An Interview with a Depressed and Suicidal Patient

Summary of the Case

The case presents a 40-year-old patient who is a clinical psychologist by profession. Recently, the patient was abandoned by her boyfriend. For over 12 years, the patient had a history of intermitted depression. Besides receiving antidepressant drugs, courses of psychotherapy, and electroconvulsive therapy, he has also been hospitalized several times (Wedding, 2014). Over eight to seven months, the patient has seen a therapist. During the interview, the therapist noticed that the patient was depressed. Her previous history of suicide attempts also indicated that she had depression. During the first session, the therapist asked appropriate questions to critically assess the patient and find out her main psychological issues. He initially assesses the patient’s level of depression and suicidal ideation. Nonetheless, he assessed the patient’s expectations of the therapy process. Repetition was critical for the therapist to keep the dialogue active. During the assessment, the salient problem was the patient’s emergence of suicidal ideation. Besides, the patients’ hopelessness, was viewed as the most effective intervention point. The therapist then tried to pinpoint the split with her partner as what led to her current despair and suicidal thoughts in the following section of the interview (Wedding, 2014). The patient does work with the psychotherapist, and it becomes clear in the last section of the session that she is prepared to step back from her issues and think about potential solutions.

A Video about the Automatic Thought Record

Therapist: “So, how have you been feeling this week, please?”

Patient: “Just depressing, as usual. I have the impression that I constantly feel this way.”

Therapist: “What specifically this weekend caused you to feel depressed?”

Patient: “Yes, I broke up with my boyfriend, and it was really difficult because I started thinking about how I will never get into a relationship.”

Therapist: “We refer to that as an automatic thought. It’s an idea that repeatedly enters our minds without any conscious thought or consideration of whether the concept is true (Alavi et al., 2019). It has a negative impact on how we feel and behave. We should perhaps take a look more closely at a few of your instinctive thoughts.”

Patient: “Okay.”

Therapist: “Therefore, let’s record this automatic idea you are experiencing. I will never get into a relationship. Breaking up with your boyfriend was the situation that triggered the thought, ‘I will never get into a relationship’.

Patient: “Yes, that’s true.”

Therapist: “How did you feel when you had that thought while working?”

Patient: “I experienced profound sadness and hopelessness.”

Therapist: Can you now see how we think can alter our emotions and feelings?”

Patient: “Yes, I suppose I would not have felt as horrible if I had not done that thinking.”

Therapist: “We have discovered an idea that is potent for you. On a scale of 1 to 100, you gave this idea a 90 for sadness. I’d like to know how much of this concept is true before focusing a lot of energy and time on it. People frequently accept such notions at a glance when they’re feeling depressed or nervous, without first considering if they are real (Alavi et al., 2019). The signs that you’ve been dealing with would undoubtedly result from believing beliefs like this to be genuine. We will produce evidence supporting and refuting the thought when we test it in this manner.”

References

Alavi, N., Omrani, M., Alavi, N., & Omrani, M. (2019). Understanding and Rating Our Feelings, and the Thought Record. Online Cognitive Behavioral Therapy: An e-Mental Health Approach to Depression and Anxiety, 69-79. https://doi.org/10.1007/978-3-319-99151-1_7

Wedding, D. (2014). Case Studies in Psychotherapy (Seventh Edition). New York. Cengage Learning.