Case Study – 2 Day Individual Program: Emily, 25, female, PhD student

Overview

“I honestly never thought I could feel this good. I keep encountering situations and being surprised at my reaction (or lack thereof). Everything seems easier to deal with… I genuinely keep getting shocked about how calm I am now in comparison to how I was. I can’t thank you enough.”

Before: Age 21-30

Anxiety

Psychological abuse

 

Eating disorder

Suicidal thoughts

Depression

Physical abuse

 

Self-harm

Suicidal acts

 

Loneliness

Sexual abuse

 

Addictions

 

Obsessive thoughts

Low mood

Emotional neglect

 

Disliking the body

Compulsive acts

 

Social withdrawal

Physical neglect

 

Perfectionism

 

Panic attacks

Not feeling good enough

Bullying

 

Alcohol over-use

 

Periods of physical illness

 

Not knowing what to feel

 

Caring for others

Drug over-use

 

Anger

Feeling afraid

Striving to please

Sport over-use

Disrupted sleep

Other:

3 months after

Anxiety

 

Psychological abuse

 

Eating disorder

 

Suicidal thoughts

 

Depression

 

Physical abuse

 

Self-harm

 

Suicidal acts

 

Loneliness

 

Sexual abuse

 

Addictions

 

Obsessive thoughts

 

Low mood

 

Emotional neglect

 

Disliking the body

 

Compulsive acts

 

Social withdrawal

 

Physical neglect

 

Perfectionism

 

Panic attacks

 

Not feeling good enough

 

Bullying

 

Alcohol over-use

 

Periods of physical illness

 

Not knowing what to feel

 

Caring for others

 

Drug over-use

 

Anger

 

Feeling afraid

 

Striving to please

 

Sport over-use

 

Disrupted sleep

 

Other: 

Before

Emily is a 25 year old female living with her long-term partner. She has been very academically successful and pursued an academic career. She has many interests, is physically active, enjoys fitness and has a good group of friends. Emily took a leave of absence from her PhD due to burnout. She was signed off work for a month at a time, resulting in an extended leave of absence of 4 months.

Emily grew up with her parents and 2 younger siblings. From a young age she was branded as difficult by her parents and she remembers them threatening to take her to the doctors to fix her if she didn’t change. Her father had a temper and although she was not regularly hit, she was occasionally on the receiving end of physical abuse. In her teenage and early adult years this led her to believe that she could never be accepted or successful. She feels the impact of her younger years led to:

  • Supressing lots of parts of her personality
  • Depression and burnout
  • Panic attacks and social anxiety
  • “All as a result of trying to be something that I wasn’t to please absolutely everyone.”

What aspect(s) of your life made you consider the Garden Gate Intensive Program and why did you decide to do it?

“I couldn’t see the point in life and felt as though I wished I did not exist. I wanted to not feel like that anymore.”

What are you hoping to get from it?

“I want to be at peace with myself. I feel like I spent a lot of time and effort mentally tearing myself down.”

Measures taken to attend to well-being

“Until the beginning of the leave of absence from work I hadn’t had any medical intervention or counselling. In fact, I was hesitant to approach the doctors as my parents would threaten me with the doctors when I wouldn’t behave. About 9 months prior to the leave of absence I had an appointment with a GP about stress and anxiety, but nothing came of it and the GP told me that what I was experiencing was “just life”.

Regarding self-care I have always had a tendency to turn, a bit obsessively, to exercise. This served more as a distraction than anything else.”

Emily had 17 sessions of counselling with Anne Lindley-French during her leave of absence before the 2 Day Program and has had 1 since.

Well-being self-assessment

Emily completed this self-assessment, showing how she felt during each decade of her life.

Age 0-10

Anxiety

Psychological abuse

Eating disorder

 

Suicidal thoughts

 

Depression

 

Physical abuse

Self-harm

 

Suicidal acts

Loneliness

Sexual abuse

 

Addictions

 

Obsessive thoughts

 

Low mood

Emotional neglect

 

Disliking the body

 

Compulsive acts

 

Social withdrawal

 

Physical neglect

 

Perfectionism

 

Panic attacks

 

Not feeling good enough

 

Bullying

Alcohol over-use

 

Periods of physical illness

 

Not knowing what to feel

 

Caring for others

Drug over-use

 

Anger

Feeling afraid

Striving to please

Sport over-use

 

Disrupted sleep

Other:

