Chapter 13. Case “A” (2)

Present Illness)
A’s emotional problem started already when she was a junior-high student. She began to have episodes of hyperventilation and “syncope” (unclear if she lost consciousness or not) in her classes, and she visited a psychiatrist. Her EEG (brain wave test) turned out to be normal and A was told that she did not need any treatment. In her high school days, her hyperventilation subsided and had relatively a stable school life.
In college, she majored in economy. She lived by herself near the college. Although she was a diligent student, A was known to sometimes “go out of her mind” and suddenly talks like a small child, especially when A experienced some minor trouble or stress in her relationship with her friend or her boyfriend. She also had episodes of depressive mood, irritability and excessive eating. She was advised to visit the students’ clinic, where she was told that she might have minor depression. She was also prescribed some antidepressant that she never touched.
After she graduated from the college, she moved back to her home town and lived with her parents and her younger brother again. She got a job of a secretary for a local welfare office. She was initially a hard worker and was well accepted by her boss and colleagues, but several months later her problem started. When A experienced some minor stress, she had seemingly dissociative episodes. She became dazed or sobbing, confining herself in the bathroom, where she secretly cut her wrist. A was amnesic about most of these episodes. One day her boss told A that she looked tired and she should better take a day off, which deeply hurt her. She felt that her boss no longer trusted her. A’s relationship with her boss worsened since then and her job performance deteriorated further as she had dissociative “episodes” more often. Finally her mother was contacted, who took an initiative in taking her to the local clinic where I took charge of A.
It was later revealed that A’s conflict with her mother at home was also to an exhausting level. A felt that her mother was watching her all the time and emotionally dominating her as she has always been. A got easily argumentative with her mother, and would not talk to her for days, although A never became dissociative or childish in front of her.