Resolving cognitive dissonance by acquisition of self-organizational skills may decrease drug-resistant seizures — A case report

Abstract

A recent review of psychobehavioral therapy for epilepsy recommends case reports as a research design to explore specific psychological mediators of psychobehavioral interventions for epilepsy that address the bidirectional relationship between psychological states and seizures. The report was prepared according to the consensus-based CARE guidelines for standardized clinical case reporting.This is a case of a 16-year-old male individual with a diagnosed seizure disorder and learning disability who continued to have daytime and nighttime seizures on a regular basis despite exhausting of available conventional treatment options. A psychological assessment led to the working hypothesis that cognitive dissonance between fear of failure and high expectations of self had led to a “broken” self-image and active avoidance of responsibility that resulted in intense emotional distress which correlated with the occurrence of seizures. This working hypothesis resulted in a treatment plan that employed the acquisition of self-organizational skills and relaxation techniques as the main therapeutic strategy. Motivational strategies were employed to facilitate the regulation of lifestyle-related seizure precipitants. In this case, the acquisition of self-organizational skills and the development of seizure interruption techniques correlated with a clinically significant decrease of seizures. Methodological limitations of the interpretation of the presented data are discussed.

How Can We Enhance the Sense of Self-Efficacy in Epilepsy Individual Responses from 2 Qualitative Case Reports

“…The literature suggests that the Andrews/Reiter (A/R) intervention is one of the most comprehensive psychological approaches to epilepsy [11]. Prospective uncontrolled and retrospective evaluations have demonstrated a decrease in seizure frequency and an increase in HRQoL in individuals who participated in the A/R intervention [12,13,14,15]. To the knowledge of the authors of this study, a qualitative study investigating the concrete behavioral, cognitive and psychological effects of epilepsy-specific psychological interventions in general and the A/R approach in particular has so far not been conducted, even though qualitative research seems pertinent to the investigation of the complex effects of psychotherapeutic interventions by exploring and representing patient perspectives.…”