Case Study 2: Individual Work

Note: Composite example to protect client confidentiality.

Mia was a first-year university student who was experiencing cycles of anger and unhappiness that were becoming longer and more intense. She felt that she was doing the wrong degree and was slipping further behind in her studies. Mia went home to her parents every other weekend and lately had found herself getting into heated arguments with them over seemingly trivial issues, which was unusual. After four sessions, Mia was still struggling to engage with therapy, and her sense of despondency and hopelessness was getting deeper.

Mia reacted with interest when I suggested we use the Rainbow Map to help with her cycling episodes of anger and low mood. I explained it briefly to her and she commented on the coloured bands and what they meant to her. She focused on the trigger cycle column and recognised how quickly she got angry with her parents. She pondered on why that was happening and started to reflect on whether it might be connected to a fear of letting them down. She also thought more about the intensity of her anger and whether it ever got into the red zone. She said the arguments could last for up to an hour and that afterwards she felt totally exhausted – her mood and energy collapsing into the blue to dark purple hypo-triggering band. She said she could remain in those bands for two to three days on her return to university and was unable to do much work, which was what was causing her to fall behind in her studies.

I asked Mia how she recovered out of the blue hypo-triggering band. She wasn’t sure but thought that perhaps the first sign that it was happening was feeling able to open a textbook, and this was easier if she chose one relating to the module she had some interest in. This led to a conversation that generated other ideas about how she could re-engage with her studies.

Our conversation then moved on to whether she noticed any physical signs as she became increasingly angry with her parents. Mia thought that the pitch of her voice went up and her throat felt increasingly tight. I asked her to consider whether her tightening throat sensation could be used as her personal Trigger Flag. This stimulated a discussion about how that could help her realise she was triggering before the conflict became too intense. I asked Mia what she might be able to do to help calm herself if she noticed her trigger flag and she thought that going for a run might distract her, or perhaps massaging her throat to ease it. As the session ended, Mia asked if she could take the Rainbow Map away with her. She wanted to put it on her pinboard in her dorm room to remind her what we had been talking about.

At the following session Mia reported that, on her last visit to her parents, she had managed to hold her triggering within the yellow zone on her Rainbow Map, as she described it, while having a conversation with them about what was happening at university. She felt as though a weight had started to lift from her shoulders, but that more work would be required if she was to hold onto these gains