychologist through the local Community Mental Health Team.This included weekly sessions and participation in individual and group Dialectical Behaviour Therapy (DBT) sessions.
After 18 months the psychologist concluded that the therapy sessions with Sue were ineffective due to her low level of functioning, poor attention span, abstract reasoning and emotional immaturity. She recommended a more structured approach to helping Sue to develop independent living skills.
Educational and Vocational History
Sue attended her local primary and high school and can read and write at a basic level. She has not been involved in any further training or education since leaving school. Sue has never held a job or been involved in volunteer work.