Background of the selected case is in appendixPresenting Problem
Mariam appears composed and is willing to converse. She states that she understands why she is in prison, but not why she must be evaluated. She states that what she did is against the laws of God and the teachings of the Koran and believes she should be punished for her deed. When questioned as to the reason for killing her husband, she stated that she had to protect Laila and the children. She believes had she not acted, he would have killed all of them. She feels no remorse for her actions.
Through questioning it was ascertained than Mariam was a victim for many years of verbal and emotional abuse at the hands of her mother. She was next the object for verbal, emotional, sexual and physical abuse by her husband for twenty-five years. She stated the physical abuse to be most shocking. In both instances she stated she deserved the treatment received, she was not worthy of love or respect. (Lerner & Miller 1977)
Mariam states that she has felt varying degrees of depression since her mother's death. Her depressions increased with each miscarriage. She reports reliving her mother's death from time to time and believes she should be the one that is dead. She states that she does not like feeling sad and would like to change her life for the better.
Diagnosis
Based upon the discussions with Mariam and the guidelines set forth in the DSM-III-R and DSM-IV, a diagnosis of battered woman syndrome, a subgroup of post traumatic stress disorder was determined.
The criteria for a post traumatic stress disorder diagnosis is that the person experienced, witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others; the person's response involved intense fear, helplessness, or horror. The traumatic event should be of a type that would cause significant symptoms or distress in almost anyone and that the event was outside the range of the usual human experience. The disorder can appear any time from several months to many years after the traumatic event. (Jones & Harris 1967)
The four criteria for a diagnosis of battered woman syndrome are that the woman believes that the violence was her fault and she is unable to place responsibility for the violence elsewhere. She fears for her life and/or the lives of her loved ones, and she has the irrational belief that the abuser is omnipresent and omniscient. (Ross 1977)
Mariam clearly believes all of these things. She believes Laila was being beaten because her husband told her repeatedly that she had corrupted Laila against him. Had she not become close to Laila, there would not be reason for her husband to believe she had corrupted her against him; therefore the beating was her fault. Because of this belief, Mariam is unable to place the responsibility for the beating on her husband where it ...