Case Formulation!

OMG this is like the hardest-to-study-for exams ever!! o_O

Not only not enough time, the content is so turn-off. Let's not talk about F, we all know how bad that is... but I never expect CP to be so bad!!!!

The notes are super sampat lah! Can throw 3-4 textbook chapters into one set of lecture notes, and each textbook chapter is at least 30 pages, but only occupies 4-5 slides in the lecture notes. Why? Coz the lecturer super smart lor; put ALL the headlines of the textbook into the notes. What the fish leh. I feel so demoralized making notes that I finally gave up tonight!! It's like so much notes to make for each chapter, and after so long, I'm still at the same set of lecture notes!!! -_-'''

Doesn't help that the textbook can repeat the same words over and over again for 14 chapters. How to remember like that, it's like gestalt psychology/fuzzy memory leh! -.-

Pardon me for being grumpy. I tried so hard to study, and ended up taking so long and having to skip a fabulous gathering I so wanted to go, and have to study all that crap which I can't even take in! =(


SO. Since it's not very productive, I shall do case formulation to aid my learning! Hahaha. Happened to see this TV program on Channel 8 last night. It's those more documentary type of show I think, didn't catch the program name =X

Anyway, they featured/interviewed this actual person who has Obsessive Compulsive Disorder (OCD). So I shall try to do a case formulation with the 20 minutes worth of information I got from that program! Hahaha.

DISCLAIMER: Doing this purely out of fun, please take it with a pinch of salt!


Presenting Problems:
Lady in her 50s who has had OCD for 20 years. Has cleaning compulsions that seriously disrrupts her daily functioning. Cleans her house repeatedly and thoroughly, especially when objects come into contact with the door/floor/furniture/walls/etc... Loses sleep often thinking about things she have not cleaned, then gets up in the middle of the night to clean them.

She especially hates advertisors stuffing flyers at her door. It upsets her and makes her clean repeatedly everytime she sees a flyer being stuffed at the door. Even when she warned the flyers-distributor not to stuff flyers at her door, they still do it repeatedly, and she got into a quarrel with them as a result, which turned into a court case.

As such, she uses at least 15 big boxes of cleaning detergent every month, and her utilities bill works out to over a thousand dollars monthly because of the amount of water used for cleaning. Her hands/skin has become so worn from all the scrubbing and cleaning, to the extent that her fingerprints are no longer visible. She has not gone out of her house for a long period of time, for fear of contamination. Did not allow reporters to go into her house either for fear of them contaminating her house. Appears to stay alone although she has a husband and children.

She has seen up to 3 psychiatrists/psychologists previously, but stopped treatment for some years already because she feels that it didn't helping.

Precipitating Factors:
20 years back, after she gave birth to her youngest daughter, she started to take charge of all the household chores at home, from cooking to cleaning. Whenever she hung out her clothes to dry, the neighbours upstairs would throw down cigarette butts or ash and this dirtied her clothes. Upset with this, she confronted her neighbours, who denied this and claimed that they do not smoke. She started to hang her clothes along the corridor instead. However, kids who ran along the corridor would knock down the clothes onto the floor, and this dirtied the clothes as well. From then on, she started displaying symptoms of OCD, from being very particular about cleanliness, to showing signs of anxiety, distress and cleaning compulsions.

In the recent years, her condition has worsened after more advertisors started to stuff more and more flyers at her door. Despite the warning signs she put up not to stuff newspapers and flyers at the door, her signs were ignored. This causes great distress in her, and increases her cleaning compulsions. It was also from that point of time that she stopped going out of the house.

Predisposing Factors:
Causes are not elaborated upon/unknown here. It seems that she was already particular about cleanliness previously. It is also possible that the delivery of her youngest daughter has caused some hormonal changes or chemical imbalances that increased her susceptibility of getting OCD, which was then triggered by the incident of her clothes getting contaminated by the neighbours.

Perpetuating Factors:
As long as advertisors continue stuffing flyers at her door, her illness will likely continue to cripple her. Also, her unwillingness to step out of the house will possibly increase her fear of contamination overtime, and worsen her compulsions. Furthermore, without stepping out of her house first, she is unable to seek therapy.

Moreover, her unwillingness to continue treatment greatly perpetuates her illness, as there is hardly any chance of improvement without continuing treatment.

Prognosis:
The long period of illness may significantly lower the chances of recovery.

However, when interviewed, it seems that her family is actually supportive of her going for treatment. Her husband has been footing the utilities bill and is having a hard time with them. She expresses great desire to attend her daughter's upcoming polytechnic graduation ceremony, but insists that she is unable to step out of the house. Both she and her family expresses longings of reunion and "normal" family outings. If her family is able to encourage her to return to treatment, there might be a chance of recovery.

***
I seriously felt very sad for her when I was watching the program! =X

Ok, that's all! I shouldn't be online for so long!! Hahaa. Tchao!