Answer Happy

Ee Von is a 15 year old student attending a private International School, preparing for her IGCSE. She has a 9 years old younger brother attending the primary wing of the same school. Both her parents work and for practical reasons, the siblings were essentially raised by their Aunt, who is in her 60's. Ee Von's father works as a senior manager in a pharmaceutical firm and her mother works as a human resource manager in a manufacturing firm The School Head and Class Teacher had requested to meet the Aunt to discuss their concems about Ee Von's worsening behaviour in class and in school generally. After some initial pleasantries and enquiries as to Ee Von's conduct at home. the Class Teacher shared her observations of Ee Von's behaviour in class.
Initial assessment following a brief meeting with a psychiatrist: A physically well-presented 15 year old. Had her phone in one hand and a water bottle in the other. Articulate - clear, fluent and effective use of English. Well orientated to time and place. No evidence of problems with thought process, content of thought was relevant and appropriate. Stated that she felt fine and she was well cared for. Mildly tensed, nervous and apprehensive, but beyond that she appeared emotionally withdrawn and is determined to control and suppress her emotions. Collaborates by responding to the questions but her reluctance is apparent. Deflects questions about her emotional state with, 'I have been ok', 'I feel fine', and that she has no problems'. 'I have my phone and I'm ok - watching what I want'. Clearly, she could benefit from working with the Clinical Psychologist to address her psycho-social and emotional difficulties.
The Clinical Psychologist, after 3 sessions, provided this summary of her work with Ee Von. After overcoming her initial discomfort, she started to warm up and talk about her problems. She did not enjoy being in school as she did not have friends. She would join in group activities but essentially she was alone. Academically she was able to get by with minimal effort. Her experience of school has been generally poor. In social relations, she prefers talking to older people as opposed to her peers. She did not have much in common with them and did not share their interest, especially their mindless, childish ways'. She also acknowledged that she did not know how to relate, avoids socialising with peers fearing rejection. She perceives herself as unworthy and why would anyone want to befriend her. Risk of developing social anxiety. As she was raised by her aunt and she continued to live with her, only seeing her parents very infrequently, usually once a week over the week-end, though there has been times when she had not seen them for several weeks. Though she makes light of her parents being absent in her life by rationalising that they have to work and she was fine with that. She appeared ambivalent about her relationship with her parents. She does not look forward to their visits as it upsets her (usually angry), though she tries hard to present 'a happy face' when they are with her. She was clearly aware that she was emotionally disturbed and recalled that she had been depressed when she was 13. During that episode she was self-harming and engaged in suicidal thoughts. She believes that she should not allow herself to break down' i.e. become emotional, hence she would do her level best to distract herself, usually through isolating herself and immersing herself in a video on her hand phone. She also believed that her parents desperately needed psychological help for their problems. She recalled that their arguments/fights could escalate to an extent where she once saw her mother lunging at her father with a kitchen knife; she was disarmed by her father. She viewed her father as an angry person who drinks and smokes. Mother is usually depressed and agitated. She tries to engage her brother occasionally by interfering with him and even engaging in play fights, as she fears her brother is also showing signs of social distress and isolates himself. The father had indicated that he would do everything he can to be helpful and supportive. Would like to spend more time over the week-end taking them out etc. He also expressed his wish to move the children back with him.