Each month, IndoPsyCare clinician-scientists take turns sharing insights we gleaned from treating anonymized cases of actual patients.
In January 2023, Rafael Aditya Marjoto, M.Psi., Psikolog, presented the case of Nabila, a 26-year-old female who came to us reporting stress, feelings of emptiness, and difficulty identifying what she was feeling and how she should be.
- Harm OCD: She feared negative feedback, was terrified of letting anyone down, and worried about giving others incorrect instructions.
- Perfectionism OCD: She felt her work was never quite enough or up to standard.
- Contamination OCD: Nabila felt the need to repetitively and excessively wash her hands throughout the cooking process.
- Moral OCD: She experienced guilt, as though her decisions and workplace performance made her a burden to others.
- Symmetry OCD: Everything in view needed to be organized in a particular way; she would experience distress when her laptop was slightly tilted.
Nabila’s Exposure and Response Prevention (ERP) sessions focused on:
- Regaining a sense of agency over her work
- Responding to her WhatsApp messages
- Going outside Nabila is now regaining control over her mind.
She has gone from ruminating all day, ignoring her group chats for days, to gathering the strength to reply within 15 minutes. At the current time, Rafael is monitoring Nabila’s progress.
If she remains stable, she will enter the relapse prevention stage, where he will teach her techniques to avoid falling back into old thought processes.
Treating this case taught Rafael invaluable lessons:
- Psychotherapy is not a walk in the park. Clinicians and patients must openly discuss the process to find a starting point that is both effective and manageable.
- Psychotherapy is a joint effort. Clinicians can help patients better recognize the thoughts and behaviors that are symptomatic of their diagnosis. Through their involvement in psychotherapy, the patient should make a conscious effort to become more aware of their triggers and responses.
- Improving patients’ insights and awareness of their own symptoms and instilling them with a sense of agency is paramount.
- Patients should be their own biggest advocates and be aware of when they need to seek out further professional guidance.