Humera, a 42 year old woman, was diagnosed with health anxiety. her psychiatrist suggested to undergo psychotherapy along with medications. During Preliminary intervention, Humera told us that she faced continuous criticism in society for being overweight. She was also diagnosed as hypertensive with high cholesterol levels, doctors recommended her exercises along with healthy eating and medicines.
This diagnosis changed her lifestyle drastically, she said I have successfully controlled my eating habits upto 85%, only in a few family functions she broke the rule of healthy eating. as far as medicines were concerned she never had any problem. The only challenge for her was to develop interest in exercises.
She found it extremely boring, and always liked to escape the exercise hours. From her experiences and readings about her health issues, she developed a belief which was disheartening.
That belief was "If I don't exercise, I will die causing heart failure just like my sister". I asked her how strong is this belief if we are to rate it from 1 to 10. She rated this belief as 10. Further while having a discussion she said repeatedly that she was not finding any interest in exercises.
We mutually agreed to address the Initial problem of developing interest in exercises. I found that she was doing two types of exercises everyday. After introducing her to new sets of exercises, She agreed to workout alternative days in a week. Every day she monitored her mood levels.
On workout day she rated her mood and energy levels two times i.e. before and after workout. On off days she w rated her mood and energy levels exactly on the same times as she would do on workout day. Client agreed to follow this routine for two weeks until we meet in the next session. When she was back her records were as shown in
table 1
Her Exercise schedule Pre Consultation was, stationary bike for 30 minutes and 10 push ups a day. Her exercise schedule was redesigned as shown in below table 2.
She maintained the above workout routine for two weeks. In the next session we found her arriving before the scheduled time. She informed me that her overall experience was good and she enjoyed most of the newly introduced exercises. She also said she could have done this before to get rid of repetitive and boring exercise schedules.Her mood and energy levels improved gradually during these two weeks. She discovered that on off days her mood and energy levels declined as the day progressed. Towards the end of the day mood & energy was significantly low compared to that of workout days.
She agreed happily to stretch her workout schedule and make it 5 days a week. She decided to continue it for 14 weeks. Thus making small changes in exercise routine helped Humera. We recommended few more exercises and a new diet plan for the coming 14 weeks. She was asked to see the therapist every 15 days online/in-person for review. Further work for the therapist was to address her belief about fear of death, weight training and also to build confidence in joyful healthy living in the next sessions. Thus paid consultation helped her to take first step in achieving health goals.
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