Using cognitive behavioral therapy (CBT), counselors aim at making the patient suffering from adult separation anxiety disorder to regain their control over any reaction to external stimuli and stress. According to the research, CBT was very helpful to those patients, who might have secondary anxiety disorder, dependency on alcohol and other substances, and depression (Weilding, 2012). This technique helped patients suffering from adult separation disorder to identify thoughts that affect them during separation causing anxiety. After patients had successfully identified these thoughts, they were taught on the techniques used to develop a plan for dealing with the ones.
James used CBT to help Anne deal with the fear of being separated from her husband, Frank. Anne stated that she always felt stressed, when she did not hear from her husband for more than twelve hours (Weilding, 2012). It was because she felt that maybe he might have been killed or was lying injured in a remote place. Whenever her husband was free, Anne skipped her normal duties and tasks to avail herself of an opportunity to spend more time with him. It made Anne miss a lot of things, since she would rather spend every minute with her husband than do other things that affected her life (Weilding, 2012). In case her husband happened to go for any business trip, Anne spent sleepless nights wondering whether her husband was safe. In some instances, thoughts came into her mind that maybe her husband would meet another woman and fail to return home. It made Anne cry every time, whenever her husband went on business trips.
Using CBT, James told Anne to keep a diary daily, where she would record all anxiety attacks and thoughts about her husband. It was in an attempt of helping her know how to identify anxiety reactions and thoughts as soon as they occurred. After this, James taught Anne how she could challenge and understand anxiety reactions that affected her due to the separation from her husband (Wielding, 2012). Anne was made to understand that all fears, which she sometimes had, were unrealistic. It forced her to identify false assumptions causing anxiety at all times, whenever she was separated from her husband. CBT was successful, and she learnt of new ways of coping with her fears.
Priyamvada, Kumari, Prakash, & Chaudhury (2009) also used cognitive behavioral therapy to treat an Indian patient suffering from anxiety disorder. He was 27 years old and suffered from social phobia that resulted from anxiety. He was not married being the youngest child in his family. The patient said that his confidence was low, and he was always afraid of being in any crowd. He had negative thoughts many times, feeling inferior in comparison to other people and disliking interacting with them in the community (Priyamvada et al., 2009). Conducting the study on this patient, the researchers identified that his mother was overprotective towards him being a young boy. In addition, his father was a dominating figure in their family, who did not like being told to do anything by any other person. It made the patient be afraid at all times, when he was growing up. He always depended on other people for the completion of simple tasks. The patient started avoiding crowds, since he was afraid of interacting with other people. It made him develop low self-esteem, since he thought people were avoiding him. Whenever the patient interacted with others in public, he sweated a lot.
The researchers used several therapeutic packages in order to offer treatment to this patient. Some of them included systematic desentization, cognitive restructuring, Jacobson’s progressive muscular relaxation technique, psych-education, and exposure and response prevention technique (Priyamvada et al., 2009). They had conducted cognitive behavior therapy on the patient for about 15 weeks. The goal of these sessions was to prepare the patient for facing all situations that he avoided due to anxiety. In addition, the researchers wanted to modify all negative thoughts that he had into positive ones. After seventeen sessions of cognitive behavior therapy, the patient felt a significant improvement. His self-esteem rose as compared to the one before therapeutic treatment. Moreover, the level of guilt and the feeling of anxiety also decreased. The patient started attending social gatherings, and all negative thoughts that he had about himself were modified. Therefore, he could live a normal life just as other people in society.
Exposure therapy is also used to treat patients suffering from adult anxiety separation disorder. Psychologists use this technique to help patients gain control and face any fears that they may have (Neudeck & Witchen, 2012). It is also used to deal with distress after a particular trauma. In order to treat adult separation anxiety disorder using exposure therapy, the psychologist should be careful and avoid re-traumatizing the patient seeking treatment. This condition especially happens, when a particular patient suffers from post-traumatic stress disorder. In this case, the psychologist may use the flooding or desensitization techniques. When he uses the former, all memories from a particular trauma are confronted at once. In contrast, the latter is mostly administered to individuals having severe traumas. In such cases, the psychologist may decide to use the relaxation technique in order to cure a particular trauma affecting a patient. Exposure therapy is also applied to help patients deal with any phobia that they may have. Such people are exposed to these, which help them cope with all fears. Psychologists use both relaxation exercises and imagery to help patients overcome the fears.
Michael helped Washington deal with the fear of being separated from his wife using exposure therapy (Neudeck & Witchen, 2012). Washington owned a business in Arizona. His wife was a marketing manager in one of the firms. Her work required her to travel in order to market new products introduced by the company in neighboring states. Washington hated it, whenever his wife went on these business trips. He sometimes felt nauseated and hard to concentrate, whenever being separated from her for more than one day. At one time, Washington advised his wife to consider quitting her job to spend more time together. However, they both agreed that she needed that job to pay for their daily expenditures. Using exposure therapy, Michael helped Washington overcome adult separation anxiety disorder and systematically confront the fear of being separated and losing his wife. At first, he was taught on how to face the latter and could predict instances when it would occur. After all exposure therapy sessions, Washington was successful in controlling these fears, making them less threatening (Neudeck & Witchen, 2012).
