Presentation Case Study Debate Coursework

Mechanisms of Mind-Body Therapies Debate Case Study

Sommerville Surgery

10 Magnolia Street

London

Dear Mental Health Team,

Please accept this referral to your service. Stan is a 55-year old male who took early retirement from work as a construction worker, on medical grounds. Stan tells me that he experienced chronic pain after an accident at work 10 years ago. He was working on a building site when he fell at height from some defective scaffolding. Stan needed to have major surgery on his back and leg after the fall and was unable to work on a building site again. Although Stan recovered from most of his major injuries within a year of his surgery, Stan reports being left with chronic pain in his back and leg, meaning that it is an effort to walk. Stan received compensation for the accident, which he used to build a luxury shed in the garden and to go on holidays with his wife. He mentioned that he and his wife had always gone on active holidays in the past and that he found it hard to adjust to more sedate activities, due to his reduced mobility. Before his accident, Stan reports being “just fine”, enjoying meeting friends in the pub, DIY and going hiking with his wife and two adult children. When I enquired about his childhood, Stan remarked that his mother had always had high expectations of him and that he had not known his Dad.

Stan reports that he sits at home most days, despite his wife’s attempts to get him out of the house with her. He dislikes leaving the house because he feels embarrassed by his reduced mobility and anticipates most activities as being hard work and painful. Stan has a few friends that he used to go to the pub with regularly, however he hasn’t felt able to tell them about his pain meaning that he has avoided seeing them.

Stan has been married to his wife for 30 years and he reports feels guilty for not being a better partner to her. He tries to make up for this by taking care of long-standing home repairs. Stan recognizes that he often overdoes it when he takes on one of these projects, which exacerbates his pain and leads him to feel hopeless. He starts to focus on all that he has lost and imagines a future in which he is weak, and house bound. He also acknowledges that, when he is in this physical and emotional state, he is likely to snap at his wife and say things he later regrets. I have offered to refer Stan for talking therapy, but he is hesitant about the idea of talking to a stranger about his emotions. I therefore wonder if there is anything else that your service could offer Stan?

Yours faithfully,

Dr Reese