Before we start, there was this cafe I visited a few weeks ago in K11-MUSEA that allowed you to print any image you have on a cup of coffee (or chocolate, if that's what you prefer) as long as you airdrop it to the barista.
Naturally, I thought there was only one correct answer for me.
After all, I had just published Alstroemeria at that time.
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Basic Information
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Referral question
(This is a self-analysis, and some of the information presented may be incorrect.) “I was referred to as practice for the examiner.” Let’s just say this is a self-experiment on my personality, an analysis on who I am, and how I could further improve myself.
In this case, the report will be written in third person.
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Presenting complaint
Arella has been presenting anxious and depressive behaviors for approximately seven years. She harms herself emotionally by comparing herself to others, feelings of alienation (not to mention isolating herself from everyone), and having a sense of being a burden and having nothing to offer to the world. She engages herself in self-mutilation, her grades are falling a lot, and she has many thoughts concerning death, dying, and suicide.
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Case background
Arella is a 17-year-old female presenting with social anxiety disorder and clinical depression. She is approximately 153 centimeters tall and weighs 44 kilograms.
Arella was born in Hong Kong. She is the only daughter of two parents, and has an older brother.
According to the individual herself, she has been feeling a lot more down lately. Possible reasons could come from school stress. However, a huge factor appears to stem from a fear of failure and not letting anyone down. She is scared of failing expectations of people and wants them to see her as someone that can be depended on all the time. Whenever she knew she fell short of expectations, she would “punish” herself - ranging from inwardly criticizing herself for hours to comparing herself to her friends to creating papercuts on purpose and rubbing hand sanitizer over her scars. But following her punishments, she noted that nothing would change. Except she felt worse and couldn’t talk to anyone about anything. She would feel anxious and guilty - and focus on the many flaws she has.
Her issues with perfectionism started in sixth grade - when she was known in her class for being “perfect” as far as academics could go. Being desperate to never let her classmates down, she ended up developing clinical depression and anxiety due to caring too much about what others think. It then worsened in her sophomore year, when the thoughts of suicide increased tenfold. She couldn’t concentrate on anything, and she believed she had lost everyone because of her condition and identity - to the point where she attempted to kill herself and failed (realistically speaking, this did not do anything to alleviate her concerns).
According to her, perfection is an ideal in every single part of society. It was a goal she wanted to obtain, as she believed it was necessary to live a happy life. It was also an issue that troubled her a lot. It made its way into her thoughts frequently. Being a former grade representative, the president of a psychology club, and an online therapist (which surprised me) - she already has a lot to carry. She strives to be the best student she can be but can’t because she believes that depression has been weighing her down. All her friends were able to obtain perfect 4.00 GPAs but her. And it did nothing but rub more salt in the wound even further (especially when her family forces her to prioritize academics over relationships).
The client recalled an instance in March 2020 wherein she finally told someone of her problems, and in April 2021, she finally confided in her school counselor. But she admits that talking to them has alleviated her difficulties for some time, and she still feels very alone. She has a social phobia and is terrified of asking people to help her because it might destroy the image they have of her. She also suffers from FOMO constantly due to never being able to hang out with friends (and checking social media constantly). Following this, she decided to distance herself from her friends even more, believing everyone’s lives were better without her.
At present, Arella has been going on a self-discovery journey of her own (by writing this) and trying to analyze how she could clean up all the messes she left behind. She has been trying different methods to improve herself and taking up various hobbies to figure out what she’s interested in - since she lost interest in journaling a long time ago. She has never been diagnosed or hospitalized for those behaviors mentioned above.
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Classroom Observations
Arella was observed throughout her classes for a day, and feedback from her teachers in previous report cards. She was reticent, rarely talking with the other students around her. Not only was she very comfortable with the group, but she was sometimes distracted. She only answered when she was called on (which needs to change if she wants to obtain her goals truly). And when she speaks, she seems to always process her words in her mind before saying them out loud.
Her teachers have commented that she is “conscientious,” “excellent,” “hardworking,” “consistent,” “helpful,” “empathetic,” etc. There were many compliments, but they also wish she would speak up more in class and have confidence in her abilities.
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Tests Administered
Myers-Briggs Type Indicator
Rorschach Inkblot Test
Beck Depression Inventory
Revised NEO Personality Inventory
Test Anxiety Inventory
Love and Apology Languages
The Profile of Emotional Competence
Wong’s Emotional Intelligence Scale
Wechsler Adult Intelligence Scale
Palmistry (results not meant to be taken seriously)
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Feedback Session :
No formal feedback provided since this assessment was conducted for training purposes.
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Test Results :
Under the wishes of the patient, no results will be publicly provided.
