Case Study: Insomnia Triggered
Case Study, Sleep Disorder Nov 14, 2023

Patient Background: 

Name: John

Age: 32

Occupation: Marketing Professional

Family Structure: Married with two children

Presenting Issue: Severe insomnia following the death of his beloved dog and the subsequent revelation of his parents’ impending divorce. 

Background:

John, a marketing professional, sought therapeutic help due to debilitating insomnia that began after a series of emotionally distressing events. A few months before seeking help, John experienced the sudden death of his cherished canine companion, Max. This loss affected him, as Max had been a constant source of comfort and companionship throughout his adult life.

As John struggled to cope with Max’s death, another emotional blow hit him hard—his parents, who had been married for over three decades, announced their decision to divorce. The combination of these two significant losses created a perfect storm of grief. It triggered intense emotional turmoil for John.

Initial Assessment:

Insomnia Severity: John reported difficulty falling asleep, frequent awakenings during the night, and early morning awakenings, consistent with the diagnostic criteria for insomnia.

Duration of Insomnia: Insomnia symptoms persisted for approximately four months, coinciding with the death of his dog and the revelation of his parents’ divorce.

Psychosocial Factors: John displayed symptoms of acute grief, expressing feelings of sadness, guilt, and a sense of isolation. The news of his parents’ divorce added a layer of emotional distress.

Factors Contributing to Insomnia:

  1. Grief and Loss: The death of Max triggered a profound sense of grief, disrupting John’s ability to process and accept the loss.
  2. Family Turmoil: The revelation of his parents’ divorce compounded John’s emotional distress, introducing uncertainty about the future and destabilizing his sense of security.
  3. Emotional Regulation: John struggled to manage the intense emotions associated with both events, leading to heightened anxiety and rumination, particularly during the night.

Treatment Plan:

  1. Grief Counseling:

– Engage in individual therapy focused on grief and loss to help John navigate his emotions surrounding the death of Max.

  1. Family Therapy:

– Invite John’s parents to take part in family therapy sessions to address communication issues, provide support, and ease the transition through the divorce.

  1. Cognitive-Behavioral Therapy for Insomnia (CBT-I):

– Implement CBT-I to address maladaptive sleep patterns and associations, focusing on restructuring negative sleep-related thought patterns.

  1. Mindfulness and Relaxation Techniques:

– Teach mindfulness and relaxation exercises to assist John in managing anxiety and stress, especially before bedtime.

  1. Medication Evaluation:

– Consider a short-term, monitored medication plan to ease acute insomnia symptoms while the therapeutic interventions take effect.

Progress and Follow-Up:

Grief Counseling: John demonstrated progress in accepting the loss of his dog, and sessions helped him navigate the grieving process.

Family Therapy: While the divorce process was ongoing, family therapy sessions provided a platform for open communication and emotional support among family members.

CBT-I and Relaxation Techniques: John reported gradual improvements in sleep quality, reducing the frequency and intensity of insomnia episodes.

Medication Use: John and his healthcare provider monitored medication use, focusing on a gradual reduction as therapeutic interventions took effect.

Conclusion:

John’s case highlights the intricate relationship between emotional distress, grief, and insomnia. Through a multifaceted approach involving grief counseling, family therapy, and targeted insomnia interventions, John was able to regain a sense of emotional balance and improve his sleep patterns. The case underscores the importance of addressing the interconnected nature of psychological and emotional well-being in treating insomnia triggered by significant life events. Ongoing support and follow-up sessions are crucial as John continues to navigate the complexities of grief and family changes.

Sleep is the golden chain that ties health and our bodies together." - Thomas Dekker
About author

Karuna Kaul is psycho socio clinical psychologist, who works with all age group people. Her profession motivates her to serve people who are facing behavioral issues. She has over 8 years of experience and has successfully established credibility in the areas of counselling and wellness. Assessment and behavioral analysis and training and coaching. She has been an active advocate of mental health awareness. And all her endeavors in the field are primarily focused on educating more and more people about Mental Health concerns and promoting Holistic Wellbeing. She has done master in clinical psychology PG Diploma in counselling and guidance and certified in drug addiction counselling Also she has done neuro medicine psychology from London University, Kent College of United Kingdom. With an experience of six years, she had worked with various organization which provides mental health services.