Case History for Chapter 4 Application Response

Case History for Chapter 4 Application Response essay

Case History for Chapter 4 Application Response
Ken is a 45-year-old Caucasian male, of average height and weight. He is married with two children. He often complains of “worrying about everything and not being able to relax.” He has been unable to sleep and “feel normal” for a long time, at least 5 years. Ken has been experiencing a lot more severity in his symptoms over the last month. Ken states that he has difficulties with thoughts that enter his mind that he calls “necessary.” He often experiences disturbing images of disease and thoughts about how these thoughts could harm him and his family. These images cause him to experience intense disgust and alarm as he can “see” the presence of all the germs and disease around him.
When Ken has these thoughts and images, he experiences a great deal of anxiety and he then has to clean the bathrooms, bedrooms, and kitchen that family members had used. He also described how this morning when he pulled out of the driveway he noticed a piece of litter on the curb. He pulled back in to the driveway, picked up the litter, and went into the house to throw it away. He then reports having to clean his pathway to the kitchen and is preoccupied with the germs, bacteria, and viruses all around him. He is worried that the illness will come and cause death. He reports that when these thoughts are present he must clean to relieve them. When he does not clean he feels a blast of panic and reports that he “must clean or else.”
Ken reports that in the last month he has been increasingly concerned about the possibility of death and harm coming to him and his family from a break-in as well. He states he is constantly checking and rechecking everything after his family to make sure the house is secure and that no one can enter the house to harm the family. He often locks, and relocks, the door just to verify it has been done correctly. He is extremely afraid of having his residence robbed even though he lives in a neighborhood that has had no real crime to report in the last 5 years. When he thinks about his house being robbed he repeatedly checks and rechecks the doors and windows, and the then cleans them so there will be no germs on the door handles and windows. If he cannot check the windows and doors, or be able to clean them, he becomes petrified with fear.
Ken is aware that his thoughts and behaviors are causing him harm and reports frustration, anger, embarrassment, and a sense of worthlessness regarding his inability to control his thoughts and emotions. Ken reports also that these thoughts and behaviors take up so much of his day (several hours) that he often forgets to bathe due to his constant concerns. Similar concerns have affected his work and personal relationships.
Ken reports that he was employed as a manager for over 5 years at a local convenience store. As a manager he was under a lot of pressure to make sure things are done right and that he had a very strong sense of control and need for perfection. Ken reports this was demanded by his job. Ken thinks he did a very good job as manager, but was let go recently because of his “managerial style.” Ken reports that internal problems forced him to constantly check and recheck his reports and figures, and he demanded more out of his employees. He found it increasingly difficult to leave his office. His high need for order had become increasingly more rigid. He reports his thoughts about disease also escalated during this time period and the pressure of them conflicted with his ability to carry out tasks.
Ken reports a strain in his relationship with his wife due to his intrusive thoughts and behaviors. He reports that his wife has become increasingly angry with him, yelling at him when he requests reassurance regarding his thoughts. He reports also feeling concerned about the impact this will have on the quality of their relationship. His intense desires for cleanliness while neglecting his own personal hygiene has not improved matters related to intimacy with his wife. He states he loves his wife, but he can’t control his thoughts and behaviors. He also fears that his relationships with his daughters are being affected.

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Case History for Chapter 4 Application Response

Case History for Chapter 4 Application Response

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