Case Studies

CBT for depression and anxiety with a young man who felt abandoned and disconnected

Steven felt lonely a lot of the time and worried about people leaving him or not liking him. Since his mother died a few years previously, Steven hadn’t really talked about how this loss had affected him.

He got on well with his father and step mother, but felt like an outsider in their house and had disengaged from them and other people. A recent relationship had ended after he was treated badly, and he felt angry with his ex. This had triggered feelings of abandonment and he had been doing things to try to connect with his ex, although this made him feel worse. He felt low in mood and said he had been drinking too much and using drugs when he was out drinking with friends. He had already recognised that while he felt better in the short term, this was making his mood and feelings of anxiety worse. He was also avoiding social invites from work friends because he didn’t feel like being with people. He made excuses or delayed replying until it was too late because he couldn’t stand the feeling of letting people down and felt he couldn’t be honest with them.

Treatment for OCD with a young woman who wanted to keep everyone safe

Amy had several rituals to keep her family safe and to manage “bad” thoughts. She had had these for nearly 3 years, but they got a lot worse after she went for a routine medical check and then thought that she had contracted an infectious disease.

She was preoccupied with this thought, which was enormously distressing. She described imagining ‘the worst-case scenario’, which made her tearful and she felt totally overwhelmed and unable to cope. She described knowing rationally that it was highly unlikely that she had contracted a disease, but this thought still showed up and bothered her in a lot of situations.

CBT for trauma symptoms and binge eating with a man who had been reminded of the past.

Philip described a history of comfort eating since he was a child. He had had this under control for a few years, but it had re-emerged as a problem over the previous 12 months.

He reported problems with self-esteem and described a pattern of always trying to please other people. He said he needed to be able to say ‘no’ to people because he either felt guilty if he did or angry if he didn’t. Philip also reported having flashbacks. He said he had previously buried memories and disclosed that he had been abused as a child. Media attention to a prolific historic abuse case had re-triggered trauma symptoms, and his flashbacks were readily triggered by a noise or a smell.

Philip had lost trust in people and had withdrawn. He had a worry about his work productivity, and he dismissed positive feedback as people being patronising because of his physical disability. When we explored his thoughts, he was getting caught up in some truly horrible critical thoughts about himself as a person. He wanted to feel that what he was doing was worthwhile, wanted to manage stress without binge eating, and wanted to feel less angry, less stressed, be out more, doing more and meeting people.

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