Case of the Blues from the practice


Hello, today we will examine the case of chronic depression, its symptoms, causes, and treatment outcomes. In this, as in all the following examples, all data on the client is modified and is described only with the consent of the client.

Yevgenia, 32, filed a request for a long depression, accompanied by suicidal thoughts. In the past three months, Eugene has practically ceased all contacts with his friends, meeting them was uninteresting and pointless. Of complications: insomnia, waking up every morning at 4-5 am, slept after midnight. Sometimes I woke up middle of the night from a nightmare, next to it there is someone.

analysis of the past: father died when she was 12 years old, in school she is regularly humiliated by classmates. In school as in College, had one girlfriend, which was built very strong relationships. Relationships with men are not lined up, there were a few people from Dating sites with whom Eugene had met for sex. Brothers and sisters there, the mother raised her daughter alone, and they lived together until Eugenia are under the age of 30 years. Last 6 years worked as a salesman in the store.

Key events 2-3 months prior to treatment: the rupture of relations with the only friend my mother's illness.

Analysis: a key role in the formation and development of depression played mom. From an early age, mom was always dissatisfied with the activities of daughters, any manifestation of itself, was perceived by critics. Direct aggression and beating was not. All activities were accompanied by maternal words: "why are you so clumsy", "you do not ask", "give it to me, and then you're bad", etc. Also in the mother's behavior was not adopted, as a rule, she was always cold towards his daughter. However, as Eugene remembers when as a child she was joyful moments in life and she experienced joy, the mother usually began to hurt. The disease required the constant presence of the daughter of the house. In the end, Eugene formed the conviction: I am nothing. This was accompanied by a constant feeling of guilt. An aggravating factor was the behavior of the mother, in which she was in pain when daughter experience the joy that so clearly Eugenie learned two beliefs:

  1. I-nothing.
  2. If it brings me happiness, so, someone (mother) will be bad (this belief is often supported by cognitive distortions like: this does not happen always only white stripes; if I feel good, means someone in this world is very bad, etc.).

With these two beliefs to develop normally personality was simply impossible. In school because of low self-esteem it is constantly humiliated by classmates, a repulse she could not give them because were afraid that then she will be fine, but this was impossible to avoid.

the Main goal of therapy was to change self-concept, in which Eugene is able to assess ourselves, based on reality, not on a baby installation.

of the key beliefs that need to be changed:

  1. "I am nothing" gradually, by first transfer, then Socratic dialogue, to read "I'm healthy, productive, self-confident girl."
  2. If I feel joy, so do evil close to me. Through debate, questioning, and then to remove the logical error is that when I feel good, this implies that someone is bad.

the Consultations were held via Skype for 3 months with a frequency of 2 times a week.

the psychoanalytic methods were the most effective transfer. As significant changes began to occur, when Eugene after two weeks of joint work began to show early behavioral signs indicating the desire to receive attention (to satisfy his injury of deprivation "cold mother" that was one of the most fundamental in the development of the concept of "I am nothing"). The important point was to show complete neutrality when dealing, as the critic might regress the psyche, and the approval could result in feelings of suspicion toward the therapist (because the client is absolutely not used to it) with Just this period could begin to question the beliefs and behavior of the mother and to bring self esteem to reality.

To date, therapy is continuing. Awareness of the client in the course of therapy, the influence of the mother and the irrational beliefs with further rethinking and replacing gradually led to lower levels of anxiety, and a more realistic assessment itself. The reduction of anxiety and the realization that from this situation there resulted in normalization of sleep and no nightmares. Therapy continues, as is still very repressed childhood experiences that are not recognized by the client that reinforces the old irrational beliefs, but each time the situation improves.

Ivan Kharchenko
Статья выложена в ознакомительных целях. Все права на текст принадлежат ресурсу и/или автору (B17 B17)

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