Age 11-20

Anxiety

Psychological abuse

Eating disorder

 

Suicidal thoughts

Depression

Physical abuse

 

Self-harm

Suicidal acts

 

Loneliness

Sexual abuse

 

Addictions

 

Obsessive thoughts

Low mood

Emotional neglect

 

Disliking the body

Compulsive acts

 

Social withdrawal

Physical neglect

 

Perfectionism

 

Panic attacks

 

Not feeling good enough

Bullying

Alcohol over-use

 

Periods of physical illness

 

Not knowing what to feel

 

Caring for others

Drug over-use

 

Anger

Feeling afraid

Striving to please

Sport over-use

 

Disrupted sleep

Other:

Age 21-30

Anxiety

Psychological abuse

 

Eating disorder

Suicidal thoughts

Depression

Physical abuse

 

Self-harm

Suicidal acts

 

Loneliness

Sexual abuse

 

Addictions

 

Obsessive thoughts

Low mood

Emotional neglect

 

Disliking the body

Compulsive acts

 

Social withdrawal

Physical neglect

 

Perfectionism

 

Panic attacks

Not feeling good enough

Bullying

 

Alcohol over-use

 

Periods of physical illness

 

Not knowing what to feel

 

Caring for others

Drug over-use

 

Anger

Feeling afraid

Striving to please

Sport over-use

Disrupted sleep

Other:

During

Emily provided the following answers to questions about why she chose the Garden Gate Intensive Program, her experience of doing it and what she thought of it.

How did you feel in the run-up to the 2 day program?

“I was nervous. The whole idea seemed a bit radical and I wasn’t sure I was convinced it could work. I was in a better place than I had been in the months previously, but still felt quite fragile. I also felt quite tense because I had to make a career related decision at roughly the same time as the 2 day program. I was having nightmares almost every night as I had been for a very long time (maybe whole life). I was having to listen to podcasts to get to sleep to drown out panic inducing intrusive thoughts.”

There are 10 components in the Garden Gate. Which were the most useful for you? Which were the least useful for you?

“Whose Garden – “This was maybe the least useful, or maybe I just really didn’t like the questions.”

Four Legged Chair – “This was really important to me, it made me realise what my priorities are and since the program I have been able to indulge in what I now know I need.”

Rule Book for Self – “Very important- I still read this to myself. As the months have passed it’s nice to see that I am starting to live by these rules without having to try. I am more comfortable in myself and don’t feel the need to apologise for being the way I am.”

Did visualising your garden make a difference for you? If so, why? Did you expect this to happen?

“Yes. In a bizarre way, it made me want to take care of myself better having seen the garden in disrepair.”

What was the most memorable aspect of the Garden Gate for you?

“When Anne asked me if I would impose my views on myself as a toddler (she had me pick out a picture) I realised that I couldn’t.”

What were the most 3 most effective aspects of the Garden Gate for you? Please put them down in order of effectiveness.

“Accepting that I did have a problem and I wasn’t just being pathetic. This gave me agency to actually set to solving it.”

Were there aspects of the Garden Gate which you found unhelpful, disappointing, ineffective or boring?

Was there anything you hoped to gain from the Garden Gate which was not forthcoming?

Would you recommend the Garden Gate Intensive 2 Day Program to others? If so, why? If not, why?

“Yes, I would. It got me to a place that I think would have either taken a long time to reach/or never could have been reached with weekly sessions. The two day format allows time to get at the really deep down problems, the problems that would have potentially stuck with me and brought me down again at a later date.”

Is there anything else you would like to say?

“I honestly never thought I could feel this good. I keep encountering situations and being surprised at my reaction (or lack thereof). Everything seems easier to deal with.”

3 months after

What measures are you currently taking to attend to your well-being? Please include details of self-help, medication, counselling/therapy, intervention from health professionals, periods off school/work, time spent in hospital.

“Currently just focusing on getting back on my feet and doing all the things I know I need (from the 4 legged chair). I am back to working full time and really enjoying my life. I try to make the time to visualize my garden and read through the rules to keep me on track.”

Having completed the Garden Gate 2 Day Intensive Program please put a ✓ next to any of the elements that you experienced now and leave the others blank. Please add any aspects of your current experience which are not listed in the ‘Other’ column.

