The
Intercommunity Counseling Center in Uptown Whittier has been providing
life-changing mental health services since 1976, and still finds that many in
our community view mental health services as a mysterious, potentially scary
experience. What follows is an
illuminating success story of one client whose personal strengths and
commitment to therapy, combined with the therapist’s training in providing
effective treatment, dramatically increased the client’s quality of life. She is one of hundreds of ICC clients who
reclaim their lives from the effects of anxiety, depression, and fear.
A
young woman named “Mary” came to ICC seeking relief from her anxiety. At the beginning of treatment, Mary suffered
from occasional panic attacks. Panic attacks occur suddenly and last 5-10
minutes. Common symptoms include increased heart rate, sweating, shaking,
nausea, dizziness, shortness of breath, and chest pain. Mary had suffered
multiple panic attacks, and the fear of having another prevented her from
enjoying life like she used to. She spent less time with her friends, felt
distracted when with her family, and was less active at her church. Although
Mary wanted to continue in her education, she felt as though her anxiety was
holding her back.
Her
ICC therapist chose to utilize Cognitive Behavioral Therapy (CBT) with Mary.
CBT was developed in the 1960’s by Albert Ellis and Aaron Beck and is highly effective
in treating many disorders, especially anxiety and depression. An important
component of this type of therapy is education: providing the client with
information regarding the process of therapy, expectations of therapy, and
their personal diagnosis. By doing so, the therapist begins to build a trusting
relationship with the client and invites the client to actively engage in
treatment. The focus in CBT is on thoughts and actions: if destructive thoughts
can be identified and replaced, positive actions will follow. This type of
treatment is typically structured and short-term (about 10-20 sessions). Each session usually begins with a symptom checklist
to provide an avenue to track and measure change. Then the therapist and client
decide on a focus for that session with the goal of achieving a new perspective
and understanding. From that new perspective, the therapist and client create a
homework assignment which allows the client to implement changes in day to day
life.
In
Mary’s treatment, the checklist helped the therapist understand what symptoms
Mary experienced throughout the past week and how severe the symptoms felt. Mary
and the therapist reviewed the survey each week to chart her progress and focus
on particular symptoms. After reviewing the checklist each session, the
therapist chose the most appropriate intervention to address Mary’s current
concerns. CBT offers many effective interventions. One that was particularly helpful for Mary is
called the Interactive Model which outlines the connection between thoughts,
emotions, physiology, and behavior. Together the therapist and client reached
an understanding about the common trigger of Mary’s panic attacks.
For
example, while spending time with family or friends, Mary would have a negative
thought: “What if I can’t take care
of my family well?” That thought would lead to physiological sensations such as increased heart rate, shaking, and
nausea. These sensations would feel threatening to Mary, triggering feelings of anxiety and fear. Her behavioral reaction would be to retreat,
isolating herself from others. Gaining insight into this pattern is a crucial
and significant first step; Mary could identify this pattern as it occurred (a
frequent homework assignment), empowering her to initiate a change.
The
next step in therapy was to provide Mary with the tools to translate this
knowledge of the interactive model into practical and positive change. The
therapist introduced several relaxation techniques for Mary to practice both in
and out of session. For example, deep breathing exercises were particularly
helpful for Mary in stopping the pattern triggered by negative thoughts. Now
she responded to a negative thought with deep breathing, thereby stopping the
cycle before it resulted in a panic attack.
After
10 sessions, Mary’s hard work and commitment to the therapeutic process yielded
positive results. Her symptoms gradually lessened as she consistently used the
insight and tools she gained in therapy. Mary was able to slowly re-engage with people
and activities that were meaningful to her. Her anxiety no longer prevented her
from enjoying time with family and friends. She also became more active in
serving at her church and felt confident enough to re-enroll in her college
classes. As promised, Mary is a wonderful example of how the client’s personal
strengths and commitment to therapy, combined with the therapist’s training in
providing effective treatment, increase the client’s quality of life!
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