Question

Nadine has been dating Jim for eight years. They began dating in college and Nadine reports that she remained supportive of Jim throughout his years in medical school and residency as a doctor. Nadine reports that it has not always been easy for her as she often will feel neglected by Jim due to his busy schedule, though she has never communicated these feelings to Jim, since she does not want to appear “selfish” or “nagging” and she does not want to be a cause of further stress in his life. Nadine was recently diagnosed with kidney disease, which has created a considerable amount of stress in her personal and professional life. She reports that her graduate school program was not understanding of her need to miss classes due to multiple doctor appointments. Furthermore, she was not able to request a medical leave from her program, which ultimately led to her having to leave her graduate program due to her medical issues. Nadine reports that while she has discussed these current stressors with Jim, he does not always appear to understand the loss she is feeling. She reports that Jim will tell her that she should seek legal action against her school and that she should not be so passive. Nadine reports that Jim is often dismissive regarding the severity of her condition, noting that she will be fine. Nadine expresses a desire for Jim to accompany her on doctor appointments, however she will not ask him as he has repeatedly mentioned how busy he is and how little time he has for himself outside of work. Nadine reports that she will often cry to herself every day due to the fear she has regarding her health condition as well as her feelings of failure that she was not able to complete her studies due to becoming sick. Nadine has expressed that she would like to have Jim join a session in order to help her communicate what she has been feeling, as well as address the continued detachment she reports within their relationship. Jim has thus far not agreed to join Nadine in therapy, reporting that his schedule does not make it possible and he does not believe that therapy is necessary to address the issues within their relationship, but rather that it is Nadine’s passivity which is causing her unhappiness.

1. What are some negative automatic thoughts that you identify Nadine to have? What are negative automatic thoughts that you identify Jim is having? Describe cognitive behavioral techniques that you would use with this couple?

2. Do you believe that Jim and Nadine will be able to work through their conflict? If yes, what are the indicators that this couple has a chance to solve their problems? If no, what are the indicators that this relationship is headed toward the end?

Answer 1

1.

Negative Automated thoughts of Nadine are:

• She will not be able to complete her studies due her ailment.
• Jim is not concerned about the seriousness of her matter.
• Jim neglects her for his medical profession.

Negative Automated Thoughts of Jim.

• They don't need a therapy.
• That the reason for unhappiness is due to Nadine's passivity

The best Cognitive Behavioral Technique to address this issue could the ABC technique.

• The "A" of the technique is to focus on the Activating Event, as one of negative automated thoughts in this scenario is the disease of Nadine.
• The "B" of the technique is focusing on the Belief, as in this case is Nadine's belief that she could complete her studies.
• The "C" of the technique is focusing on the consequences. As in this case is stress, and the strain in the relationship.

The clients are made to focus on the aspects of the problem, and are made to introspect their behavior, that would give them new cognitive insights and would help them to overcome their negative automated thoughts.

2.

If Jim and Nadine could put an effort to overcome their negative automated thoughts, this conflict in relationship could be resolved. They need to understand each other by keeping aside their negative bias, inorder to workout their relationship.