James is 61-year-old divorced male who has suffered from symptoms of anxiety for years. He will wake up feeling great
James is 61-year-old divorced male who has suffered from symptoms of anxiety for years. He will wake up feeling great
James is 61-year-old divorced male who has suffered from symptoms of anxiety for years. He will wake up feeling great, and then without provocation, he develops a sense of panic. He says his heart races, and he feels nauseated, dizzy, and feels certain he is dying. His daughter is an FNP, and James calls her almost daily, convinced he is having a heart attack. He has undergone extensive physical exams and evaluations, but all tests have been normal. He is in excellent health and takes no medications.
James is a high school history teacher and has always enjoyed his job. He is very active and enjoys coaching the school’s debate team but hasn’t dated since his divorce five years ago. He is also very close with his children and grandchildren. His family history reveals his mother had generalized anxiety and his father died in a car accident at his age. He does not want to start taking medication but is open to therapy.
For the response posts to at least two of your peers:
Provide a suggestion for a different type of therapy and technique. There are many ways to approach therapy and no right or wrong answers. If you do not agree with your peer, then say why in a polite and nonjudgmental way. We are here to learn from each other. Explain why your suggestion would also be appropriate.
Post 1 :
Humanistic Therapy is optimistic and all-inclusive. With humanistic theory therapist is nonjudgmental and seeks to help the client develop a healthier sense of self. It is built on Abraham Maslow’s hierarchy of needs and is based on human desires that are reachable to reach their best potential. The goal in this theory is for the patient to become fully functioning and independent. “A person who is engaged in the process of self-actualization.” (Johnson et al., 2016)
During therapy, the patient is asked what issues they want to work on and what they hope to achieve through therapy. It is important for the patient to understand and verbalize their current struggles, so they can work on their problems and move forward.
Gestalt Theory: This theory is basically an extension of humanistic theory. “This approach is holistic, interactive, and focuses on existentialism—the present life and challenges—rather than delving into past experiences.” (Johnson et al., 2016)
Two components of Gestalt theory are the “Empty chair: Sometimes when we do not say what we want to say, and it leaves a void inside us. In this exercise, In this exercise the patient is able to verbalize their feelings to an empty chair imagining the person, they had wished to verbalize to, is sitting in the chair. The “Body Awareness: Clients frequently manifest emotional discomfort by fidgeting or shallow breathing. When the therapist notices the physical changes, they bring them to the patient’s awareness, while asking them what feelings and emotions they are feeling. (Johnson et al., 2016)
Freudian psychodynamic psychotherapy: “All behavior is purposeful and meaningful” (Johnson et al., 2016). This theory goes into detail about unconscious thoughts and conscious behavior. For example: People who forget where they parked their car because they do not want to go where they must go. This theory “seeks to bring repressed experiences and feelings into awareness and resolve unconscious conflicts in a person’s current life” (Johnson et al., 2016). The only downside is that Psychodynamic therapy works on people who are highly intellectual, not on patients who are intellectually challenged.
When I compare Humanistic Therapy, Gestalt Therapy, and Psychodynamic therapy, I would choose Humanistic therapy for James. I chose this theory for James because it is self-empowering and increases one’s self-worth. James is a man in his 60’s, he is divorced, he hasn’t dated anyone in 5 years, and he works as a high school history teacher.
Overall, apart from the symptoms of anxiety, it seems that James is living a healthier life. Working with James, with the Humanistic theory in mind, I will discuss with James the current stressors he has in his life, his fears, and things that make him feel anxious. We will discuss ways to make sense of those thoughts in a systemic way. I will then discuss with James what he wishes to get out of the therapy. Lastly, we will discuss his symptoms and what he does to alleviate them. Based on these answers, James and I will create a plan to alleviate panic attacks when they occur. Such as remove oneself from places with commotion example: supermarket, restaurants, etc., sit in an empty space, and take deep breaths. “Clients with higher levels of stress and anxiety may benefit from working with therapists who offer more direction.” (Humanistic therapy 2022)
References
Sussex Publishers. (2022, April 8). Humanistic therapy. Psychology Today. Retrieved March 15, 2023, from https://www.psychologytoday.com/us/therapy-types/h…
Johnson, K., Vanderhoef, D., & Johnson, K. (2016). Psychiatric-Mental Health Nurse practitioner. American Nurses Credentialing Center.
