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Data:
Session duration was 45 minutes, held in-office. Client appeared stuck and reported feeling trapped between anxiety and avoidance. Client stated, "I know what I should be doing, but I just can't make myself do it." Client discussed wanting to apply for new jobs due to dissatisfaction in his current role but described experiencing a wave of anxiety when attempting to work on his resume or search for job postings, leading to avoidance and worsening anxiety. Therapist introduced ACT defusion exercises, including noticing thoughts and altering their presentation (e.g., singing them, using a cartoon voice, repeating them). Client laughed during the exercises and reported the thoughts felt less heavy. Therapist facilitated values clarification, with client identifying growth, challenge, and contributing something meaningful as core values. Client recognized applying for jobs as a value-aligned action despite associated anxiety.
Assessment:
Client is making progress in understanding the relationship between anxiety and avoidance. Client responded positively to ACT defusion exercises, indicating decreased intensity of anxious thoughts. Values clarification helped client connect job application efforts to personal values, increasing willingness to take action. Client's status aligns with treatment goals of addressing avoidance and building value-driven behaviors.
Plan:
Client will complete homework of taking one small value-aligned action, such as updating one section of his resume, while practicing defusion techniques when anxious thoughts arise. Therapist and client will meet next week to review progress and continue addressing anxiety and avoidance through value-driven actions and ACT-based interventions.
Today's session was 45 minutes, in-office. Ravi came in looking stuck and said he's been feeling trapped between his anxiety and his avoidance. He said quote 'I know what I should be doing, but I just can't make myself do it' unquote. He talked about how he's been wanting to apply for new jobs because he's unhappy in his current role, but every time he sits down to work on his resume or look at job postings, this wave of anxiety hits and he just shuts down. Then he feels terrible about avoiding it, which makes the anxiety worse.
We talked about how anxiety and avoidance feed into each other, and that trying to get rid of the anxiety first isn't really the answer, it's about learning to move forward even with the discomfort present. I introduced some ACT defusion exercises to help him get some distance from the anxious thoughts. We practiced noticing the thought and then saying it in different ways, singing it, saying it in a cartoon voice, repeating it over and over until it lost some of its power. He laughed a little, which was good, and said it felt less heavy when he did that.
Then we did some values clarification work. I asked him what really matters to him, beyond just escaping the anxiety. He said growth, challenge, and feeling like he's contributing something meaningful. We talked about how applying for jobs is actually a value-aligned action, even if it brings up anxiety. The anxiety doesn't mean he's doing the wrong thing, it just means he cares. His homework is to pick one small value-aligned action this week, like updating one section of his resume, and to practice defusion when the anxious thoughts show up. He doesn't have to feel ready or confident, he just has to take the action.
Actually, one more thing, he seemed a little more willing to try by the end. We'll meet again next week to see how it went.
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