In bullet points, acting as a therapist/counselor, HOW does the following case conceptualization using the psychoanalytic theory(Freud) approach, contribute to understanding concerns and also to working with a client in therapy?

Case Study

Identification:

Name: John Duran

Age: 30 Sex: Male

Race/Ethnicity: Caucasian

Relational Status: Single

Informants: Client; client's brother

Referral source: Family referral

Presenting Problem:

John suffers from anxiety.He states that he experiences panic attacks that are triggered in social and high stress situations. They reportedly have existed at a mild/manageable level since adolescence. Symptoms have escalated since being laid off within the last year. He seemed very apprehensive during our intake session and acknowledged that the time together was uneasy, but he made it through.

Description of Problem in terms of Thoughts, Feelings, Behaviors, Bodily Symptoms

John is self-critical of his panic attacks and used the word "normal" multiple times in comparing himself to others who did not experience them. He feels that they are a large part of why he was recently let go at work.He attempted to use self-deprecating humor to acknowledge how silly they must seem to others when he experiences them.

He would like to find a less stressful work opportunity next, however he is now experiencing symptoms during the interviewing process. As a result, he is now concerned of being on downward trajectory due to being on unemployment and having few social interactions outside of his brother, Justin.

Interpersonal Relationships:

John and Justin were both close with their mother who passed approximately three years ago. John was the baby of the family and it hit him harder.The loss appears to be still with him when he speaks of her. Neither brother is especially close with their father and see/talk to him infrequently.

John leans heavily on his dog, Remy, for emotional support. His best friend from childhood, Eric, is still his life, but he lives in Florida now and has a family. He doesn't seem especially close with but does have a few friends locally.

Engages in small talk with neighbors but doesn't seek a deeper relationship with them. Has a couple close friends and more that are just acquaintances. Has a fear of abandonment (doesn't feel safe in the world and love is finite to him) and has both left good relationships prematurely and stayed in bad ones too long. It sounds like an insecure attachment style.

Developmental and Family History:

John is the youngest sibling and has just one older brother, Justin. John idolized Justin when he has younger. Justin acted as pseudo-father figure to John, as their father was not involved.Their maternal grandparents had a large influence on their lives, and they spent an extensive amount of time on the Eastern Shore of Maryland as their Grandfather was a crabber by trade.Hard work was instilled as well as financial preservation.

Medical Conditions and Previous Counseling.

No previous counseling.Has dabbled with SSRIs which he didn't like and Xanax which he said he liked a little too much.

Social History:

Substance Use and Legal Involvement:

None reported.

Cultural Context/Identity:

John and his family are Caucasian, but don't really identify with their heritage. He attended Catholic Church as a child as their mother was Catholic, however their father was an atheist. John identifies as spiritual now. His maternal grandparents lived through the depression and John may experience some generational trauma in the form of frugality, from their experiences. He asked me to confirm that the rates on my website were accurate.

Assets:

John seems cautiously open to counseling. He is smart and seems curious about Buddhist ideas having recently read some books on the topic since he has been out of work. He seems uncertain his way forward, but is very trusting of Justin's recommendation to get help from a counselor.