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Subjective:
Client reported feeling trapped between anxiety and avoidance, stating, "I know what I should be doing, but I just can't make myself do it." Client expressed dissatisfaction with his current job and described difficulty applying for new jobs due to anxiety that arises when working on his resume or looking at job postings. He noted this leads to avoidance, which worsens his anxiety and creates a cycle of distress. Client identified values of growth, challenge, and contributing something meaningful as important to him.
Objective:
Session lasted 45 minutes and took place in-office. Client appeared stuck and engaged in the session. Therapist introduced ACT defusion exercises to address anxious thoughts, including techniques such as saying thoughts in different ways, singing them, and repeating them until they lost intensity. Client laughed during the exercises and reported the thoughts felt less heavy. Therapist guided client in values clarification, linking job application efforts to his values.
Assessment:
Client is making progress in understanding the relationship between anxiety and avoidance. Client responded positively to ACT defusion exercises, reporting decreased intensity of anxious thoughts. Values clarification helped client reframe job application efforts as value-aligned actions rather than avoidance triggers. Client appeared more willing to take action by the end of the session.
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 building on these strategies.
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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