Terapia narrativa en depresión: abordaje psicoterapéutico de un caso

RESUMEN

Se trata de una paciente de 41 años derivada al Servicio de Salud Mental por crisis de ansiedad de años de evolución. La paciente relata que desde siempre ha presentado crisis de ansiedad en los momentos vitales que implicaban un aumento de sus responsabilidades (trabajo, nacimiento de sus hijas, cuidado de sus padres?). Cuenta que en los últimos 3 años las responsabilidades del trabajo han aumentado considerablemente, y que sin embargo ella no ha sido capaz de delegar, siendo también muy exigente con sus hijas.
Coincidiendo con este incremento de las responsabilidades la paciente comienza a presentar ánimo bajo, cefaleas tensionales e ideación autolítica de escasa estructuración, con sentimiento de desbordamiento y de culpabilidad, lo que motiva que solicite consulta en Salud Mental. La paciente inicia tratamiento antidepresivo a dosis bajas (Sertralina 50 mg/d) con control por su médico de Atención Primaria y abordaje psicoterapéutico breve en Psicología.
En el presente trabajo se expone la intervención psicoterapéutica llevada a cabo durante las 12 sesiones de tratamiento, focalizando en la narrativa depresiva cargada de autoreproches y descalificaciones personales de la paciente. Se co-construye junto a la paciente la pauta problema desde su historia biográfica y se realiza un trabajo psicoterapéutico sobre su autodiálogo interno mediante un ejercicio de doble silla. [ABSTRACT] This is a female patient aged 41 was referred to the Mental Health Service for panic attacks years of evolution. The patient reports that has always presented anxiety attack at vital moments involving increased responsibilities (work, birth of their daughters, parental care...). Note that in the last 3 years work responsibilities have increased considerably, and yet she has not been able to delegate, being also very demanding with his daughters.
Coinciding with this increase in responsibility the patient begins to experience low mood, suicidal ideation and tension headaches of poor structuring, and overflow with feeling of guilt, which motivates requesting consultation on Mental Health. The patient starts treatment at low dose antidepressant (Sertraline 50 mg / d) to control your primary care physician and brief psychotherapeutic approach in psychology.
In this paper psychotherapeutic intervention carried out during the 12 treatment sessions, focusing on depressive narrative full of self-reproach and personal attacks the patient is exposed. Is co-constructed by the patient from the standard problem biographical history and a psychotherapeutic work on your inner self-talk by a double chair exercise is performed.This is a female patient aged 41 was referred to the Mental Health Service for panic attacks years of evolution. The patient reports that has always presented anxiety attack at vital moments involving increased responsibilities (work, birth of their daughters, parental care...). Note that in the last 3 years work responsibilities have increased considerably, and yet she has not been able to delegate, being also very demanding with his daughters.
Coinciding with this increase in responsibility the patient begins to experience low mood, suicidal ideation and tension headaches of poor structuring, and overflow with feeling of guilt, which motivates requesting consultation on Mental Health. The patient starts treatment at low dose antidepressant (Sertraline 50 mg / d) to control your primary care physician and brief psychotherapeutic approach in psychology.
In this paper psychotherapeutic intervention carried out during the 12 treatment sessions, focusing on depressive narrative full of self-reproach and personal attacks the patient is exposed. Is co-constructed by the patient from the standard problem biographical history and a psychotherapeutic work on your inner self-talk by a double chair exercise is performed.