1. PROZAC NATION By Elizabeth Wurtzel

2. Overview of Elizabeth Wurtzel.Born in New York, 1967, well bred, raised in a Jewish family, highly intelligent and a high achiever.Parents divorced at age 2.Studied at Harvard.Started career as a Journalist writing for The New Yorker and New York Magazine.Attended Yale Law School and graduated at the end of 2008.Currently works for Boies, Schiller and Flexner in New York City.Writes regularly for the Wall Street Journal.Married and divorced

3. Case Study Parents separated when Elizabeth was 2 years of age She felt constantly abandoned by both her parents, especially her father Mother relied solely on Elizabeth for stability and nurturing. The child was forced to become the adult figure in the mother- daughter relationship and replaced the husband. She felt she couldn’t abandon her parental responsibility to her mother. Felt she was constantly standing on a battlefield between two dysfunctional parents who fought over their indifferences using her as bait

4. Case Study Visits to father grew further and further apart until there were none. He slept most of the time when she came to see him and put videos on to entertainment her. Mother couldn’t cope with her all the time and sent her for 5 continuous years to summer camp for up to 6 weeks at a time and this left Elizabeth, once again, feeling abandoned. She started behavioural changes during this stage and would beg for people to take her home if her mother didn’t return for her. She became so paranoid about being left that she didn’t play with the other children on the camp as she was totally absorbed in being left behind.

5. Case Study. Father remarried and told her about his forthcoming wedding but didn’t invite her confirming to Elizabeth that she didn’t belong..Mental illness was a direct result of her family dynamics.Unable to engage in relationships and she continuously destroyed friendships fully aware of her actions and the consequences of her actions.She acknowledged her depression from age 11 right through to her senior year in college

6. Case Study. Drugs and alcohol helped her continue to live. They masked her many anxieties when she was in the public eye..Continuously hospitalized during her University years when she was going through the ‘black wave’ and hit rock bottom. This was a time when self pity was at its worst.Psychiatric appointments began as a young child and continue today

7. Case Study. Many psychiatrists and an array of different forms of treatment used left Elizabeth undiagnosed or not given appropriate treatment. It wasn’t until quite late in her teens to early 20’s that she was put on Prozac and the chemicals gave her some degree of balance in her life.. Suicide attempts and much self abuse were deliberately aimed at herself as she despised and loathed ‘Elizabeth Wurtzel’. Self destructive personality throughout her life in all situations eg. relationships, work and family isolated her and she sunk further into depression.

8. Factors Impacting Upon Development Parents divorce, felt she had a split foundation and was a fragmented person as a result of this Growing up being the adult in a mother-daughter relationship Being sent to camp to give her mother a break made her feel abandoned and wanted her mother to pay for this Aged 5 she was not able to cope with not being invited t oher father’s wedding

9. Factors Impacting Upon Development Father told her quite young that he had to stop her mother from having a termination when she was pregnant with Elizabeth and this was confirmation that she definitely did not belong. First sexual experience she described as the most pleasurable thing she had ever experienced and therefore sought more of it from anyone willing to please her. She didn’t care about the relationship or the person – she was only satisfying her own needs.

10. Factors Impacting Upon Development.Her miscarriage caused her more depression as she felt she couldn’t hold on to anything, even though she didn’t know she was pregnant until she started bleeding. She played on this to receive sympathy and attention from others for a long period of time until it became obvious to her friends that she was abusing their friendship. Attending Harvard University exposed her to some very eccentric people who seemed drawn to her. They partied hard together and indulged in far too much alcohol and drug taking which gave her the confidence to be loud and accepted as part of the norm around campus. She had never felt like she belonged until she was high on cocaine.

11. Factors Impacting Upon Development.Her first real boyfriend left because of her emotional instability including depression, continuous crying and the negative impact she had on their relationship. This again led to feelings of abandonment. She had demanded too much, was very insecure and extremely needy..The numerous psychologists who tried helping further fuelled her problems and neglected to diagnose her properly Starting Prozac and knowing she will still have bouts of depression but her life has improved. Now it is a case of managing her illness and knowing when she needs help which isn’t always easy to do.

12. Humanistic Theory

13. . Physiological needs:.Elizabeth had all these needs met. Her mother cooked for her, sent her to a good school, paid for her medical bills. As Elizabeth aged and attended University, she didn’t always meet these needs herself due to drugs, alcohol or depression that kept her in bed for days at a time.Safety and Security: She was supplied with a roof over her head in an environment that wasn’t perfect but definitely was not abusive. Even though her parents had divorced and her mother relied on her heavily for adult support, she gave Elizabeth a safe and secure home environment for her to grow up in.

14. Humanistic Theory Love and Belonging: Elizabeth’s mother loved her very much and tried her best at rearing her. Unfortunately she felt a sense of abandonment when her father left the family home and therefore never really felt like she belonged anywhere unless she was on drugs..