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INTERPRETATION:
NEUROPSYCHOLOGICAL
Arella’s neuropsychological state was measured with multiple tests concerning anxiety and depression. The following paragraphs will discuss her performances and an interpretation of her scores.
Depression
Arella’s score of 35 on the Beck Depression Inventory indicates severe depression. This suggests that her psychological state is worse than 85 percent of people her age in the general population. From the emotional section of the test, she revealed that she has felt sad a lot recently. Her interest in people hasn’t diminished a lot, but she is more emotionally drained when interacting with them than usual. This also, unfortunately, extends to when she is alone. From the client, it is revealed that she experiences panic attacks in the middle of the night due to her fears and beliefs that no one can help her. Her thoughts extend to thinking that it would be better if she died rather than face the upcoming school year, as she believed that she wouldn’t be good enough to meet any standard.
The cognitive section happens to be her worst score - where it is clear that she despises herself as a person. She finds it hard to trust people and accept compliments about herself. And when she does trust them - she is scared of being abandoned and forgotten by them because of who she is. Due to her condition, she believes that this will happen - and would rather die before it occurs, because she prefers to live with the statement that someone at least cares about her towards the end of her life - even if it's only a little comforting lie. This is a belief that needs to be fixed as soon as possible.
Her best score comes in the form of changes to her lifestyle - where it hasn’t impacted her appetite too much. However, she has mentioned that there were drastic changes in her sleep cycle. Sometimes, she couldn’t sleep at all. Other times, she would sleep for more than 15 hours a day. Though, she is currently trying to get that under control by forcing herself to sleep at earlier times.
Anxiety
Arella’s score of mostly 4s and 5s on the Test Anxiety Inventory shows that she tends to stress herself out too much when taking a test. Similar to her results concerning depression - this will need to change as soon as possible, especially since it has affected her physical wellbeing. She had reported experiencing cramps and pains in her bowel movements every single time she felt anxious. However, this was one of the factors that distracted her from being able to fully concentrate on anything. As a result, this had cost her grades.
Despite the fact that this category is in need of more tests concerning other parts of anxiety, the therapist-in-training in question can’t find any recommended tests on a certain website that test for anxiety outside of test-taking.
PERSONALITY
Arella’s personality was analyzed with the usage of multiple tests. They were measured with tests such as the MBTI, Love & Apology Quizzes, the Revised NEO Personality Inventory, and the Rorschach Inkblot Test. Her performance is summarized and interpreted in the following paragraphs.
MBTI + Love & Apology Quizzes
Arella’s personality type is an INFJ. This implies that she is capable of giving advice to her friends with worries, that she isn’t too fond of conflict, and that she is a person who cares (despite her stoic exterior). She may have people who look up to her. However, despite being distrustful of many - she is also somewhat gullible towards those she trusts, as well as a little careless and disorganized when distracted… It’s preferable that she keeps those points in mind.
Her love language means that she wants to be the object of her (probably nonexistent) lover’s undivided attention. She wants to feel loved, cherished, and prioritized - as well as spend meaningful time with her loved ones.
Upon taking the test, it was discovered that Arella’s apology language was a combination of expressing regret and making restitution. It means that she wants someone to acknowledge the hurt they caused, to genuinely express that they regret their actions, and that she wants to feel validated in her emotions when wronged. She also wants to prove to people that she’s willing to help correct the issue - and find it important that the perpetrator “makes things right again” - whatever that may look like.
Revised NEO Personality Inventory
Arella’s score on the Openness scale indicates that she is somewhat open-minded. It means that she prefers to think and act in straight-forward, traditional ways. Others might describe her as down-to-earth and practical. While she enjoys certain aspects of the arts and sciences, the most highly conventional individuals often view these domains with skepticism or of little practical use. Conventional people tend to prefer familiarity over novelty, and this preference often underlies conservative beliefs and a resistance to change.
Her score on the Conscientiousness scale suggests that she is somewhat conscientious. She sets clear goals on a regular basis and pursues them with determination. People probably see her as reliable and hard-working, but probably not overzealous. She may occasionally prefer to live for the moment and do what feels good now, instead of delaying gratification for the sake of longer-term objectives. She is also good at detecting mistakes or inconsistencies in her environment. The most conscientious individuals tend to avoid trouble and achieve high levels of success through purposeful planning and persistence. On the negative side, they can be compulsive perfectionists and workaholics. Extremely conscientious individuals are also sometimes regarded as boring, due to their predictability and focus on work.
