The Case of James James is a 21 year old male of mixed Puerto Rican and Dominican heritage. He comes from a middle-class family which consists of himself, his mother, his father and his younger sister. James’ father works for a medical insurance company. His mother is a stay at home mom. His sister is a sophomore in high school. When James was six his father enrolled him in a little league team for baseball. He had played baseball himself when he was a child and then in high school. He had hoped to play professionally but was not quite talented enough. He often stated that he believed his son had great talent and could “make it in the big leagues.” He practiced with James every day after work. He had him work on pitching as he stated “that’s where all the money is.” James was quite successful in his little league team. As he grew older he joined travelling teams and won the accolades of his coaches. By the time he entered high school, and joined the high school team, many of his coaches believed he had enough talent to be scouted for the majors. James was a great source of pride to his father, which caused tension between himself and his younger sister who felt ignored by her father. When James was a freshman and sophomore in high school, he became known as the star pitcher on the baseball team. He enjoyed the popular social status this gave him. He had many acquaintances and was well liked by his teachers, who often mentioned his wins in class. By the time he was entering Junior year, he had been scouted by several major league teams. Toward the end of his Junior year, James severely injured his left arm, his throwing arm and needed to have surgery to repair the damage. This was devastating news to his family, himself and his team. Though his doctors told him he may be able to play baseball again, it would not be clear until after his recovery if he would have the same strength in his arm. When James entered his Senior year he began physical therapy for his arm but did not feel his strength was back. He reported feeling “lost” without being able to participate on the team and get wins. He began having anxiety, which he suffered from time to time throughout his life. His anxiety took the form of many Obsessive-Compulsive traits. By the time he completed his Senior year, his dreams of going to majors had faded. He did not feel confident in his ability to play the way he did before his injury and was not able to regain all of his strength. James’ father encouraged him to keep trying and told him his arm was probably not totally recovered yet. James reporting feeling pressured by his father to stick to his original plan of pursuing baseball as a career. He reported that baseball was the only thing his father cared about. He himself stated he did not know what else he would do or how he would ever replace baseball since he had “no other skills.” James decided to enter a local college and try to play baseball for them while he was recovering. His father encouraged him to do so and then transfer to a better school with a better team once he was stronger. James disliked school very much and never thought of an academic focus he would have interest in. He takes some liberal arts courses and experiences them as very dull. He often misses class and never does the work for the classes. His father and sister complete his work for him to maintain a decent grade point average. His sister is reluctant to do this as she believes it is enabling behavior but her father places guilt on her if she refuses. After one year at the local school James decides he is not well enough to continue pitching and does not like school enough to continue studying so he drops out and gets a part-time job in sales. He is very unhappy and appears to be stuck in the past according to his family and friends. His anxiety has gotten worse. He begins drinking heavily to help ease the anxiety. He reports feeling like there will never be anything he could do would be good enough and that he was supposed to “go pro.” James isolates himself from his family and friends. He is experiencing tension at home and social anxiety when he goes out with friends. He reports the only way he can get through anything social is by drinking.

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