Introduction Vishnu and Pooja are married and have a son. They had approached the counselor due to depression and deterioration of their relationship. Presenting Problem Vishnu and Pooja experience serious conflicts in their relationship. Pooja suspects her husband of having an extramarital affair with her cousin sister. Her husband denies it. They report frequent conflicts and depleted marital satisfaction. History of the Presenting Complaints Vishnu and Priya have been married for eleven years. They live in Chennai and have an eleven year old son. Vishnu is employed and Pooja has been the Home maker. The couple had been living in Malaysia during the time of their marriage. One of Pooja’s sisters had been living with them and Vishnu reports that she had always nagged him of having an illicit relationship with her. Vishnu had developed a cancerous tumor in his mouth 10 years ago and had undergone treatment for it. He had successfully recuperated from it after which they relocated to India. Pooja’s younger sister had moved in with them after they relocated to India. One day, Vishnu had purchased a Saree for his sister-in-law and this instigated Pooja’s suspicion that there is an illicit relationship between him and her sister. She was distrustful and paranoid about him and his fidelity. Vishnu’s job requires him to travel abroad and during one of his trip to Malaysia he discovered that he had Pulmonary Embolism (a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream). He had not taken treatment for it due to fear of medication (Chemotherapy) that developed earlier. He did not disclose it to any of his family members due to his fear of treatment. He experienced pain and emotional trauma which has also caused a rift in between the couple. Pooja had sensed the growing distance and raised frequent quarrels about his illicit affair with her sister. This further led to deterioration in their relationship. Vishnu had stopped having any interaction with his wife due to the incessant quarreling and suspicion. He is depressed due to issues in his marriage and also due to the Physical ailments that have affected him so far. He lacks social support especially from his wife.
Pooja on the other hand has developed a strong belief that her husband has an illicit affair, which has led to the distance in the relationship. However she does not have a concrete fact to base her suspicions on and thus confronts her husband about it frequently. She is also depressed due to the status of their relationship. Past Psychiatric History Vishnu suffered from a Cancerous tumor in his mouth and had undergone medical treatment for his. He developed a phobia for hospitals and treatment as a result of the Chemotherapy administered to him. He had also undergone Psychiatric treatment and counseling for his phobia for the past two years. His Phobia for Medication has prevented him from treating Pulmonary Embolism. He has undergone counseling to overcome his phobia. Past Medical History Vishnu has undergone treatment for Oral Cancer and Pulmonary Embolism. Personal History Vishnu has problems and concerns relating to the Trauma of surviving cancer and dealing with the Pulmonary Embolism. It has taken a toll on his ability to cope with the issues in his marriage. Pooja has been supporting her husband through all of his health problems. She has been depressed over the years and harbors unsubstantiated suspicions about her husband which creates unwanted friction in the marriage. Diagnosis The Counselor has Identified Poojaâ€™s Depression as a more pressing issue and as contributing to the relationship problem. Pooja is severely depressed and requires Medical attention. Counselorâ€™s Intervention Emphasis on Depression prior to the relationship issue indicates that it is the prime concern. The observation made was discussed with the couple and appropriate suggestions were provided.