Her score on the Extraversion scale indicates that she is very introverted. She is more reserved and quiet than most others. She does enjoy solitude and solitary activities, and her socializing is restricted to a few close friends because that’s how socially awkward she is. She feels somewhat uncomfortable around people who you don't know well, and is more likely to allow others to take charge so that she can avoid the spotlight, which has the advantage of being seen as less threatening by others. The avoidance of social interaction by very introverted individuals does not necessarily mean they are aloof or depressed; these people simply need less stimulation than those who are more extraverted. This independence and willingness to be alone can sometimes be mistaken by others as unfriendliness or arrogance. However, many introverts (especially those who score highly on Agreeableness) are quite pleasant when approached even though they do not actively seek out interaction.
Her score on the Agreeableness scale indicates that she is somewhat more agreeable than most others. She has more concern with others' needs than with her own. This likely reflects an occasional interest in other people's lives and/or a belief that others should be more resourceful in dealing with their own problems. She may tend to be somewhat intolerant of others' shortcomings. The most disagreeable individuals place self-interest above getting along with others. They are generally unconcerned with others' well-being, and therefore are unlikely to extend themselves for other people. Sometimes their skepticism about others' motives causes them to be suspicious, unfriendly, and distrustful.
Her score on the Neuroticism scale indicates that she is less even tempered than most people (not a big surprise, really). This suggests that she experiences more emotional swings throughout the day and reacts more strongly to stressful events. But, take heart — others likely view her as a highly passionate individual. If she’s bothered by the experience of strong emotions, consider learning more about the many healthy ways to manage them.
Rorschach Inkblot Test
Card 1 :
A demonic - looking face = suggests paranoia, anxiety issues, and a fear of looking into inner issues
A bat = common response
A butterfly = common response / suggests an ability to grow, change, and overcome
Subject took some time to answer = suggests struggle to cope with new situations
Card 2 :
Two individuals = suggests trouble with communication / need for codependency
Blood = may have difficulty suppressing emotions or controlling anger
A high five = suggests need for companionship
A butterfly = detail response
Card 3 :
One male / one female = indication of bisexuality
Participating in some form of game = indication of a competitive view on social relationships
(Some form of cooperation) = indication of generally having positive relationships with people
A butterfly = detail response
Subject took some time to answer = suggests cautiousness or lack of self-awareness in social situations / uncomfortable with own social skills
Card 4 :
An attacking figure = indication of anxiety or suppressed anger
Dragon = positive response
A person = common response
Card 5 :
A butterfly = common response
Card 6 :
A bird = indication of inclination towards tactile sensations
A seashell adorned with a flower = positive response
A mountain = suggests anxiety
An animal hide = indication of a resistance to being close to other people / feeling of personal emptiness and disconnectedness
An island = indication of a fear of being isolated or left alone
Card 7 :
Thunderclouds = indication for high levels of anxiety
Two women = common response
Look like they are gossiping = indication of not having a great relationship with my mother
Two children = same as above
Card 8 :
Four-legged animals = common response
Fleeing from a fire below = indication for a fear of the unknown / guilt for actions in the past that can’t be changed
A butterfly = common response
Had caused discomfort = suggestion of emotional instability
Card 9 :
Roses (at the bottom) = common response
A tricolored flower = common response
Fire = common response
A rocket launch = common response
Card 10 :
Flowers = attentiveness to detail + the ability to see abstract images clearly
Face of disapproval = suggests paranoia and anxiety
Spiders = indication of fear / feeling of entanglement / feeling of being trapped in an uncomfortable situation due to telling a lot of lies / may also symbolize an overbearing mother
Lobster = indication for a fear of harming oneself or of being harmed by someone else
Overall :
Seen multiple images = indication of creativity / a vivid imagination
Had tried to flip / rotate some images = indication of being self-sufficient / resourceful
Color responses = indication of emotions
Division responses = indication of common sense
Whole responses = indication of an abstract thought process + ambitions
Detail Responses = indication of alertness
A lot of detail responses = indication of anxiety, depression, or paranoia
INTELLIGENCE
Emotional Quotient
Arella’s score on both the Profile of Emotional Competence and Wong’s Emotional Intelligence Scale shows that she thankfully has a good understanding of what she should be doing as an online therapist. Generally speaking, her emotional intelligence indicates that she does not have a lot of issues understanding and dealing with her own emotions, as well as those of others.
She is capable enough to overcome difficulties in her life and control her mood in the most trying of times. It’s actually easy for her to motivate herself to overcome obstacles and reach her goals (we just need to find a good reason to be motivated).
In addition, she may sometimes find social interactions to be quite easy and fulfilling, for several reasons (she just needs to step out of her comfort zone once in a while). She is comfortable allowing themselves to get close with others, and feels comfortable being vulnerable enough to establish intimacy. She also reports having an easy time offering support to others; this is likely due to an empathetic nature and a clear mind when it comes to offering good advice.
