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一例焦虑症的心理治疗案例-给力心理
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一例焦虑症的心理治疗案例

一例焦虑症的心理治疗案例
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发表时间:2015-02-06 14:16:37 552 0 0

求助者:女,28岁,职业女性,未婚。
主诉:心慌,心跳加速,半年多了。每天都有这样的感觉,上来那一阵,什么也干不了,一般持续5到10分钟,无法正常工作。有时候一天会出现7到8次这样的情况。老感觉心烦意乱,静不下心来。很焦虑的状态。生活中也经常的担心这个,担心那个,没有安全感。去过医院检查,做过检测心电图,也做过其它方面的各项检查,都没有发现任何疾病。医生建议看心理医生。
家庭情况:她是独生子女,她母亲长年生病卧床,她在家责任很强,从很小的时候,照顾母亲的责任就落在她肩上。她妈妈从她小时候身体就不是很好,她常常放学回家要自己买菜做饭,自己照顾自己,还要照顾她妈妈。她父亲是一个不会照顾人的人,也没有能力,很懦弱的一个人,能挣点生活费,勉强糊口。所以她高中毕业就开始打工养家。主要是做销售工作。很能干,成绩不错。不仅自己做好,也经常关心别人,帮助别人,在单位也是有很强的责任心,看到谁做的不好,她都心急。有什么事情,老担心别人做不好,必须自己亲自做,很多时候碰到事情,也担忧着要出现大问题了,感觉大难临头一样。
目前状况:现在已经不上班了,感觉自己什么也做不了,自信心开始不好。因为没有安全感了。同时母亲的病也在加重,照顾不好母亲,自己无法原谅自己。我问到她母亲的病,说是慢性支气管炎。是个老病了,现在什么药都用了,没有效果。她半年前,为了母亲的病四处求医,去了不少地方,每天都心急如焚的生活,很担心母亲离去,很自责,认为自己照顾不好母亲。有一天夜里,她开始第一次感觉到心烦,焦虑不安,坐着不舒服,躺着也不舒服,后来开始感觉到心脏碰碰的跳动的很快,感觉都要跳到嗓门了,头有出汗,很难受。有10分钟就好了。从那次以后,她开始担心自己的身体,越是担心,越出现那样的症状,她开始害怕了,就辞职了。在家里养病。
她现在认为自己有了严重的心理疾病了,干不了事情。每天有7到8次那样的感觉,她不知道怎么做了,很烦恼。我告诉她这些都是和你的生活应急因素以及她的性格特征分不开的,要战胜疾病,需要先来完善个性。

心理咨询师分析如下:
因为家庭情况,她从小就承担了家庭的责任,有着很强的责任感,家里的事情大大小小都是她来当家做主。她习惯了这种的操劳。同时长大后,工作中也可以看出她的这种人格特征中责任感很强的特点,不管谁的事情,她都操心,她不是领导,也做着领导的工作,谁的心她都操。她从来都不放心别人做事情,感觉自己做才放心,做事情也很心急,要干的事情不能拖延时间。
加上母亲的病,她在多重社会应激因素中出现了焦虑,这些是和她的性格本身分不开的。
治疗方法:
1.认知疗法:在治疗早期,让她对自己的心理疾病有个正确的认识,了解焦虑的三个成分(既认知,行为,生理之间的联系)同时需要帮助她理解:人对事情的解释(比如她母亲的病),不是事情本身导致了个体对事情的负面情绪体验。对此作为认知疗法的最重要的第一步。通过举例子,以及引导她自身的例子,帮助她挑战自己的某些歪曲认知。比如可能性夸大,灾难性思维。一点小事,就认为事情很重要,自己责任感强烈,担心的不得了。并给他布置作业,做自我认知检测,挑战忧虑性思维。
2.放松训练:就是通过打断担忧和自主神经系统过度唤醒之间的习得性联系,减轻与焦虑躯体方面相关的症状。
3.担忧的暴露:把她担忧的事情,没有安全感的事情用评分的方法逐一列举下来,建立自评量表。并记录她的焦虑水平。在放松训练的基础上,用想象的方式置身这些焦虑情景中。逐一脱敏。
4.时间的管理:我们把时间的管理分为三个部分。允许把工作和责任分给别人自信心的训练,合理的日程安排。在生活和工作中,允许把工作和责任分给他人。而避免大包大拦。比如让父亲也承担家的责任。父亲做事情,相信他可以做好。最起码的生活,应该可以做好,也可以帮她照顾母亲。自信心方面,相信自己可以承担生命的责任,同时也承认自己不会呼风唤雨,很多事情,自己尽力而为了,就很好了。合理的日程安排,而不是给自己太多的任务,凡事量力而行。
通过以上几个步骤的治疗,通过一年多的时间,她渐渐康复。治疗结束后也进行过几次回访,以巩固治疗。

 

 

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本文作者

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0岁
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公益助人

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长程个案

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续单率

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咨询时
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