Please note – these cases are based on real life scenarios but have been altered to help maintain confidentially.
The client is an international student who has been in the USA for 3 months. They feel discriminated against and are struggling with loneliness and isolation, finding it easier to express their emotions in their native language. Despite having English-speaking friends, they want someone to talk to in their own language. The client is overwhelmed and finds it hard to study due to procrastination, exacerbated by a history of anxiety and depression. They have a strained relationship with their family, who have subjected them to physical punishment and verbal abuse over the years. This has led to a deep-seated belief that they are unlovable and need to achieve more to be loved, contributing to their ongoing anxiety.
How My Approach to Therapy Can Help This Client
Acceptance and Commitment Therapy (ACT)
Addressing Negative Thoughts and Feelings:
- Present Moment Awareness: Help the client become more aware of their thoughts and feelings without being overwhelmed by them. Techniques such as mindful breathing and grounding exercises can anchor them in the present moment, reducing the impact of anxiety and depression.
- Cognitive Defusion: Teach the client to separate themselves from their thoughts, such as “I’m unlovable” or “I need to achieve more to be loved,” and view these thoughts as just words, not truths. We can learn to notice the thoughts and feelings rather than being consumed by them. “I notice I’m feeling anxious”.
Absurdism
Finding Meaning and Resilience:
- Embracing the Absurd: Help the client understand that life’s inherent lack of meaning doesn’t diminish their experiences. By accepting the absurdity of their situation, they can focus on creating personal meaning and values. Good things happen to bad people, bad things happen to good people.
- Empowerment through Choice: Encourage the client to choose their own path and actions despite the absurdity. This can help them regain a sense of control and purpose.
Trauma Therapy
Healing Past Wounds:
- Safe Space for Expression: Create a safe and supportive environment where the client can share their experiences of discrimination, loneliness, and past abuse without fear of judgment.
- Processing Trauma: Use techniques such as narrative therapy to help the client process and make sense of their traumatic experiences, including physical punishment and verbal abuse.
- Building Resilience: Develop coping strategies to help the client deal with the emotional impact of their past and build resilience against future stressors.
Polyvagal Theory
Regulating the Nervous System:
- Understanding the Body’s Response: Educate the client on how their nervous system responds to stress and trauma, helping them understand why they physically feel anxious or depressed.
- Self-Regulation Techniques: Teach the client techniques to regulate their nervous system, such as deep breathing exercises, grounding techniques, and safe social interactions. These can help them feel calmer and more in control.
Implementing the Approach
- Initial Assessment and Rapport Building: Begin with a thorough assessment of the client’s current emotional state, history, and immediate needs. Build rapport and create a safe, non-judgmental space.
- Setting Goals: Collaboratively set therapeutic goals that are meaningful to the client in line with life values, focusing on reducing anxiety, improving study habits, and enhancing social connections.
- Mindfulness and Present Moment Awareness: Introduce mindfulness exercises and present moment awareness practices to help the client manage overwhelming emotions and reduce procrastination. Like ACE – Acknowledge thoughts and feelings with curiosity. Connect with the body with actions like wriggling the toes, noticing the body sitting on the chair. Engage with the wider world through what can be seen and heard through the eyes and ears. Engage with what can be done to benefit life right here, right now.
- Trauma Processing: Gradually introduce trauma therapy techniques, ensuring the client feels safe and supported while processing their past experiences.
- Polyvagal Techniques: Incorporate self-regulation strategies to help the client manage their anxiety and depression, improving their overall emotional resilience.
- Meaning and Values Exploration: Use absurdism and ACT principles to help the client find personal meaning and values, empowering them to live a more fulfilling life despite past and current challenges.
By integrating these therapeutic approaches, we can address the client’s complex needs, helping them manage their anxiety, process trauma, and find meaning and purpose in their life.