Anxiety

 

Psychological abuse

 

Eating disorder

 

Suicidal thoughts

 

Depression

 

Physical abuse

 

Self-harm

 

Suicidal acts

 

Loneliness

 

Sexual abuse

 

Addictions

 

Obsessive thoughts

 

Low mood

 

Emotional neglect

 

Disliking the body

 

Compulsive acts

 

Social withdrawal

 

Physical neglect

 

Perfectionism

 

Panic attacks

 

Not feeling good enough

 

Bullying

 

Alcohol over-use

 

Periods of physical illness

 

Not knowing what to feel

 

Caring for others

 

Drug over-use

 

Anger

 

Feeling afraid

 

Striving to please

 

Sport over-use

 

Disrupted sleep

 

Are there any other changes in your life, feelings, body, sleep which you have noticed since the program? If so, please use this space to explain what they are.

“The improvement wasn’t overnight, and I still feel I’m getting better week on week. As of now, I no longer feel like I don’t want to exist. I am no longer having nightmares. I can fall asleep without listening to anything and I am no longer suffering from an excess of intrusive thoughts. I feel generally more relaxed, energetic and able to take things as they come. I am being kinder to myself when things don’t go according to plan.

A week or two after the program, I burst into tears and cried for about half an hour. It felt like an acceptance of how sad the previous chapter of my life was and also like I was letting it go.

I have been less obsessive with sport of late, still exercising but with a healthier attitude towards it.”

Are there any aspects you would like to work on in the future that weren’t included in the program or were included but you felt did not work for you?

Anne Lindley-French’s interpretation of Emily’s experience.

Emily is highly intelligent and kind. She engages with the world through a wide range of activities – sport, crafts, cooking, friends, growing vegetables, volunteering, art, reading and I imagine over the span of her life many more to come. Emily excelled at school and pursued an academic career as a logical extension of her intellectual ability, enquiring mind and diligence in what she undertakes. She sought help for the fist time when she burnt out at work, had been signed off and didn’t know what to do to make herself better.

It soon became clear that Emily’s view of herself, whilst strong in some aspects, was incredibly weak in others. So much so that she couldn’t presume to be right on things even if logically she couldn’t find any reason why she wouldn’t be. When we looked at her background for reasons why, we saw a loving and close family whom she cares for deeply a supportive partner whom she adores and a group of close friends she sees regularly. In a sense it was difficult to see what had caused Emily to grind to a halt.

When we looked more closely what emerged was that there was part of Emily that wished she did not exist and aspects of her understanding of herself that blocked her from seeing herself objectively. This appeared to have come into being at a young age and Emily can remember being upset regularly but thinking that there was something wrong with her and she shouldn’t behave in such a way. She tried to hide her emotions, but when they were seen by her parents they were baffled and said they would take her to the doctor to get to the bottom of it. Emily slowly realised that she was different from other people (this wasn’t happening with her younger siblings) and that whilst she could rely on her academic ability to be successful at school, she doubted her core self, thinking that she must be inherently different to other people. As she got older, she tried to argue with her parents to get them to see how she felt but was told not to use her intellect to wrap things up cleverly to get her own way. It became increasingly difficult to express her upset and she came to believe that she must be deficient to have the sad feelings and the best option was to soldier on, try hard and try not to complain. In social situations she would try to be agreeable and frequently worried that she might have said the wrong thing or inadvertently upset somebody.

I found it difficult to persuade Emily that her social processing was accurate rather than faulty. That the internal vulnerability she felt was not a fixed part of her, but an aspect of herself which had evolved in relation to formative experiences and been exacerbated by her trying to fit in to situations and be liked by people rather than believing that she could take the risk of being who she genuinely is. The breakthrough came when she was able to vocalise the long-held assumption that it would probably have been better for everyone had she not existed and that despite putting a lot of energy into her own life her emotional expectations of it were low meaning that existing was difficult and not necessarily desirable.

Emily came to see that her struggles were valid, that she (like all of us) has the right to exist just as the person she is and that she can take care of her emotions when she feels unhappy or anxious rather than seeing herself as weak or deficient. She began to realise that her place in the world is to live confidently as who she is, as a genuine and full version of herself, rather than being constantly on the hop about whether she is fitting in appropriately. Emily left her job, accepted a new job and is enjoying it. I hope that she is now able to see the value to the rest of us that being genuinely herself brings, she is unique, energetic, insightful, compassionate and beautifully full of beans.

 

We would like to thank Emily for her feedback. Her name has been changed to protect her identity. None of her words or circumstances have been changed. Emily has participated in compiling this case study and has approved it to be shared with others.