15. Humanistic Theory Esteem and Self-Esteem: From a young age she never had much in the way of self esteem and would self mutilate. When at her lowest in primary school she would slice her body open which she saw as art and something quite beautiful. This is the part of Maslow’s Hierarchy of Needs that starts to falter for Elizabeth. She had absolutely no respect for others and wanted others to pay for the lack of understanding they had of her.

16. Humanistic Theory. Self-Actualization:.Due to her self destructive type of personality, depression and drug taking, Elizabeth couldn’t be accepting of others without destroying the person. She lost her morality, creativity and spontaneity which were overshadowed and remained hidden by her regular substance abuse.

17. Freud’s Psychoanalytic Theory. Elizabeth was unable to fit in comfortably at parties without taking cocaine which boosted her confidence. She became gregarious, loud and the emptiness she felt disappeared..Ego – Elizabeth was unable to tolerate the turbulence that was caused between her ego and ID. She became angry and sunk further into depression. Her friends were tiring of her constantly crying at parties and the demands she placed on their friendship. The Cocaine helped quell this and allowed her ego to negotiate with her ID and allowed her to fit in and become normal until the drug effect wore off.

18. Freud’s Psychoanalytic Theory. Super-Ego – constantly Elizabeth felt she couldn’t achieve much with her life. The super-ego inside her consistently told her she was useless, she would be unable to achieve good marks at University, she wouldn’t be able to complete her story for the piece that was due at work and worse she would never be able to hold down a relationship.

19. Freud’s Psychoanalytical Theory. ID – Elizabeth would sleep with her girlfriends partner just because she could. She would pleasure herself at the cost of a good friend who had stood by her so she could satisfy her own needs without any thought for others. Her ego told her it was wrong but she went ahead in any case and destroyed many friendships. She ignored her values and morals to seek self satisfaction..When on cocaine, Elizabeth wasn’t afraid if the ID came out as this gave her the confidence to function in society in a normal state and become accepted. The super-ego left her alone whilst she was substance abusing.

20. Erikson’s Life Stages Stage 1 – Trust –v- Mistrust (0-1 yo) Can I trust the world? Elizabeth’s first year of life was spent in a fairly normal family with a loving, devoted mother. She had nothing to concerned about her and trusted those around her. Everything in her life at this stage was quite normal. Stage 2 – Autonomy –v- Shame and Doubt (2-3 yo) Is it OK to be me? She had lost her family security and father’s role model in her daily life and at this stage was definitely starting to query whether it was OK to be Elizabeth Wurtzel. Doubt was developing in this child’s self-conscious.

21. Erikson’s Life Stages Stage 3 – Initiative –v- Guilt (3-6 yo) Is it OK for me to do, move, act? At this stage she had big issues with abandonment and was starting to become needy. She always wanted to know when she was going to be picked up and was showing signs of behaviour not normally acceptable in a child of this age. She was left feeling guilty about her mother and how she was dealing with the divorce and this escalated when she went to visit her father or talked to him on the phone

22. Erikson’s Life Stages Stage 4 Industry –v- Inferiority (7-12 yo) (Can I make it in the world of people and things?) By now she is querying her place in the world. Feels unloved, abandoned and totally tied to her mother who now sees her as an adult and expects adult behaviour. She is starting to self mutilate and is extremely needy Stage 5 Ego Identity –v- Role Confusion (12-18+ yo) Who am I? What can I be? Elizabeth had lost the desire to impress others, especially her peers and was on a course of self destruction. She was unable to settle or concentrate on anything including her studying, work or relationships.

23. Erikson’s Life Stages Stage 6 – Intimacy –v- Isolation (20-30 yo) Can I Love? Elizabeth’s issues with abandonment destroyed her relationships with others throughout her teens and early adult life. Because of her unstable pattern of interacting with others, her self image, impulsivity, emotional instability and chronic feelings of emptiness, she was never able to hold onto a close, loving relationship. She would become paranoid and destroy the relationship rather than nurture it.

24. Borderline Personality Disorder Elizabeth more than likely had Borderline Personality Disorder (BPD) and showed signs of: Frantically avoiding real or imagined efforts of abandonment Constant patterns of unstable and intense interpersonal relationships Identifiable disturbance Impulsivity Recurrent suicidal behaviour Emotional instability Chronic feelings of emptiness Inappropriate, intense anger Transient, stress related paranoid thoughts.

25. Recommendations and Referrals More awareness from both parents and mutual raising, even though divorced, of their daughter School to engage in therapy at an early age and make the environment safe for this child who was self mutilating in the toilets Student Wellbeing Officer To be diagnosed sooner by finding a suitable psychologist or psychiatrist who was prepared to treat her immediately Community Mental Health Services Drug and Alcohol Counseling Appropriate anti-depressants prescribed much sooner

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