Single Case Study
The following is a single case study that details the therapeutic treatment of a suicidal, depressed man. Interventions with this individual did not follow strict therapeutic guidelines and instead JMA training was used to teach concepts of mindfulness to make the client more comfortable with his feelings and with socialization. To make the narrative flow easier, the author will refer to himself in this section in first person. The name of the client has also been changed to protect confidentiality.
Eddie is a 26 year old male of Puerto Rican descent. When I had met him, he had been chronically homeless for the past six years. He had been accepted to live in a permanent assisted living facility as his diagnosis of depression was considered severe enough to warrant Eddie as being labeled legally disabled.
Eddie had been abandoned by his mother and father at age 15 and was forced to live with an emotionally distant aunt. At age 18 his aunt told him he was on his own and kicked him out of his house. He had been homeless ever since then, and was shuffled around from one shelter to another before being allowed to stay at his current assisted living center.
In order to be allowed access to the facility, Eddie had to be considered disabled. Several psychiatrists interviewed him and considered his depression to be so bad it warranted the label of disabled. Eddie’s mental state was often so low he had contemplated and attempted suicide multiple times. When I had met him, it had been 8 months since his last attempt and two weeks since his last reported suicidal ideation. Combined with his diagnosis of Major Depressive Disorder, Eddie displayed some symptoms of undiagnosed illnesses such as Post Traumatic Stress Disorder, Agoraphobia, and during his depressed days would he would occasionally hear voices and display possible symptoms of schizophrenia.
At the start of treatment, Eddie had not made many friends in the facility and was very socially awkward. Eddie described he always felt like he was being judged negatively by people. He had continuously dropped out of his GED classes, and was financially irresponsible to the point of having to sign his SSDI check over to the director of the facility as his payee.
Eddie revealed to me he had interest in Asian culture and I found this to be a subject we could talk about to establish report. The first few meetings we had, he would tell me what he had read about Asian culture and I would talk to him about my JMA experience and my journey to Japan and China. I asked him if he would be willing to learn some JMA from me. He agreed.
I believed that through the lessons I would teach him in JMA he would learn to be more mindful of his own feelings and become more comfortable with himself. We began practicing partner based exercises that were each meant to convey a specific type of attitude. We moved through exercises practicing what it would feel like to be confident, fearful, assertive, or compassionate. Some exercises are more suited to different feelings than others, and we explored how at certain times, certain feelings did not seem appropriate. The JMA mindfulness based concepts of “one-mind”, “no-mind”, and “remaining-mind” were practiced, and I encouraged Eddie to practice these mindful sensations on his own as he goes about his daily business. After each lesson we would discuss how practice had made him feel and how he can be mindful of those feelings at other times.
After several weeks of JMA practice, Eddie began showing an increased awareness of his personal feelings and was more accurate with picking up on social cues than he had been at the start of practice. Over the course of practice, Eddie had made slow, but steady progress with few set backs in his abilities to be mindful of his life experience. Originally stating he felt like a 2/10 on the SAD person’s scale, signifying intense depression, he was now saying he felt more like an 8 or 9.
The JMA practice Eddie and I worked together through was a means to get him more comfortable with his own thoughts, but also a means to helping him control the unwanted automatic thoughts of worthlessness, depression, and anger. Using the exercises mentioned above, Eddie learned how to willfully change his emotions when he had an unwanted automatic thought. As he became more aware of his unwanted thoughts and could change them accordingly, he became more comfortable in social situations.
JMA practice appeared to help Eddie in much the same way that a more typical mindfulness based cognitive therapy might have done it. Beckerman and Corbett state the goal of mindfulness based therapy is to help the client with attention control, non-judgmental examination of feelings, and disengaging from depressive thinking by suspending automatic thoughts (2009). These treatment objectives were all met to a satisfactory level through the JMA practice in which Eddie participated.
When it was time for termination of the therapeutic alliance with the client, Eddie had made several friends, engaged in casual social conversations he originally shied away from, and was one test away from completing his GED. He had become aware of his spending habits to the point where he was given control back of his own finances. His depression appeared to be in full remission, as h stated not having a very depressed thought for months.
