The Case of Janine

Identifying Demographic Information

Janine is a 25-year-old woman of Filipino descent living in a diverse urban environment in

the United States. She was born in the Philippines, but her family moved to the US when she was
10 years old. Janine maintains strong cultural ties to her Filipino heritage. She is single and
currently resides in a small apartment in her city's multicultural neighborhood.

Reason for Referral

Janine has sought counseling due to her ongoing struggles with self-esteem and anxiety.
Her experiences of gender inequality in both her personal and professional life have exacerbated
her emotional distress. She frequently encounters situations where she feels undervalued and
overlooked due to her gender, especially at work. Additionally, she often finds herself thinking
about an emotionally abusive relationship that ended two years ago, which has left her feeling
angry and resentful.

Janine exhibits a perfectionistic trait. Driven by a fear of failure, she constantly strives for
excellence in every aspect of her life. This perfectionism has contributed to her anxiety and self-
esteem issues, as she places immense pressure on herself to meet high standards, both at work and
in her family role.

Relevant History

Family History:

Janine is the eldest daughter in her close-knit family, which includes her parents and two
younger siblings, a brother and a sister, both of whom are still in high school. Her family emigrated
from the Philippines in pursuit of better opportunities in the United States. Janine's parents, while
loving and supportive, have always had high expectations for her success. They see her as the hope
of the family and have instilled in her a sense of responsibility to take care of the family's needs.
This pressure has been a constant presence in her life, even to this day, as her parents rely on her
for support.
 From a young age, Janine was thrust into a role of responsibility, as her parents often
worked long hours to make ends meet. She became the de facto caregiver for her younger brother
and sister, taking on the roles of cook, babysitter, and mediator for their disputes. Janine's early
years were marked by a strong sense of independence and self-sufficiency, as she had to learn how
to navigate her responsibilities at a young age.

Social History:

Janine's socialization as a female from an Asian background emphasized traditional gender

roles and expectations. She was taught to be nurturing, respectful, and obedient, and she often felt
pressure to conform to these societal norms. Furthermore, her upbringing instilled in her the value
of hard work and academic achievement. Janine was very ambitious from a young age, excelling
in her studies, and often receiving praise from teachers who had high expectations for her.

In school, Janine's persistence and dedication were evident. She studied diligently, striving
to meet and exceed her teachers' expectations. However, this drive for success came at a cost, as
she began to develop self-doubts and perfectionistic tendencies. She constantly questioned whether
she was doing well enough and feared any sign of falling short.

Employment History:

Janine works as a software engineer at a large tech company. While she is passionate about
her job, she often experiences self-doubt. She feels overlooked in meetings and excluded from
important projects, which make her question her capabilities. She feels that she is not performing
as well as she should be and worries that her colleagues and superiors share this perception. This
contributes to her self-esteem issues and exacerbates her anxiety, compounded by the additional
stressors associated with working in a male-dominated industry, where she sometimes feels
discriminated against due to her gender.

Medical, Psychiatric, and Substance Use History:

Janine frequently experiences tension headaches, which she attributes to her stress levels.
She occasionally takes over-the-counter pain medication when they occur. She has no prior
psychiatric diagnoses or treatment history. Her self-esteem issues and anxiety have developed
gradually over time. Janine does not engage in substance abuse. She occasionally consumes
alcohol in moderation during social gatherings as a way to unwind.

Past Coping Skills:

Janine often coped with societal pressures, workplace challenges, familial expectations,
and the toxic relationship by internalizing her feelings. She rarely expressed her emotions to other
people, fearing she would be seen as overly emotional or not resilient enough. Her parents see her
as strong, independent, and highly dependable; her ex-boyfriend was usually dismissive of her
feelings during their relationship, often making her feel like she was just overreacting and being
“overly emotional.”

Present Coping Skills:

Janine has started attending a support group for women facing gender inequality in both
personal and professional spheres. She has also begun seeking therapy as a way to address her self-
esteem issues, process her emotions from the abusive relationship, and develop healthier coping
mechanisms for her anxiety.

