The Most Distressing Symptom

Julie, a 32-year-old graphic designer, presents distressing symptoms in several aspects of her life, such as low mood and a lack of motivation, she has low energy and finds it a huge effort to do just about anything, especially things that she once loved to do. She has not been socializing with her friends, as she no longer finds enjoyment in it and also finds it to be too much of an effort – even though she used to really enjoy these times.

From this, her relationships are suffering, and she is afraid that she will lose these friends if she does not do something about this. In her work life, she feels that the work she is producing is not of use, and has a very low view of herself and her abilities as a designer – she is becoming increasingly worried that because of her lack of acceptable work, she may lose her job as well. Julie has been presenting with these symptoms, which have been becoming increasingly prominent and distressing, since Christmas time, therefore she has been dealing with this for close to 12 weeks now. 3 weeks ago she was prescribed antidepressants by her general practitioner, but these have not seemed to help her with her symptoms. There are many perspectives and approaches of which would look at Julie’s case and could help her with these distresses, and we will look at three of those: Carl Rogers’ Person-Centered Therapy, Rational Emotive Therapy (Cognitive Behaviour Therapy) and .

Carl Rogers developed Person-Centered Therapy, which is based on humanism – which dictates that each of us have the natural abilities and potential to actualize, through which we can find meaning – however the theory also has ties to existentialism. Person-Centered Therapy could be an effective approach to help Julie, because of the motivation she feels for change – she expresses that she needs to make a change so that she does not lose her friends nor her job. This intrinsic motivation that she is expressing is significant to her counselling journey, in that she has accepted that there is a problem, and is motivated to change it. Julie would be a good candidate for Person-Centered Therapy because she is seeking out help herself, which speaks to her level of motivation to change and she will be able to take charge to direct conversation

Person-Centered Therapy could be effective for Julie, where she feels her depression is limiting her in her activities such as going out to socialize with friends, or affecting her effectiveness at her job, this approach to therapy could allow to give her the tools to help her feel empowered in different dynamics in her life. The empathy-based approach to Person-Centred Therapy

A therapist using an approach of Cognitive-Behaviour Therapy, more specifically Albert Ellis’ Rational Emotive Behaviour Therapy, would conceptualize Julie’s case as being caused by earlier experiences such as in childhood, these experiences leading to emotional disturbances could be irrational beliefs of significant others, parents, or peers leading the individual to then re-create these irrational beliefs throughout their lives. They may do this by actively reinforcing self-defeating beliefs, such as in Julie’s case she says ““I am stuck in a rut”, “Everyone else is doing better than me”, and “I’m going no-where”.

Those self statements reinforce the irrational beliefs, and the individual then begins to act out those beliefs – such as Julie is when she is not creating adequate quality work for her designer job, or when she does not hang out with her friends when they ask because she does not want to be a burden. Albert Ellis’ Rational Emotive Behaviour Therapy is largely based on the assumption that it is not the repetition of others’ irrational beliefs about an individual that causes the disturbance, but the repetition of the individual themselves that eventually leads to distress and self-defeat, as well as the emotions and cognitions playing a role in influencing behaviour, and behaviour influencing emotions and cognitions.

Approaches of Cognitive-Behaviour Therapy have significant evidence to help with mild to moderate depression, and therefore would be well-suited for intervention in Julie’s case.