*** Note: As with this and all future case studies, the basic details will be based on a true event but various details will be switched or melded together to protect the privacy of my clients***

Working as a Licensed Professional Counselor (LPC) for Kranz Psychological Services, I have informed my schedulers of the types of clients I see so it is possible for them to schedule without contacting me first. And the clients do not always tell the scheduler exactly why they want to see me. 

So, I was a bit surprised when a middle aged female presented herself for counseling by starting her story with, “My husband of 15 years suggested I see you for therapy because I can’t stop following or tracking him. I text him several times a day and I always want to know what he is doing. I should know better because he’s always been faithful as far as I know but I can’t get past the feeling that he is cheating on me.”

I work very hard to be objective, to try to get the other person’s side of the story (even when I don’t see couples for therapy), and to stay with assuming the best until the facts show otherwise. 

After this new client revealed she was telling me the truth by sharing her own texts to her husband and by talking briefly with him on the phone, I had a strong enough case that my client was indeed stalking her husband. He was not amused or flattered by these actions by her and in fact, felt that she didn’t trust him and she was accusing him without any proof. 

As any practicing therapist would do, I proceeded with a biopsychosocial assessment which is a combination of the client’s history including family (of origin and current), physical health, and overall mental health plus an inventory of how the client is currently processing their world (hallucinations? delusions? etc). 

I worked through various “resource building” exercises next which might include “containment exercises,” a “Safe Space” work through, identifying any people in their entire life who would be considered “good enough” caregivers, and emotional “testing” exercises. These will usually both help the client relax and regulate their emotions but also reveal what may be contributing to the reason they chose to pursue counseling. In this case, “resource building” was successful on many fronts.  My client was able to relax and we learned some very important information about her childhood and a primary caregiver, her father. 

My client’s father would likely be what we would today call a “Narcissist.”  He very much demanded that the “world revolve around him” in many ways in the family, his friends, and his work life.  At home, one particular peculiar behavior he demanded of his daughter, my client (age 10 at this time), was that every morning, she had to bring him a cold diet coke before he got out of bed.  This was usually around the same time in the morning and my client usually was able to meet the demand by planning ahead and setting an alarm. 

One morning, she awoke to realize she had neglected/forgotten to place a case of diet cokes in the refrigerator so they would be cold the next morning.  When she saw the case sitting out at room temperature, she panicked.  First she attempted to bring her father a room temp diet coke which resulted in him physically abusing her and verbally abusing her.  She left the room rejected and in fear but with a determination she would “make it right.”  

Once back in the kitchen, she proceeded to place a can of diet coke in the freezer, hoping to get it cold faster so she could return with the “prize” that would make him happy again.  She forgot the time and soon, her father got out of bed and came to the kitchen to search for his own diet coke. She told him there was one ready in the freezer.  When he opened the freezer, the laws of physics were in full effect and the carbonation in the aluminum can, having been frozen and expanded, suddenly exploded all over my client’s father and the kitchen.  

He proceeded to again physically abuse her and mentally abuse her until she literally passed out from the physical and emotional pain.  At this point in telling me the story, my client was in full out panic mode in my office and crying without ceasing.  We engaged in the various emotional regulation techniques she had been practicing and before long, she was able to sit calmly in my office.  Any mention of her father, however, threatened to cause her to dysrequlate once more which involved much crying, wailing, and general dysphoria.

I considered beginning EMDR to process the memory of the diet coke incident at age 10 but then remembered that during “resourcing”, she had mentioned having an uncle (her father’s brother, ironically) whom she really loved while growing up.  As we began to talk about her uncle, she made the seemingly offhand (but actually significant) remark, “I wish he had been my father.”  Bingo!  That revelation gave me the idea to use a technique out of “parts therapy” (not strictly IFS), where a wounded part is allowed to think about what life would have been like had another nurturing and protective person had been present in their life instead of the wounding caregiver.  

I had her remember the qualities of her uncle she liked and then reinforced these and strengthened the good feeling using alternating bilateral stimulation through a set of vibrating hand held devices we often call “tappers.”  As she worked with the tappers, she began to bring up more positive memories regarding her uncle and by the end of this exercise (probably 10 minutes in duration) she remarked that she felt very safe, loved, and at peace.  So we began the next step. 

Reminding my client of the diet coke memory, I asked her to imagine what it would have been like if her uncle had been the person to enter the kitchen and open the freezer with the subsequent result of the diet coke blowing up.  She closed her eyes, tappers started, and for a few minutes she played this “movie” in her mind.  When she finally opened her eyes, she was smiling!  I asked her to tell me what she had experienced and she said, “Oh my, it was so different.  When the drink exploded my uncle grabbed me in a protective hug and asked me if I were ok.  Then he proceeded to offer to help me clean up the mess.  He then asked me if I knew what had happened (I didn’t at the time) and proceeded to explain how a carbonated beverage frozen can expand and burst its container (the can).  He said that since I didn’t know that and was never taught that information, I shouldn’t blame myself for what happened but should take it as a learning experience, not do it again, and move on”  

When I asked her how she felt with this different outcome, she said “It’s remarkable. I don’t feel anything but validation, love, protection, and peace.”  When I then asked her what the difference was between the first real incident and the imaginary incident using her uncle, she said, “My uncle was the difference. He truly cared for me”  Just to be certain her mind was getting the message, I asked her, “If it was your uncle who was the difference, then did the incident really have anything to do with you?”  She seemed very surprised to think about that question but then remarked, “No.  It had nothing to do with me. I did everything I could but my father simply could not help himself when it came to demanding and abusing.”

I then asked her to think about the real incident when she was 10 years old and more specifically, her father and how he treated her.  Again, she was surprised as she stated, “I don’t feel any bad emotion surrounding the incident any longer. It’s like it never happened although I clearly know that it did.”  Noteworthy on top of her realization was the fact that she was no longer crying or becoming dysregulated when thinking about or talking about her father.  We both commented on how incredible this outcome was and I suggested she consider to think about the difference between her father and her uncle and notice how that continued to make her feel until our next session in two weeks. 

Well, just prior to our next session, my client’s husband called me, asking “What did you do to my wife?”  While his tone was pleasant and not accusatory, I was immediately thinking, “Uh oh, what did I DO?”  But it was not necessary to worry.  With prior permission from my client to discuss our sessions with her husband, he went on to tell me that since our session where we did the visualization of her uncle in place of her father (my client’s husband did not know we had done this technique), his wife had seemingly become a different person. Almost immediately she stopped texting multiple times a day looking for where he was but instead would text or call a few times just to say, “I love you” or “I miss you.”  She no longer followed him to the gym or the local restaurant where he often met friends after work.  All in all, she stopped worrying about him.  I was pleasantly amazed and explained to him in brief what we had done.  

That next session, my client and I were able to talk about her “new” self and what that meant to her.  She was pleasantly surprised as well and commented that she no longer felt compelled to constantly check on her husband but instead, just knew in a positive way that he was simply doing “ok”. My client attended a few more sessions to check her responses but she basically continued to exhibit very positive, healthy responses to her husband and stopped worrying about him so much.  This helped them work on a very positive, fulfilling marital and friendship relationship that to the best of my knowledge continues today.