Evaluation of a Client with Dysthymia by a Humanistic Therapist

1.     Therapist: What is it you’re exactly experiencing?

2.     Client: Well, I feel rather tired today and wasn’t sure if I wanted to come in today.

3.     Therapist: It seems as if you had doubts about coming today.

4.     Client: Yeah…yeah I guess so.

5.     Therapist: What is it? Something seems to be holding you back. You can tell me.

6.     Client: I…I didn’t think anyone would want to listen to me. I feel like a waste of time.

7.     Therapist: You seem to believe you don’t matter to anyone. Of course, this is not true. I am here, aren’t I?

8.     Client: Yeah…yeah I guess so. I guess you’re right.

9.     Therapist: So, what exactly do you have on your mind?

10.  Client: Well, I feel as if no one cares about me. I don’t think people should be with me. I feel like a waste of time for everyone.

11.  Therapist: So you feel like no one cares about you? You think you don’t amount to anything?

12.  Client: Yeah, I guess you could say that. I just always feel so hopeless.

13.  Therapist: You feel hopeless? How so?

14.  Client: Well, whenever there’s a problem I feel like whatever I do, it can’t be helped.

15.  Therapist: So you’re feeling helplessness.

16.  Client: Yeah, I feel helpless. I also feel like I can’t compete with anyone.

17.  Therapist: Interesting. How do you feel like you can’t compete?

18.  Client: I feel like if I ever try to do something, someone else can do it better.

19.  Therapist: You feel like there is always someone better than you. Why?

20.  Client: Ever since I was let go from my job, I felt like a complete loser. I mean, no one got let go from that job except me.

21.  Therapist: You seem to feel that you, being the only person to have been let go, makes you inferior to other people. Why do you think you were let go?

22.  Client: Well, I…I don’t really know. I guess I wasn’t performing as well as I used to.

23.  Therapist: That makes sense. Why do you think you weren’t performing like you used to?

24.  Client: I guess…I think I was distracted.

25.  Therapist: You feel as if your mind wasn’t focused on what matters most?

26.  Client: No! I mean, yes. I…I don’t know.

27.  Therapist: You’re confused. What was on your mind at the time you were let go?

28.  Client: I…I guess I was too focused on…no, that can’t be it.

29.  Therapist: What can’t be it?

30.  Client: I…I had just gone through a break-up. But I swear, it was mutual; we both decided it was for the best.

31.  Therapist: The breakup had a bigger effect on you? It was what was distracting you?

32.  Client: Yeah…yeah, that seems to be it. After that day, I felt as if I would never be able to get into another relationship again.

33.  Therapist: You felt as if your self-esteem had been diminished.

34.  Client: Yeah, something like that.

35.  Therapist: Well, I think it is important for you to realize that everyone goes through breakups. Of course, they’re hurtful and they can cause a lot of pain. But just because you have lost one person, doesn’t mean you’ll lose everyone. And going through a breakup doesn’t make you a failure. In fact, the breakup could be a sign of success. A sign that you’re one step closer to moving on to a more positive relationship.

36.  Client: Yeah, you’re right. I guess I never thought of it that way.

37.  Therapist: Well, it was great for you to open up today. I look forward to seeing you again next week.

38.  Client: Yeah, this was good. Thanks for listening.

39.  Therapist: No, thank you for being so cooperative.

 

  1. What were the main challenges for your client? Explain.

My client was dealing with dysthymia. In the beginning, my client reveals he feels that he is a waste of time for everyone and later continues to say how he thinks he will never be able to get into a relationship again. This shows one symptom of dysthymia, which is feeling of low self-esteem. Also, the first thing the client tells the therapist is that they were feeling tired today and weren’t sure if they would want to come in. Finally, the client also displays signs of hopelessness and helplessness when they state that whenever there is a problem, it cannot be helped.

  1. What were the main challenges for your therapist? Explain

The main challenge for the therapist was getting the client to open up. Clients can be embarrassed to share at first, and this was an important fact that needed to be included in the dialogue. As a humanistic therapist, it was difficult to not interpret the client’s experiences. For example, when the client said they felt as if whenever it is a problem it cannot be helped, it seems like that should be interpreted as a result of the client’s breakup. However, being a humanistic therapist, that is not allowed and instead the therapist had to rephrase whatever the client said for them to realize exactly what they’re experiencing.

  1. Why is this therapy or combination of therapies the best for the disorder? Explain.

A humanistic therapist was ideal for this disorder because it allowed the client to hear what they were feeling. Whatever the client was experiencing before, they weren’t able to fully comprehend what they were going through. When the client had a chance to talk out the situation in a welcoming environment, they were able to realize why they were feeling the way they were. I feel if this client had gone to a psychoanalytic therapist, the interpretations would have been more confusing and perhaps more biased and based on the therapist rather than the client.

  1. How do you feel this type of therapy could be improved or be more effective? Explain.

I feel this type of therapy could be improved if it allowed more a little bit of interpretation. When the therapist was repeating what the client had said, the client was able to realize exactly what they were saying. But if the therapist was able to offer a little bit of insight, the client may be able to realize what they’re experiencing faster. I feel that bit of interpretation can nudge the client into fully understanding what they’re going through. The only problem with interpretation is that the therapist could be biased and interpret other’s experiences based on the therapist’s experiences. This could mean what the client is going through may be something totally different than what the therapist may have experienced, but the therapist would insist it is the same.