Evaluation of Relationship between Schemas and Panic Disorder through a Case Treated with Schema Therapy

Abstract

Introduction: Schema therapy (ST) is a form psychoterapy combining existential, cognitive-behavioral, psychodynamic and object relation techniques that was developed by Jeffrey Young for personality disorders and severe behavioral pathology which are resistant to other therapy techniques . Altough the technique was originally developed for axis II disorders, in recent years there are studies proving it also being effective in axis I disorders. In this paper we report the schema formulation of a female patient who had an axis I panic disorder with B class personality and chronic life problems. Case: 36 years old female patient with collage degree. She was introduced to the clinic with severe panic attack symptoms which had been effecting her functionality. We started schematherapy for the patient as she had no improvement on her panic disorder symptoms with medical treatment due to her maladaptive schemas and schema modes thet she had used frequently. Her panic attack symptoms dissappeared during the advanced sessions of the treatment as her maladaptive schemas and the schema modes she had been using were emphasized during schema therapy, even though her personal interaction problems continued to exist. She started to deal with life stressors and was able to pacify herself. Discussion: Early maladaptive schemas and inadaptive ways of behaviors that has been developed by patients to handle these schemas may underly the axis I disorder symptoms such as anxiety, depression, drug abuse and psychosomatic disorders. As we look have a look at our patient, it can be said that her seperation with parents before elementary school may have led to her schemas of desertion and distrust and also teacher being over guarding at the levels of harming sovereignty to compensate the absence of the parents forms the basis of schemas of dependence / incompatence, being harmed and weakness against ilnesses. These schemas may be the reason of the patient's inability to handle certain life problems that may be triggering her panic attack symptoms. Schema therapy led to awareness of the patient about her schemas. Patient who had been thought of more functional ways coping instead of inadaptive ways was free of her panic attack symptoms which were resistant to medical treatment. The schema therapy proceess that has been going on with our patient is a good example for schema therapy that was originally developed for treatment for axis II disorders may also be effective for axis 1 disorders.