Maldonado, Neri, Calafell, & Salazar (2009) conducted a study in order to establish whether virtual reality exposure therapy can be used to treat school phobia. It was because they discovered that the latter made students have an excessive fear of events, such as public speaking, doing school examinations or being bullied by other classmates. It caused students to perform poorly in classes or consider the option of dropping out of school. The researchers selected eighteen participants, who had school phobia to participate in their study. The virtual reality environment facing the participants of this study helped to reduce the nature of phobia related to school largely (Maldonado et al., 2009). It was built considering all triggers to anxiety found in the school environment. Exposure therapy lasted for about eight sessions. Six of them concentrated on relaxation training and providing exposure to students by using virtual reality and imagery.
Developing Case Analysis
The failed marital relationship between E. D. and his wife made the former develop depression. According to the research by Bech & Alford (2009), a person may develop such a state after undergoing through stressful life events. The latter include breaking up with a boyfriend or girlfriend. Students may become depressed when they fail a class. In case this happens, they may lose their self-esteem and sometimes drop out of school. A person may also become very depressed, when someone close to him/her dies. The researchers also established that children, who had undergone child abuse, had a very high possibility of becoming depressed as compared to other students (Lam, 2012). When a child witnesses domestic violence between his/her parents, there is also a very high possibility of developing depression, because he or she grows up to become an adult. Couples, who separate or divorce, may also face such a state. An employee may also become depressed after losing a particular job, where he has obtained his income. Considering the case of E. D., he became depressed due to being separated from his wife, with whom he had spent a lot of time. In addition, he was separated from his children, whom he loved very match.
Psychologists have established that when a person becomes depressed, he/she starts feeling very sad, miserable, unhappy, and down. In case the symptoms continue to worsen, the patient may start developing extreme sadness, frustration and anger, and may eventually become ill. E.D. stated that he felt angry in many instances. It could be contributed by depression caused by being separated from his family. E.D also underwent child abuse, when he was young. Although he stated that physical abuse received from his physical brothers was normal, it could have contributed to him developing depression.
Depressed patients exhibit several symptoms, namely, they are always agitated, or may become restless and irritable (Lam, 2012). In addition, they may have difficulty in concentrating on one thing, and become isolated and withdrawn. In some instances, patients may have a dramatic change in their normal appetite, making them gain or lose more weight as compared to their previous one. Such patients may also have trouble sleeping or end up sleeping for more hours than before becoming depressed. In addition, they sometimes have extreme guilt issues. Some of the depressed patients have feelings of helplessness and hopelessness. When E.D. explained how he felt through the phone, he stated that he was sad, anxious and had stress of restlessness and anger. These are the symptoms of depression described above.
During the first session, E.D. confirmed that he remembered having anxiety when he was a child. According to medical experts, anxiety is a severe disorder that may cause a person to become extremely nervous and to have a fear while performing certain tasks (Barlow, 2008). Several factors may cause anxiety. Researchers have established that environmental factors may contribute greatly to it. One of them is a trauma originating from such events, as the death of a loved one. E.D. lost his mother when he was only four years old. She died from heart failure. This event could have traumatized E.D. making him develop anxiety. In addition, he underwent physical abuse being a child. His brothers used to beat him. It could be among the factors that caused E.D. to develop anxiety when he was a child.
School stress may also cause a person to develop extreme anxiety. According to E.D., truancy was an issue throughout his high-school years. One of the reasons that could have made him develop truancy was stress received while he was at school (Simpson, Neria, & Schneir, 2010). In addition, he stated that he could not relate well with other students. A poor relationship in his high-school years might have caused him to develop anxiety. E.D. might also have been having stress in his university years, since he could not develop a meaningful friendship. Anxiety could have resulted from this, since he distanced himself from other people.
E.D. also reported to psychologists that he had anger management problems. Patients with such disorder cannot control their feelings of rage. In addition, they do not know how to control anger and frustration emotions, if they happen to affect them. Medical experts argue that patients, who have anger management problems, hold their anger for a very long time (Adams, 2008). It causes them to have a risk of developing health problems, since they may be affected by high blood pressure. In some instances, patients may be angry over a particular issue for more than five years. It may be caused by something that has happened in the past, because people remember this issue. Such patients may also get angry over anything affecting them. Some get irritated about anything. Issues, which other people find to be petty, offend them. These patients may also allow their anger to control them. Due to this, such people try to look for things that will make them become angry, since they feel at peace when being angry over something or with someone (Woodruff, 2008). As a result, they may engage in constant violence. Patients with anger management issues may sometimes have intense anger to the extent that their vision starts being blurred. They may also have difficulty in breathing.
Anger management problems could have caused the failure of the marriage between E.D. and his wife. According to the former, they had been happily married for twenty years. They had grown-up kids, and it suggested that their marriage was previously successful. However, E.D. said that his anger had caused all major problems that recently affected their marriage leading to the failure. Since E.D. could not manage his anger, he ended up becoming depressed.