Topics/Issues Discussed

• Client and counsellor reviewed updates in clients life since previous therapy session.

• 39 weeks pregnant, has random contractions.

• Son has COVID -  really sick; lots of anxiety around that

• Client reports pitying herself

Themes & Impressions

• Sickness Anxiety - gets anxiety when family members are ill

• Psychological Rigidity

• Lack of responding to body ; never allowed herself to just listen to bodies needs.; including hunger

• Dissociative state - has lived the most of her life in a dissociative state, not fully connected to self.

• Numbness

Interventions

• Counsellor provided support and validation throughout.

• Counsellor obtained ongoing consent to proceed with therapeutic interventions.

• Socratic questioning used to challenge idea of pitying herself. Validation provided around pitying herself.

• explored practical ways to listen to body; hunger cues, body  check ins, breathwork.

• explored function of client ignoring her body - both good and bad.

• connected experiences of anxiety to polyvagal theory

• psychoeducation provided on dissociation

Plan & Homework

• Sessions to continue

• listen to body - food cues & check ins.

Treatment Plan/Therapy Direction

• Sessions & Treatment Plan To Continue

• Therapist to incorporate polyvagal theory to further explore dissociative tendencies

• Continue ACT for values work, CBT for anxiety management.

Case Conceptualization/Thoughts for Future Sessions

• Dissociation techniques