Post 2:
Freud believed human behavior could be explained by intrapsychic processes and interpersonal patterns outside of a person’s conscious awareness and based on childhood experiences. Psychodynamic therapy seeks to bring repressed experiences and feelings into awareness and resolve unconscious conflicts in a person’s current life. Those with a reasonable degree of intelligence and a history of stability in relationships and daily functioning respond well to this therapy. It is ineffective in individuals who are psychotic, mentally challenged, or otherwise have limited functioning because they cannot access and articulate memories (Wheeler, 2020).
Humanistic theory and person-centered psychotherapy, which Carl Rogers created, are fundamentally distinct from Freud in various aspects. He believed that pathological conflicts and unconscious desires were the exclusive focus of psychoanalytic theory (severe mental health disorders). The humanistic perspective is thus positive and holistic, with the therapist remaining nonjudgmental while assisting the client in developing a healthier sense of self (Wheeler, 2020). It is based on Abraham Maslow’s hierarchy of needs and recognizes that humans strive to achieve self-actualization.
Gestalt therapy was created in the 1940s by Fredrick and Laura Perls as a type of humanistic psychotherapy (Wheeler, 2020). This method emphasizes existentialism—the present issues—rather than focusing on the past. It is holistic and interactive. Gestalt therapy can therefore be categorized as humanistic-existential psychotherapy, although it also draws on a wide range of other theoretical tenets. Gestalt therapy aims to help clients regain their inherent capacity for self-regulation to lead more true and fulfilling lives. Rather than assigning blame, gestalt therapy emphasizes the significance of comprehending and accepting responsibility for the current circumstances of a person’s existence.
I recommend James’s Psychodynamic therapy. This is a specific kind of talk therapy based on the theories and tenets of psychoanalysis. In actuality, discussing issues in a therapeutic atmosphere can benefit the patient. In contrast, psychodynamic therapy emphasizes the patient’s interactions with the external world and less on the patient-therapist relationship. The patient is encouraged to express themselves freely, including present concerns, worries, desires, dreams, and fantasies. The goal is to experience a remission of symptoms but also derive such benefits as increased self-worth, better use of a patient’s talents and abilities, and an improved capacity for developing and maintaining more satisfying relationships. Psychodynamic therapy differs from other types of therapy in that it emphasizes identifying, acknowledging, comprehending, expressing, and overcoming negative and contradictory feelings and repressed emotions to improve the patient’s interpersonal experiences and relationships. This includes assisting the patient in comprehending how past repressed emotions influence current decision-making, behavior, and relationships. Psychodynamic therapy also seeks to assist patients who are aware of and understand the roots of their social problems but cannot resolve them independently. Patients learn to analyze and resolve their current difficulties and change their behavior in current relationships through deep exploration and analysis of earlier experiences and emotions.
James can utilize cognitive behavioral therapy to help identify the root cause of his anxious thoughts. Psychological conditions, such as marital problems, anxiety, substance abuse, and eating disorders, can benefit from cognitive therapy. The main objective of cognitive behavioral therapy is to help patients understand their current ways of thinking and behaving and equip them with the proper tools to change their maladaptive cognitive and behavioral patterns. (David et al., 2018). James can develop problem-solving skills to deal with stressful situations and better understand his behavioral patterns.
David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00004
Wheeler, K. (2020). Psychotherapy for the Advanced Practice Psychiatric Nurse. Springer Publishing Company.
Requirements: Minimum 300 words
Nursing
150 each
Also in my original post I recommended Gestalt therap
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