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Maria's presenting concerns reflect an existential struggle with death, isolation, freedom, and meaningless. The death of her relationships with her family was devastating. Adding to that, the "ideal" marriage never answered her search for self. She was forced to survive abuse, isolation, and shame. No one validated her pain or acknowledged her loss of self in the world. Maria has challenged the cultural traditions for Latinos and for females on many levels and for many years.

From her early separation at college to the present situation as a single parent, Maria has been isolated from her culture and family. The more she wanted refuge in her family and culture, the more she was shamed by those she sought. Confronting a loss of identity, Maria experiences existential isolation. To find meaning, or to escape from finding it, she has become depressed, developed problems at work, lost the ability to adequately feed herself, and withdrawn from her relationships. Other than her children, the focus of her reason for existence, Maria has lost her identity and sense of self in the world. Even the freedom to date and get back into "circulation" provides traumatic memories from her marriage and the responsibility for the choices she has made. The life Maria has constructed is fragile.

The potential loss of her role as a parent seems to have intensified the nightmares as well as her declining ability to maintain herself, her relationships, and her children. Maria has coped in the past by creating meaning in and through others (e.g., a new family, teaching, her children). However, her choices have brought her pain and abuse and have left her alone with responsibilities she feels unable to manage. She now lives through her children. Her brittle existence is crumbling with the fear of losing her independence. Maria's cultural ties have diminished as her family of origin has turned away from her. Religion has abandoned her because her priest sent her to a physician due to her severe depression and helplessness. In facing her life without culture and with pressures to create a new meaning from her broken past, Maria, as in her dreams, has no escape. She is left alone and afraid.

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