This client is a 65 year old retired Accounts Manager who presents as physically well but describes themselves as permanently anxious, occasionally with low mood, and seeks help to explore their thoughts/feelings regarding the additional stress/anxiety experienced whilst dealing with their granddaughter’s diagnosis/treatment of Leukaemia. They also wish to find ways to cope generally with their anxiety.
Introduction and Initial Consultation
From our initial meeting a consultation form was completed and further information is presented below:
Client lost their mother at age 3, and lived with relatives between 3 and 8 years old yet felt they never belonged, which left them feeling alone/lonely. Client rejoined their family after their father remarried, gaining 3 step-sisters in the process. At age 16 they left home. At 18 client gave birth to a stillborn baby and experienced a relationship breakdown at that time, later marrying and producing a daughter. Their daughter married but became divorced after her daughter was born. To support both their daughter and grand-daughter this client became overly involved in their lives. After retiring, they were due to look after their grand-daughter more frequently, but in 2010 their grand-daughter was diagnosed with acute lymphoblastic leukaemia. Whilst their grand-daughter underwent all her treatment, this client and their partner gave additional emotional support to their single daughter. They describe this period as frantic, living in a vacuum/tunnel, detached from the outside world.
This client is after focusing on exploring/understanding their thoughts/feelings regarding the additional stress/anxiety associated with their granddaughter’s illness particularly after realising their mind had been in overdrive. They also wish to find some ways to cope generally with their longer-term anxiety. Both of these issues are their goals.
From information collected and deducing I have the skills to treat them, a contract was completed initially offering 6 therapy sessions.
Reassessment of the course of therapy will be a continual process.
Summary of Therapy Sessions
At our first session and after establishing how it was best for us to work, this client re-iterated many facts from our initial meeting and consultation, but what the client was after was the space to catch up with their own thoughts and feelings because they had become aware they were thinking about what had been going on realising they hadn’t spoken to anyone about it. They knew they felt generally anxious noticing how their thoughts were what they described as “going beyond the norm, often becoming irrational.” The client also knew their anxiety stemmed from their past, but they had reached a point in their life where they wanted to feel more comfortable/content within and enjoy their self/their journey for who they are as opposed to listen to the chatter of their mind. This became emotionally challenging for the client as they realised their opinion of themselves was quite low. It appears they also suffered from regular nightmares and sleep walking.
Allowing the client to speak and be heard was very important to them because at our next session, they arrived appearing to be of a much brighter disposition. During this session, the client reflected on our last meeting but also talked about how well their grand-daughter is now after all the stages and different medications at various stages of her treatment. The client finished by mentioning how agoraphobic they had felt and likened it to living in a vacuum/tunnel for the period of time their grand-daughter wasn’t well and now feels they are coming out of it. Conversation with the client changed track to talk about their families past, but in particular the departure of their mother who died of breast cancer when they were three and the separation of the siblings to live with other family members, coupled with their thoughts and feelings surrounding the trauma of these events.
At our third meeting, the client made reference to finding our work so far very helpful as they were beginning to feel less worried/less anxious to the point of entering their own engagements in their diary again. They were beginning to feel themselves again, beginning to take hold of their life again. The client talked about their daughter’s life before their grand-daughter was born. It appears that whilst their daughter was giving birth to their grand-daughter, their daughter developed a blood clot and begun haemorrhaging. It transpires their daughter later divorced their husband. As life settled…..their grand-daughter was diagnosed with Leukaemia.
Expressing their past worry and concern as to whether or not their grand-daughter would respond to treatment and the effects it had on them, the remainder of our session was quite emotional and tearful. Further information followed as the client’s older sister was often ill and became very ill six weeks after their own daughter was born. After the death of their own mother, their older sister had become like their mother. There were further exchanges of emotions and words and how the client often felt alone/isolated having repressed a lot of emotion over the years whilst they recognised they avoid change because it creates anxiety in them. As a therapist I was the first person they had ever talked to. To complete this session I showed the client the practise of breathing techniques to give them a coping mechanism in aiding relaxation whilst energising them and handed out information regarding the process of stress to help further understanding of how we react to circumstances.
At our next meeting, the client was looking forwards to having their grand-daughter to stay. They tell me they feel different within, notably far less tired/more energised. During this session a family tree was drawn (genogram). What followed was a summary of memories for the client from their mother dying to when they left home at 16 years old, plus an exploration of their thoughts and feelings connected to the issues mentioned. As the client gazed at the genogram, they realised the connectiveness of the age of their grand-daughter’s diagnosis of Leukaemia being similar to the age they were when their mum died of cancer. From this the client gained a lot more understanding as further connections were made, but in summary, it became apparent they worried about dying at one point a long time ago, leaving their own daughter without a mother just as it had happened to them. The session continued with the client not even knowing where their mother is laid to rest but wondering what they were able to do to find closure. The suggestion of writing cards/letters/preserving memories in boxes/in art or visualisations etc. The client liked the idea of a memory box as they had already been considering this for their grand-daughter.
In between the last session and this one, the client mentioned they had experienced a range of emotions from hurt/sadness to feelings of anger which began to ease when they reached a level of acceptance and understanding within. The client also wondered if they had ever grieved. When working with clients dealing with loss and grief a “tool” I find helpful is either a diagram of a grief curve, grief wheel or a whirlpool of grief because I find it useful in helping clients understand and see that what they feel is normal, it is OK to feel how they feel. With this client we looked at the grief curve and the whirlpool of grief. This client realised they had been carrying the grief for the loss of their mother for a very long time but by looking at the whirlpool of grief it gave them a sense of clarity. Parts of this session were emotionally tearful for the client but what came out of it was that they decided to dedicate a rose in their garden and consider writing a letter to their mum and place things in a memory box, which would include their father too.
Further sessions continued ………..