While an EQ score of 126 isn’t shabby, there is always room for improvement.
Intellectual Quotient
Arella’s score on the Wechsler Adult Intelligence Scale is above average. And that’s all I can say for now. More details about her results will be talked about below.
Now, the full scale IQ test refers to the combined (and thoroughly analyzed) results of the Memory IQ, Verbal IQ, and Spatial IQ tests. The fact that Arella has a Full Scale IQ of 146 shows that she scores above the 99th percentile - and that she could possibly succeed as a professor or researcher (except we both know very well who she wants to be).
OTHER
Palmistry
(Keep in mind that the examiner only did this to satiate her curiosity)
Based on the results, we can “infer” that she has a rather sharp mind, and has the potential to possibly manipulate other people to do what she wants. She has good self-motivation abilities and could possibly influence others for the better. And her character can be quite multi-sided (... as expected of everyone) - sometimes she could be quick-tempered. Other times, she could be completely phlegmatic.
She prefers to avoid direct confrontation and prefers harmonious relations. Quite often, she is a mediator and a diplomatist. (... Really?)
She is rather amorous and a little naïve in relationships with people that she trusts. She is often a rather romantic and sentimental idealist in life - and would be better off avoiding people who are rather critical.
Apparently, she does have a rather critical view of the future. Quite often, she lacks self confidence - and is obsessed with obtaining perfection at any time possible.
From her results, she is loved by her friends (honestly I’m hoping she could realize that, even if it's hard). Family values are important to her, and she’s also aware of the necessity to professional growth and material independence.
She is often careful in her communication with others, to the point of inhibiting herself a lot. She does her best to cater to the needs of others and listen to their miseries. However, she should really stay away from those who expect too much from her.
In personal life, she is romantic (as mentioned before), and chooses her partner based on who she hopes to have a serious relationship with. She believes in strong, pure, idealistic love (love without any concealed motives).
However - she is highly unlikely to find and keep a partner based on these standards(...).
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SUMMARY
Based on her results on the administered tests, it is clear that Arella suffers from clinical depression - which must be treated as soon as possible. While she has made steps to recovery, her loved ones are recommended to watch over her more carefully. Her lifestyle has completely changed because of this. Not to mention that it changed her mindset for the worse. As mentioned earlier, she can only depend on herself throughout the recovery process. Even if she has people who encourage her to take the steps to recover, she has to be the one to take them herself. Technically, she had gone through several dark periods recently. But she'll get over them, like with other dark periods in her life. With that in mind, allow me to put some recommendations in the paragraphs below.
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RECOMMENDATIONS
In order to serve the needs of this individual, there are several areas that need to be targeted for intervention.
1. Primary Focus should be focused on managing her symptoms for anxiety and depression. She needs to learn how to communicate her needs in an assertive manner and develop her capability to initiate conversation. Strong therapeutic bonds are essential for the client when interacting with others. In other words - she needs to find people she could talk to freely without worrying about anything too much (or be extremely comfortable enough to curse to their faces). She may have the capability to benefit from cognitive behavioral therapy techniques as well as other activities such as mindfulness, stress management, and variations of positive reinforcement. Also, remind her to not reevaluate her life in the middle of the night. Most of the time, that will only lead to mental breakdowns.
2. It is imperative that the client establishes structure and boundaries on when she should stop. She should learn to never take criticism from someone who she wouldn’t depend on advice from. It is recommended that her loved ones play a role in this as well. The consistency on the part of everyone will enable her to internalize the controls and allow her to further monitor her own behavior. She needs to have this in order to develop a better sense of self and independence.
3. It is also important that she finds some hobbies to sustain herself. She should remember that it is alright to take mental health breaks when needed. So, instead of binging reddit posts for entertainment - she could pick up the hobbies she used to do. Journaling is an option - but it could only do so much for stress relief. Besides, not every day of her life will be interesting unless she is an anime protagonist (in which she definitely is not). Activities such as gaming (simulators, pokémon, etc.), calling her friends, reading, etc. can help out a lot. The same goes for discovering new ones, such as stargazing, observing her surroundings, online therapy work, and more. And of course, continuing to work on airnima to write more short stories, random thoughts, or literally anything she wants to post. It would definitely cheer her up.
4. Continue with her therapy work. Enough said about that.
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Arella Ng (Examiner): Therapist in Training
Date: August 16, 2022
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On a random note, I told my dad a few months ago that he should learn to embrace his mistakes.
So he embraced me tightly and pretended to cry.
...To this day, I have no idea how I feel about this.
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