Essay Example on Problem to their relationship and is almost ruining their Marriage








Sally is a 32 year old married woman and a mother of a five year old boy who works a transcriptionist Her husband works as one of the executive managers with a healthcare organization Their son was born during her third pregnancy after having previous miscarriages Her parents got separated when she was 8 years old although she still maintains a good relationship with both of them In the last two years she has had difficulties falling asleep Even those times that she manages to fall asleep it still does not relieve her as she wakes up feeling exhausted This has had a great impact in her work and family as she is not longer able to concentrate or to meet her deadlines It is a cause of concern to her as she is afraid of getting fired Sally is also anxious about the health of her son She takes her to the physician almost every month and insists on his the performance of unnecessary medical tests

He has constant minor illnesses that shock her and place her in a state where she expects the worst possibilities Her husband has tried to assure her that he is well but it does not work She feels like she is a bad mother as she considers the first two miscarriages a result of her failure She has constant complaints about random rapid heartbeats that make her anxious and can result in a panic attack Most of the time the attacks make her breathless and shaking She sweats a lot but has a dry mouth In addition she has neck and back pains She has tried some relaxation classes and attended yoga classes but soon gives up stating a feeling of awkwardness and silliness She is always blaming herself for her failures and clumsiness She has since gained weight from eating too many sweets Sally also admits that she is often irritated or overreacting Any bad news of accidents or injuries keeps her awake all night as she imagines that the same can happen to her family Due to their son's illness and many other likely dangers she does not want to travel This case has brought constant fights that is a problem to their relationship and is almost ruining their marriage At the end Sally s husband insisted that she must see a mental health professional Theoretical Explanation It is clear that Sally is worried to extreme pathological levels She suffers from a number of unreasonable fears which may take longer According to the Cognitive Behavioral Therapy or CBT there are a number of techniques that can be sued for the treatment of patients exhibiting such disorder characteristics The concepts of cognitive model indicate that the most common cause of mental disorders is thinking in a dysfunctional way 

This means that people tend to have irrational beliefs that influence their subsequent reactions as indicated by Ellis 1977 It can be seen in the case of Sally where she thinks that she is a bad mother based on the two previous miscarriages she is convinced that her son is sick and does not accept professional medical opinions or the attempts to convince her by her husband It is these that lead to her unstable behavior and emotions leading to distorted perceptions in life Alford and Beck 1997 indicate that the cognitive therapy that can be offered for general anxiety disorders should include the techniques that aim at identifying and modifying the thoughts and beliefs that affect the progress of the patient during treatment In essence the first thing should be to establish and maintain confidence between the doctor and the patient It is vital to give Sally explanations on the nature of her disorder and the explanations that are provided by the CBT This is done with the application of special techniques that include the Socratic dialogue to show her that her thoughts are irrational to the point that they affect her emotions and her behavior For Sally it is significant that her terminated pregnancies are discussed to make her understand that she had nothing to do with the miscarriages It will help her eliminate the statement that she is a bad mother and that those children did not want her

 This stage involves the ability by Sally to monitor her progress by practicing the different thoughts about the situations in her life in the everyday perspective by keeping it in her diary She should be in a position to describe a specific situation the feeling of anxiety or fear that is related to it and her subsequent thoughts in this respect This should be followed by the discussion of these episodes with her therapist Cognitive restructuring is the followed by the ability by Sally to understand her behavior and to change to a more positive and meaningful way of thinking This is achieved after making her aware about the different coping skills It is important for her to learn the varied ways with which to manage and resist stress on her own It is a method that was developed by Donald Meichenbaum in the effort to change the responses by the patient towards stress without worry or anxiety It is an approach that involves provocation that encourages the patient to apply skills of stress management in difficult situation Meichenbaum 1975 This training is attained in three stages that include conceptualization the acquisition and rehearsal of skills and the application as well as follow through The conceptualization stage will help to guide Sally to understand that she is currently using inappropriate coping mechanisms It is from this that she will be in a position to realize that responses that involve distress and anxiety are not appropriate and are thus not the only solutions

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