A 22-year-old woman sought therapy to address a myriad of emotional challenges that were impacting her daily life. Constant self-doubt, emotional outbursts, aggression, and frequent headaches were among the issues she faced. Despite achieving academic success with a high GPA in her B.Com degree and harboring aspirations to pursue Chartered Accountancy, she found herself overwhelmed and demotivated. Living with her family, which included her parents and younger brother, further compounded her stress. In therapy, we explored her family dynamics, emotional struggles, and the cultural pressures she experienced, shedding light on the complexities of her situation.
Case Background:
A young woman, 22 years old came to therapy complaining of constant self-doubt, emotional outbursts, aggression, and frequent headaches. She had completed her B.Com degree with a 9 pointer scale and wished to pursue Chartered Accountancy. She lived with her family comprising her parents and a younger brother in PUC. Her father worked as a consultant in a firm while her mother was a homemaker. We spent some time exploring her immediate family and the presenting concerns. She was feeling overwhelmed and stressed particularly about her ‘Self’ and capabilities. She was unable to manage her simple, day to day chores and felt demotivated to go about her day. She felt a sense of constant pressure both internally and externally to remember everything she studies, to perform exceptionally well in her work as an intern. She also wanted to pursue CA and was taking up some coaching classes to help with the same. However, over the past three months especially, her lack of motivation to do chores and complete her work made her feel low and ‘all over the place’. As we started to touch upon the concerns and family context she got teary eyed and at the verge of crying.
We spoke more about the emotional context of her family. They had gone through their own share of distress. The parents went through a lot of financial struggle. Things especially got really hard when her younger brother was diagnosed with Craniopharyngioma, a rare category of brain tumor. Her brother underwent crucial surgery and chemo treatment. He got fairly better but was still fighting his own battles. The family went through several ups and downs together but struggled to cope emotionally. The client did not feel emotionally connected to the family and struggled with the cultural burden of ‘elder one’ having to understand everything that happened. She would not share much as she did not want to burden them. Growing up in a strict household with conservative values around how she ‘has to be’ as a ‘girl’, frustrated her even more. She would often meet with negative taunts from her family members.
As a young girl she always wanted to make friends, stay connected with them, and hang out more often. However, she would have conflicting ideologies with her mother especially over time spent with friends. Her father was critical towards her and work. He came from a place of preparing his daughter towards a critical world so that she did not have to suffer in her future. The critical nature and temper of her parents was emotionally hurtful for the client. She wanted to have appreciation and validation from her close circles. She simply wanted to ‘fit in’ amongst a knowledgeable crowd and her extended family. She thought that her friends and extended family had stopped asking her to meet because they knew she would not turn up or that her mother wouldn’t allow her. The client would go ‘all out’ to help her friends but feels like she has been taken for granted. She felt that the love was not being reciprocated by anyone around her. She felt lonely and hurt throughout her school and college. Her outbursts in front of her parents made her guilty and this lowered her self esteem even further.
Throughout this emotional battle, she prided herself for being excellent academically and remembering content. She remembered herself to be an empathetic person and a fast learner. She liked reading everything about a certain topic. She was inquisitive and wanted to ‘know everything’ surrounding her subjects and workplace. Over the past few months due to a depressed state of mind and lack of motivation, she would push her tasks, avoid gatherings and engagements with friends. With regards to her interning she wanted constant validation from her father because she was unsure of her work. She also had a few negative incidents surrounding her work at the firm. She mentioned that since she represented her father in the firm, she wanted everything to be ‘perfect’ and this would eventually lead to overthinking and stress. She said she zoned out and lost focus on almost everything. She felt that she was not good enough and would not be able to do anything. Despite all this, she always enjoyed teaching her cousin, talking to her closest friends, reading, dancing, and cooking new dishes for the family. She remembers her father appreciating her only when she cleared a CA related exam. She would end up feeling dismissed but yearned for validation from her parents internally. She sought appreciation from her parents, hearty emotional conversations, and understanding.
For Parents -Our answer: It was important for the client to notice her strengths and academic accomplishments that existed already. A problem free conversation and active listening helped her vent and clear her muddled thoughts. Since she felt low self esteem and lack of confidence to go about her work, we helped her frame short, doable goals that she can gradually begin with. Jotting down the tasks helped her to prioritize and complete her work. Procrastination is often due to anxiousness rather than laziness. Breaking down tasks and prioritizing can help a ‘planner’ feel at ease.
Sometimes for a few people, anxiety can manifest as pain. People may experience pain in different parts of their body such as arms, head, stomach, or back. She mentioned that the headaches would come along especially when she is worried about work and academics. She felt angry mostly at her parents and brother because of conflicting opinions and taunts. To help her with emotional regulation and anxiousness, we suggested box breathing. It’s a stream of phased inhaling and exhaling for a calm nervous system. The goal framing and breathing technique eventually made her feel better and less angry at the world. She sought connections with her extended family but refused to call them for a few months. We gently nudged her towards connecting with friends and extended family more often so that she feels a sense of belonging.
The undue pressure of excelling came with its toll on her. Restructuring her negative thoughts and helping her see different perspectives alleviated her stress a little. Overall, she reported feeling better in terms of her mood, sleep, and doing simple activities. She also started managing her tasks well both at home and academics related. She was happy to meet her friends and hang out after a long time. She also started teaching whenever she could. In our initial sessions, she would cry profusely and keep asking ‘Why can’t I do’ questions a lot. Eventually the self doubt questions started coming down. The parents also reported seeing healthy changes in her post the sessions.
Counsellor in charge : Yameni (Specialist Psychologist – The Newage Therapist,)