Social Support:

Janine maintains a small but highly supportive social circle, primarily consisting of like-
minded friends who share similar experiences as a woman. These friends have been her pillars of
strength, helping her deal with the breakup by their genuine readiness to listen. Over time, she
started opening up to them about her emotions and vulnerabilities. They offer understanding and
empathy, which Janine finds invaluable in coping with her challenges.

Predisposing Factors:

Growing up in a Filipino household, Janine was socialized into traditional gender roles and
societal expectations. She learned to be nurturing, respectful, and obedient, which influenced her
perception of how she should behave as a woman.

Her parents, immigrants from the Philippines in search of better opportunities, brought with
them a vision of success that they fervently instilled in her. They saw her as the beacon of hope for
the family's future and passed on a sense of responsibility for their welfare. This expectation
extended to academic and professional excellence, setting an exceptionally high bar for Janine.
The weight of these parental expectations further fueled the fires of her perfectionism, contributing
to the roots of her self-esteem and anxiety issues.

From a young age, Janine displayed a natural inclination toward perfectionism. She
possessed an unrelenting drive to achieve excellence in all her pursuits as a means to avoid failure.
This perfectionistic trait, while propelling her towards many accomplishments, also acted as a
double-edged sword. It laid the foundation for her ongoing self-esteem and anxiety challenges, as
the fear of not meeting impossibly high standards became a constant companion.

Precipitating Factors:

Janine's ongoing responsibility to support her family, coupled with their high expectations,
continues to be a significant source of stress. The pressure to excel in her career and provide for
her family contributes to her emotional distress.

She finds herself feeling angry and resentful whenever she remembers her past relationship.
Her ex-boyfriend's manipulation, isolation, and cheating had negative impacts on her self-esteem,
and the relationship's toxicity had lasting effects on her mental well-being. Although she has since
“moved on” from him (she reports not having any love left for him), she still feels angry at how
he has treated her, but more importantly, she feels angry at herself for “allowing it to happen.”

Working in a male-dominated industry, Janine frequently encounters gender bias. She has
been sidelined during meetings, excluded from important projects, and sometimes feels
discriminated against due to her gender. These experiences trigger her self-doubt and exacerbate
her anxiety.

Protective Factors:

Janine maintains a small but highly supportive social circle, consisting of friends who
understand her experiences of gender inequality and discrimination. These friends offer her
understanding, empathy, and emotional support. She has taken proactive steps to address her
challenges. She attends a support group for women facing gender inequality and has personally
sought professional help to work through her self-esteem issues and emotional trauma. These
coping strategies empower her to confront her difficulties. Despite her emotional struggles, Janine
demonstrates resilience in facing adversity. She continues to work diligently and seek help,
displaying a strong commitment to improving her mental well-being.

Perpetuating Factors:

The continued pressure from her family to excel in her career and provide for their needs
perpetuates Janine's sense of responsibility and stress. Her sense of duty keeps her in a cycle of
high expectations and emotional distress.

The unresolved emotional trauma from her abusive relationship, although two years in the
past, continue to affect Janine's self-esteem and mental well-being. Her inability to fully process
and heal from this trauma perpetuates her emotional distress.

The persistence of gender discrimination and bias at her workplace perpetuates her self-
doubt and anxiety. She often witnessed her voice being drowned out in meetings, found herself
excluded from pivotal projects, and, on more than one occasion, experienced the biting sting of
discrimination solely due to her gender. Continued exposure to these stressors reinforces her
emotional distress.

Risk Assessment:

Janine's struggles with self-esteem, anxiety, and experiences of gender inequality,

compounded by her unresolved emotional trauma from an emotionally abusive relationship and
perfectionistic tendencies, have led to increased stress and emotional distress. While she does not
currently have thoughts of self-harm or suicide, her emotional burden is significant. Continued
exposure to gender inequality, unprocessed emotional trauma, and ongoing familial pressure may
put her at risk for developing depression or other mental health issues. Her supportive social
network and her proactive engagement in coping strategies are protective factors that can help
mitigate these risks.