A Cognitive-Behavioral Approach to Panic Disorder in a Woman With a History of Incest: A Case Study

This case study is of particular interest because it highlights phenomena that behavior therapists have not described until recently. Such phenomena are regarded as important to an understanding and appreciation of the holistic and complex functioning of human beings.

Michael Mahoney and other cognitive therapists (Eelen & Fontaine, 1986, Mahoney, 1980, Mahoney, 1986) have brought our attention to the unconscious processes, psychological self-focus, dynamic conflicts and childhood experiences that may be essential issues in therapy. These personal processes may be very important in coping with anxiety, especially anxiety that derives from early stages of development.

The description of this case is an attempt to show how cognitive-behavioral techniques can lead to disclosure in psychotherapy and help a client who suffers from panic attacks.

The case study describes how a 47-year-old, married woman, Laura, a victim of incest in early childhood, was helped through cognitive-behavioral psychotherapy. The intense experiences of encroachment and invasion involved in incest are described, together with a demonstration of how cognitive methods are useful in uncovering tacit or unconscious processes. Methods used are in essence similar to well- known treatment procedures with clients suffering from panic attacks (Hawton, Salkovskis, Kirk, & Clark, 1989). In addition, the highly damaging phenomenon of incest in this case involves obstacles of resistance and brings us into deeper levels of interpretation and understanding.