Achieving your goals: a student case brief review

The next short story is a real case situation, authorized to be shared to illustrate how is it like to have some help to overcome life challenges.

The content involves topics related to mental health problems that could trigger negative thoughts in some people. If you are going through a hard time, please reach out to me to offer some guidance.

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A student named "Rose", 22 years old, wrote to me on Facebook saying that she can't sleep due to nightmares, panic attacks, and unexpected bad performance in her education. She was not sure what the problem was exactly, but she knew that it was probably something psychological about her personality or her past.

As usual, she answered a few questionnaires for me to explore further symptoms and we book a first online session. Her mental health was worst than I expected, and she was going through a lot of emotional pain, isolation, and suicidal thoughts.

During sessions, we started by developing a system to increase her tools to regulate negative emotions, especially anxiety and sadness. We tried different ways, until she found the one suit better for her: the anchor technique.

This method aims to create a strong association between a stimulus with the desired behavior. In other words, you make a promise to yourself to activate the desired behavior every time you engage with the chosen trigger (eg. a ring, necklace, or similar). In Rose's case, we discovered that she was very sensitive to jokes, criticism, or rejection, tending to overthink people's intentions, especially during lectures and group works.

Some e.g. are:

"the teacher said today's lecture is going to be hard... would he say that to not make me feel that bad for not understanding? ... What could I say if he asks me a question?... seems like everyone else understand everything and I don't..."

A quick analysis of these thoughts reveals that Rose is usually thinking that people around her are "better" than her and they are "aware" of this. This is a common problematic trait in social anxiety, where individuals mentalize (think about what others are thinking - also known as "theory of the mind") in a negative way without any strong evidence. The reasons behind this are very different in every person, but for Rose, it was mainly related to the rejection and criticism experienced in the relationship with her parents and peers during her school period.

The anchor technique, in her case, works as an agreement to previously assume that most people like her, and if someone doesn't, It is ok because she doesn't need to like everyone to be accepted, loved or respect. This is difficult to do just by saying it, so it requires some cognitive reframing and deep reflections about interpersonal relationships and social skills.

We also developed cognitive schemas to act and think when she is going through these insecurity patterns. Seeking to replace them with her new cognitive schemas adapted through her values.

In concrete, she chose a ring as her anchor object, so every time she touches the ring she needs to correct her body posture and review her new core ideas: "I'm worthy of love and respect. There is nothing wrong with me and I don't need to worry about pleasing others; I need to please myself and trust that others will tell me if I do something wrong to them". This work practically as a commitment to perform a ritual that we design and practice in therapy, to extend it over her daily life.

Please, don't worry if this doesn't work for you, It doesn't work for all personalities, but be aware that you probably already have "anchors" or "rituals" to behave in your life, and you can explore them to slowly shape your behaviour.

Once these main negative thoughts could be "handle" better, the next step was to built structure and overcome other residual cognitive patterns when she was trying to study:

"I try to write my paper, but I can't think... I don't know what to write and I have to read so much to write something that I think is wrong... maybe I should not be studying this".

The fear of failing and the belief of "not being good enough" would sabotage her attempts to learn. Instead of studying, she spent that time daydreaming about public humiliation scenarios at her University or wondering how to tell her family that she failed university. That's why we created systems to help her let go of these concerns:

• take the time and spend 10 minutes only planning concrete steps to get the homework done (reading a related text, writing a draft, interviewing this person, etc). If the task seems complicated, you split it into smaller steps. For example, reading a text could be hard and complicated, so you divide it into sessions of 5 minutes or more according to your stress level and ability to regulate emotions. Reading the text can also be the only task of the day, following the principle of achieving small goals rather than big frustrating goals.
• give up on the idea of doing the work perfectly on the first attempt. Do it basically and fixed it later.
• create structure: designated time to do study/research/homework and time for recreation, respecting it as sacred.
• Don't think about the paper. Read and write the paper.

These tips are very "customizable" and they don't work in everybody in the same way. They need to be built to cope with your negative thoughts to be more effective. In Rose's case, the problem usually is the overthinking and the negative prediction of the future: "I will not make it; I'm losing my time; this is too hard... I will not understand", which for her was easier to bypass by forcing herself to act instead of trying to change her thoughts. In other words, just following a list of to-do allowed her to focus only on the task instead of second-guessing every step on the list.

Similar procedures were made in other issues leading to a beautiful story of academic success and boundaries set in her relationships. The insecurity patterns are still there, but they lost their power, and are not impairing her wellbeing significantly anymore.

I hope this helps! If you will like to me cover some others topics, please let me know!

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