title: 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.
authors: Dept. of Neurology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany ; Andrews/Reiter Epilepsy Research Program Hidden Valley Lake, CA 95467, USA ; Faculty of Health, Department of Medicine, Chair for Theory of Medicine, Integrative and Anthroposophic Medicine, Integrated Curriculum for Anthroposophic Medicine, University of Witten/Herdecke, Witten, Germany.
authors: Rosa
authors: R
authors: Michaelis
authors: Andrews/Reiter Epilepsy Research Program Hidden Valley Lake, CA 95467, USA.
authors: Donna J
authors: DJ
authors: Andrews
authors: Andrews/Reiter Epilepsy Research Program Hidden Valley Lake, CA 95467, USA.
authors: Joel M
authors: JM
authors: Reiter
authors: ARCIM Institute, Filderklinik, Filderstadt, Germany ; Dept. of Pediatrics, Fribourg Hospital HFR, Fribourg, Switzerland.
authors: Tido
authors: T
authors: von Schoen-Angerer
keywords: Cognitive–behavioral therapy; Drug-resistant seizures; Epilepsy; Psychotherapy; Seizure trigger; Stress