Treatment
To combat her copious disorders, Diane has chosen to seclude herself in a controlled environment, i.e. the house, to preclude interaction with all possible triggers. It must be acknowledged that her coping strategy has been successful: her symptoms and OBs, particularly those of her anxiety disorders, have been drastically reduced since her self-imposed isolation. Despite these outward signs of improvement, we believe that Diane’s disorders remain as formidable as ever within her mind. Additionally, it appears that two of her current disorders, IED and DD, developed as direct results of her extreme coping method. We believe that the anxiety disorders lying dormant within Diane’s mind comprise the core disturbances of her inner psyche. Therefore, we must first combat her GAD, PDA, and SAD in order to conquer her IED and DPD.
Diane’s treatment includes a series of Implosive Therapy (IT) and Imaginal Flooding (IF) sessions: we walk Diane through several IF and IT hypothetical and imaginary scenarios likely to induce her OBs. At various intervals, we ask her to gauge her level of anxiety using the Subjects Unit of Distress (SUD) 10-point scale, with “one” meaning no distress and “ten” meaning severe distress. Thus far, we have been pleased with the degree to which these sessions have improved Diane’s imaginary understanding of her disorders. We hope soon to progress to more traditional forms of Cognitive Behavioral Therapy (CBT) and In Vivo tasks, but feel her anxiety is too volatile and her mind too delicate at this point in her treatment. We fear that, were she to encounter actual, real-life scenarios requiring her immersion in threatening situations (TS), she would go into total relapse (TR), forcing treatment to restart Back At The Beginning (BATB).