CASE Formulation - Amy\'s PTSD PDF

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Case Formulation of Amy’s PTSD Flashback   

Images of an accident (TD) Images of debris and broken bodies (TD) Images of the accident are so real… I smell it… taste it (56)

Primary NATs/Biases

SEVERE ANXIETY

There’s going to be a crash (TD) Something’s going to happen! (TD)

Amy had a very positive view about her life, and after the accident that view shattered and started to think negatively about everything around her. Therefore, her rigid, positive views made her vulnerable.

Reasoning bias: relying on intuition, as both of her thoughts are about the future. I know something’s dreadful’s going to happen (65) It’s got to collapse soon, best sit by the wall (82) Reasoning bias: extreme thinking, as she is coming to the worst conclusion that the ceiling is going to fall.

Secondary Difficulties She’s getting fed up with me (87) I know she hates being around me (97) Reasoning bias: relaying on intuition, as she is thinking about Claire’s thoughts. I’m no fun anymore (90) Reasoning bias: self-blame, as she is blaming herself for the problem.

Avoidance I don’t trust myself anymore… I daren’t drive (54) She will never test her core beliefs and keep thinking that the world is dangerous.

CORE BELIEFS The world is dangerous. I’ve no control over it or anything else (58)

CORE BELIEFS I’m unlovable Fear of loneliness- “I don’t want to lose her; I don’t know what I’d do without her” (96)

Avoidance Avoid talking to Claire about the issue therefore she’s going to keep relying on her intuition

Dismiss contradiction

Contradiction

Luckily though things were ok and it stays up while I was there (84)

It’s got to collapse soon (82) But the ceiling did not fall

Supporting evidence

Hypervigilance

Make Amy’s anxiety worse as she is going to find more danger because she is looking for signs.

Keep an eye out for signs of trouble (66) Constantly scanning the street (TD)

Dismiss contradiction Nuisance to Claire (SD)

Contradiction

Claire is pretending: “she won’t say what she’s really thinking because it’ll hurt me, but I can tell” (94-95)

She tells me she loves me (91) She held me while I went back to sleep (SD)

I know she’s getting fed up with it all (92)

KEY How the difficulty develops How the difficulty...