Case Studies

The following is the case study of a young person I have been working with through a psychological therapy and diagnostic assessment clinic.

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The young person agreed for their Coaching journey to be shared here, but wished to remain anonymous.

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Like most people who were doing GCSEs during lockdown, K was surprised to discover they were struggling.

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Suddenly, the whole:

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• Structure

• Institution

• Routine

• Predictability

• Sense of control

• Feeling of Belonging

 

Was all taken away.

 

On top of this, the pressure to have to decide on a career path, and work towards it, whilst approaching the age of sixteen became intensified and sharply focused during COVID.

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Despite achieving great grades, K was left feeling like a failure, mainly because they felt they had been working towards a profession and hence goal that they had not chosen, but had instead been advised to pursue.

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One problem was that they still did not know what they wanted to do.

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The pattern repeated during further education, by which point, it was felt as though a lot of things had unravelled.

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The approach to Coaching was gentle. It needed to be. Scheduling a specific time slot on the same day each week would not work, as sometimes K would not feel ready for coaching. A more ad-hoc process was followed. This was formulated by working together with the other professionals that K was working with.

 

Coaching sessions were then conducted upon joint agreement:

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• That K felt comfortable.

• That the timing was right.

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First and foremost, we reinforced that K did not require fixing, for nothing about them was broken.

 

In the first session, we touched upon strengths, using a character strength activity to spark discussion.

 

This led to an exploration of some traits that are deeply common within ADHDers.

 

E.g.:

 

Rejection Sensitive Dysphoria (RSD).

 

K was aware of it, but had always interpreted the experience as a belief and feeling of failure.

We reframed this.

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Yes, the crushing pain felt from real rejections (not perceived ones) in K’s case were felt deeply and physically.

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However, it was acknowledged that the feelings were usually only temporary, even if they lasted different durations of time.

 

And then what usually happened?

 

Bouncebackability!

 

So we recognised and celebrated the fact that RSD could be reframed as a certain resilience.

 

We explored how strengths, together with RSD resilience, require balance. Yes, when they happen, they feel great. There’s that Dopamine hit.

 

But…

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• Overuse them? Burnout…

• Underuse them? Lose interest…

 

Both cementing a belief of failure. Burnout having a devastating effect.

 

We were able to target two small goals that would help towards preventing overuse, using the SMART template:

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• Specific

• Measurable

• Achievable

• Realistic

• Time-bound

 

One Goal was:

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“To lock devices in a drawer, twice in the next week.”

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As a People Pleaser, K was worrying too much about others, without any focus on their own wellbeing. It was felt that they could not escape this, because of the bombardment through notifications on devices. Turning off all notifications would lead to missing things when they were important.

 

So this solution was proposed instead.

 

The days chosen were Tuesday and Friday. The time chosen was 1 p.m., i.e. in the afternoon. After locking the devices away on silent and turning off computers, K was to then set a timer for ten minutes. During this time, they would engage in an activity that brought them happiness. Colouring in, furthering the build of a Lego set, writing in a journal.

 

It was suggested that by setting the goals to be smaller, and manageable, there would be a greater chance of success.

 

K had initially wanted to set the goal for each day for an hour each time. This may be achievable, and have greater benefit in the long run. But if it was not achieved immediately, it could easily lead to the feeling of failure again.

 

With these smaller targets, it would feel so much better when they could be reflected on, and then they could be built up.

 

The goal was a success. It was achieved.

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The Coaching sessions have dovetailed with the other support that is being received, so as to not repeat or overlap too much on other areas K is already focusing on.

 

We were wary that we did not simply want to be repeating what may already be being tried elsewhere.

 

K has since taken things forward into other aspects of their life. Mentioning RSD to others.

 

K has been able to set boundaries with people. E.g. Stating that tasks may provoke a sensory overload, and requesting they tackle them in smaller chunks in order to be able to complete them.

 

K has also recognised areas where things may not have worked out as originally expected. Whilst the RSD still kicks in, K takes time to explore it, questioning whether the beliefs are real. Sometimes they are, although a lot of the times they are not.

 

Instead of allowing the instant thought of “I’ve failed” to totally paralyse them, K is now asking advice from others to seek whether they could have done things differently.

 

Often, nothing was done wrong, it was just due to inexperience, or a difference in technique was required. Sometimes an offer of help is suggested to assist until the task in hand feels more comfortable.

 

Occasionally, the response is, “no, that was difficult, and that often happens to me, there’s not much that can be done to prevent it”. But the reassurance that K is not at fault, does not allow different thought processes to take over, and K is able to move forward, little by little, once again.

 

K’s positive journey continues.