Anxious Anna

Anna is a thirty-four year-old white female.  Currently she is married with four children and works full-time as a homemaker.  Her non-verbals (picking at nails and clothes, very talkative) indicated a moderate level of anxiety regarding the appointment.  The client perceives her primary difficulty at this time to be marital issues including betrayal and a desire to forgive and submit.

Anna was raised by a maternal grandmother.  She left home at the age of sixteen, to escape her father’s sexual abuse.  Anna married her current husband in 1992, although they had already had a child together before that time.  Neither Joe nor Anna were Christians when they met, and she briefly described a history of personal alcohol abuse, as well her husband’s drug and alcohol abuse and an escalating pattern of pornography addiction.  Both Anna and her husband were recently saved at a Pentecostal Church; a decision that Anna believes dramatically changed their lives.

‘Recently’ (2 years ago) Anna was made aware of her husband’s affair with a seventeen year old.  She states this is the first she knew of his adulterous behavior, although she describes his long standing patterns of staying out all night, finding hickeys and following him to bars where he would leave with other women.  She states that she is very angry with him about this behavior, although she believes that this was an isolated incident.  When discovering that she was aware of the affair Joe also became physically violent with Anna, but she states that this was an isolated incident as well.

Anna’s goal for seeking counseling was to learn how to control her anger toward her husband and gain coping skills for the situation.  She desires to learn how to forgive him for his past actions and learn how to submit to him.  On her intake papers Anna describes herself as a ‘kind, loving, affectionate, meek shy and blessed’ person’; her husband believes she has low self-esteem and little confidence.

Currently Anna is on Oxyeontin for pain management; Flexoral for muscle spasms and Relafen for arthritis.  She currently suffers from Fibromyalgia and Osteo-arthritis.  The client indicated prior counseling at SMH in 89-90 for Anorexia; she also has a brief history of lesbian behavior.

On the phone, as well as during our initial meeting Anna presented as a very chaotic and angry person.  She arrived at the session approximately twenty minutes late after getting lost on the way – apologizing profusely when I went to greet her.  Once inside the office she asked if she could start the session with prayer, then got on her knees and touching her forehead to the ground and prayed for approximately five minutes, primarily asking the Lord to help her become a more submissive wife to her husband.  It was extremely difficult to end the session, with our time lasting almost twenty minutes over the hour; she was not prepared to pay at that time.  She subsequently missed her follow-up appointment, and when called stated that things were much better with her husband and she would no longer need counseling at this time.

1. What are the spiritual implications for this client?
2. Is the use of religion functional or dysfunctional?
3. What spiritual interventions might be appropriate?

Yarhouse, M.A., Butman, R. E., McRay, B. W. (2005) Modern Psychopathologies: A comprehensive Christian appraisal.  Downers Grove, IL, InterVarsity.  ISBN 0-83082770-6

 Collins, G. R. (2007).  Christian counseling: A comprehensive guide (3rd Ed.). Thomas Nelson Publishers. ISBN 1418503290

 Corey, G., Corey, M. S., Callanan, P., & Corey, C. (2014). Issues and ethics in the helping professions. Stamforf, CT, Brooks/Cole.