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Case Study Josephine Miller

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Text Preview Case Study: Josephine Miller
Sheridan College
Jonathan Louis
Betty Buder
October 8th, 2014

1. Four symptoms of anxiety/panic that Josephine is experiencing are, fear, urination, tremors and trouble concentrating. These symptoms are evident through the way Josephine is behaving at home and at the hospital. These four symptoms are usually found in people who are actually diagnosed with an anxiety disorder and panic attacks, cognate to Josephine. The symptom fear is evident in Josephine’s story when it is stated that she stayed home for 4 straight weeks, missing 4 weeks of work because of her fear of communicating. Fear is one of the early symptoms of anxiety and can start very small as not feeling comfortable speaking on the phone or not wanting to speak with someone of authority. These small incidents can turn into something as extreme as Josephine’s, not willing to leave your own home for extended periods of time. Unusual urination is also a symptom of anxiety that not too many people know about. The average person would not recognize this as an actual symptom, but it is. In Josephine’s case, her husband found her sitting on the floor in the corner of their bedroom covered in urine. This may have been going on for weeks and she was able to hide it until the husband found her in that state. “There are two types of anxiety urination. There is instant urination that generally occurs during moments of complete terror, and there is frequent urination, which is the sensation of needing to urinate often without necessarily drinking excess water/liquid”. Out of these two types of anxiety urination, Josephine has instant urination because she was caught in the moment of fear in her room covered in urine. Another symptom Josephine has is tremors. When she was admitted to the hospital, she was panicky and fearful while her hands were continuously moving. There are many types of tremors but the one Josephine specifically had was muscle tension. “Anxiety and stress also causes muscle tension. Muscle tension puts a great deal of strain on your muscles and in some cases this type of tension can lead to unusual muscle movements”. Josephine’s “unusual muscle movements” was the constant movement of her hands. You can also connect this type of behavior with Josephine’s need to pace back and forth in order to be admitted. This can also be viewed as a method of eliminating the tremors. Lastly, the fourth symptom Josephine has is trouble concentrating. In order for her to be more harmonious and to concentrate more, 3 mg of lorazepam was administered to her intramuscularly. Lorazepam is a high potency drug used to treat anxiety for short-term purposes. In Josephine’s story, its stated that she is a successful interior decorator but encountered an uncontrollable amount of stress when her major biggest client decide to cancel his contract with her. This would be stressful for anybody but considering Josephine’s illness, it affected her in different, harsher ways. Maybe her anxiety and ability to concentrate is what triggered her major client to go separate ways, as he was not getting the service/attention that he wanted as a customer. When Josephine was admitted to the hospital, directions had to be repeated to her several times for her to fathom the information due to her inability to concentrate or focus. 2. Three therapeutic techniques: Active listening, Hope and Open-ended questions. Active listening is being attentive to what the client is saying. Sitting face to face with the client, having open posture, leaning toward the client and maintaining eye contact are all important components of active listening. I think active listening would meet Josephine’s needs by providing a sense of comfort/compassion. The feeling of someone being there for you to listen to your problems and fears would give anyone a good feeling. This type of therapeutic communication can also spark conversations of motivation and confidence... Show More

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