Address the following: which therapeutic modalities would you consider to beappropriate in this case? Why? Cite sources from the text or articles where appropriatefor direct quotes or paraphrasing.What questions do you have that would help you understand the best way to structuretreatment? What other information might you need (i.e., tests, medical or psychiatricexamination, etc.). What would you consider first, second, third, etc.? What would youkeep in mind about potential transference/countertransference issues?
Esperanza Mesa, a bilingual (Spanish English) lesbian bora in Durango, Mexico, is one of sixchildren whose parents emigrated from Mexico when she was approximately 4 years old.Spanish was her first language, and she learned English in the public schools. Esperanza was anoutgoing child who always doubted her self-worth. Feeling the sting of discrimination because ofher dark coloring and accent when she spoke English, she changed her name to the Englishtranslation, Hope, while in high school. When Hope was a teenager, she wondered if otherteenage girls were drawn to women like she was. She succeeded in suppressing her feelings, andfollowing her family and cultural dictates, she married and gave birth to a daughter by the age of20. Hope never questioned her choices and felt compelled to follow the mandates of her familyand Catholicism. Without these buffers, she would have felt even more desperate when peopleconfronted her for being a “greasy, lazy, wetback Mexican who should just go home.”As a married woman with a new baby, she felt lonely most of the time, and she knew it was notbecause she longed for her husband. There was a part of her that she shared with no one. She feltlike she did not fit anywhere, particularly with the other wives who gathered together in theafternoon before their husbands came home. She slowly began to realize that her motivation forvisiting with this group was different from that of the others and that a strange attraction wasgrowing within her toward one of the women. Unable to reconcile her cultural values and familyloyalty with what she was thinking and feeling (including guilt and shame at wanting to putherself first), she told her husband about her dilemma. Hope’s traditional Mexican husband couldnot tolerate the option that Hope proposed—a divorce with her having full custody of theirdaughter. In fact, he threatened to expose her as a lesbian to her family and church and to taketheir daughter away. Because Hope feared her family’s and priest’s disapproval and rejection aswell as the possible loss of her daughter, she sought psychotherapy for symptoms of anxiety,insomnia, loneliness, and rage.
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