The following is a single case study that details the therapeutic treatment of a suicidal, depressed man. Interventions with this individual did not follow strict therapeutic guidelines and instead JMA training was used to teach concepts of mindfulness to make the client more comfortable with his feelings and with socialization. To make the narrative flow easier, the author will refer to himself in this section in first person. The name of the client has also been changed to protect confidentiality.
Eddie is a 26 year old male of Puerto Rican descent. When I had met him, he had been chronically homeless for the past six years. He had been accepted to live in a permanent assisted living facility as his diagnosis of depression was considered severe enough to warrant Eddie as being labeled legally disabled.
Eddie had been abandoned by his mother and father at age 15 and was forced to live with an emotionally distant aunt. At age 18 his aunt told him he was on his own and kicked him out of his house. He had been homeless ever since then, and was shuffled around from one shelter to another before being allowed to stay at his current assisted living center.
In order to be allowed access to the facility, Eddie had to be considered disabled. Several psychiatrists interviewed him and considered his depression to be so bad it warranted the label of disabled. Eddie’s mental state was often so low he had contemplated and attempted suicide multiple times. When I had met him, it had been 8 months since his last attempt and two weeks since his last reported suicidal ideation. Combined with his diagnosis of Major Depressive Disorder, Eddie displayed some symptoms of undiagnosed illnesses such as Post Traumatic Stress Disorder, Agoraphobia, and during his depressed days would he would occasionally hear voices and display possible symptoms of schizophrenia.
At the start of treatment, Eddie had not made many friends in the facility and was very socially awkward. Eddie described he always felt like he was being judged negatively by people. He had continuously dropped out of his GED classes, and was financially irresponsible to the point of having to sign his SSDI check over to the director of the facility as his payee.
Eddie revealed to me he had interest in Asian culture and I found this to be a subject we could talk about to establish report. The first few meetings we had, he would tell me what he had read about Asian culture and I would talk to him about my JMA experience and my journey to Japan and China. I asked him if he would be willing to learn some JMA from me. He agreed.
I believed that through the lessons I would teach him in JMA he would learn to be more mindful of his own feelings and become more comfortable with himself. We began practicing partner based exercises that were each meant to convey a specific type of attitude. We moved through exercises practicing what it would feel like to be confident, fearful, assertive, or compassionate. Some exercises are more suited to different feelings than others, and we explored how at certain times, certain feelings did not seem appropriate. The JMA mindfulness based concepts of “one-mind”, “no-mind”, and “remaining-mind” were practiced, and I encouraged Eddie to practice these mindful sensations on his own as he goes about his daily business. After each lesson we would discuss how practice had made him feel and how he can be mindful of those feelings at other times.
After several weeks of JMA practice, Eddie began showing an increased awareness of his personal feelings and was more accurate with picking up on social cues than he had been at the start of practice. Over the course of practice, Eddie had made slow, but steady progress with few set backs in his abilities to be mindful of his life experience. Originally stating he felt like a 2/10 on the SAD person’s scale, signifying intense depression, he was now saying he felt more like an 8 or 9.
The JMA practice Eddie and I worked together through was a means to get him more comfortable with his own thoughts, but also a means to helping him control the unwanted automatic thoughts of worthlessness, depression, and anger. Using the exercises mentioned above, Eddie learned how to willfully change his emotions when he had an unwanted automatic thought. As he became more aware of his unwanted thoughts and could change them accordingly, he became more comfortable in social situations.
JMA practice appeared to help Eddie in much the same way that a more typical mindfulness based cognitive therapy might have done it. Beckerman and Corbett state the goal of mindfulness based therapy is to help the client with attention control, non-judgmental examination of feelings, and disengaging from depressive thinking by suspending automatic thoughts (2009). These treatment objectives were all met to a satisfactory level through the JMA practice in which Eddie participated.
When it was time for termination of the therapeutic alliance with the client, Eddie had made several friends, engaged in casual social conversations he originally shied away from, and was one test away from completing his GED. He had become aware of his spending habits to the point where he was given control back of his own finances. His depression appeared to be in full remission, as h stated not having a very depressed thought for months.
