years ago. Shortly after this incident, Randall experienced the death of both parents in an automobile accident- an event that may or may not be related to the exacerbation of the problems he endures on a daily basis when leaving his home.
In addition to feeling the effects of acute panic and fear in public settings, Randall’s condition has worsened to its current state of borderline OCD practices, including the need to go back to his home after leaving and verifying his door has been appropriately locked multiple times, not being able to leave until he verifies that there is ample supply of toilet paper in the car, and the need to map out a facility before entering as to determine the location of the restrooms. From a biological perspective, Randall may be experiencing his anxiety due to a deficit in his gamma-aminobutyric acid reception (Perspectives on Generalized Anxiety Disorder, 2009). While GABA is an inhibitory neurotransmitter that contributes to cortical functions, vision, and motor control, GABA is also responsible for regulating anxiety. This crucial function of GABA may explain Randall’s anxiety, should he be suffering from a deficit. The means of treatment from a biological perspective for this particular shortage can come in a variety of forms, ranging from medication in the form on antianxiety drugs, to relaxation
training. The psychodynamic perspective offers a very different insight as to why Randall may be experiencing the effects of Generalized Anxiety Disorder (GAD). Rooted in the teachings of Freud, the psychoanalytic perspective suggests that Randall’s fear could be based in early childhood experiences. There are correlations between the perspective’s thoughts on early childhood relationships with parents and Randall’s life. His relationship with his parents was one he described as “strained” from an early age; one where he did not feel the closeness of the typical parent-child bond. Treatment for the disorder from a psychoanalytic perspective would include psychoanalysis, a process Randall was involved in for many years. This treatment is described from his perspective as being “fruitless.” Despite his dedication to the treatment, and that psychoanalysis has been proven to determine and treat the childhood causes of the disorder in some cases, he did not see any benefit in the symptoms of GAD. The humanistic perspective of Randall’s condition points to a different set of potential circumstances entirely. Comer (2014) suggests that Randall may have been more inclined to develop this GAD than others due to a lack of positive regard from others. Randall admits to feeling an inability to regard himself with any kind of positivity at times, and this could be the humanistic explanation for the disorder. Persons without the ability to see the positives in themselves are often more likely to develop these disorders per the teachings of the humanistic perspective. These dysfunctional trains of thought are said to be the underlying cause of the anxiety. Humanistic treatment
1is based upon “a hopeful, constructive view of human beings and the individual’s substantial capacity to be self-determining” (Hurst, 2015). In a similar vein as the psychoanalytic perspective, humanistic treatment addresses past experiences that may have an impact of Randall and the anxiety he endures. This approach consists of open-ended questions designed to emphasize the innate goodness and positive potential of the affected person. Through this self-awareness, the person is thought to evaluate their methods of thinking and form more positive reactions to the environment. The behavioral perspective suggests that Randall’s anxiety is not something he suffers from due to any one event in his life, or any relationship. Rather, this approach suggests that his anxiety is something he has learned; that the ways he has taught himself to cope with the stressors in his life. Through this maladaptive learning, Randall has taught himself to react inappropriately to stimulus, and needs help in forming healthy reactions to every day stressors. The behavioral approach suggests that Cognitive Behavioral Treatment, or CBT, should be the treatment Randall should receive for this disorder. CBT is the most widely used form of treatment for anxiety disorders (Therapy for Anxiety Disorders , 2016). This treatment teaches the affected person to acknowledge what anxiety is caused by, how it manifests itself in the body, and how to confront those fears/stressors in a healthy manner. Systematic desensitization is one aspect of CBT aimed at anxiety, where the affected person is taught to gradually build confidence and skills to manage anxiety through graduated exposure. The cognitive approach to anxiety is very similar to that of the behavioral perspective. In this approach, it is explained that the person’s fear of negative impacts and the viewpoints of positive impact from the stimulus are greatly skewed. By overestimating the threats, the person also underestimates their capacity to manage those threats, thus resulting in the subsequent anxiety (The congitive Theory of Social Anxeity , 2012). This approach also utilizes the methods of CBT to manage symptoms and teach healthy coping skills for the anxiety attacks by reprogramming responses to triggers and teaching the affected person to understand the root causes of the anxiety. The sociocultural approach for GAD varies slightly from the aforementioned five approached. Here, the anxiety is said to arise from poor social conditions, ones that may even be deemed as dangerous or hazardous. Social stressors, such as poverty, can be associated with higher rates of anxiety and subsequently, associated with heightened rates in crime. It is interest note Comer’s perspective on GAD and poverty, as he notes that GAD is twice as likely in persons with low incomes as opposed to those in the upper tiers of earning. Treatment from this perspective means addressing and remedying the factors that lead to the person’s anxiety. With the sociocultural perspective stating that the root is in both social and psychological settings, the treatment plan that would follow the diagnosis would be one that was inclusive of many of the previous teachings. While Randall continues CBT treatment for his GAD, he has seen marked progress in social settings. A decline in the medications he once took daily is one sign of the benefits of treatment, as he now takes many medications on an “as needed” basis. Though GAD is a pervasive disorder in contemporary culture, the variety of means to diagnose and treat the condition stand to benefit many who seek help for the disorder. Through proper education, diagnosis and treatment, those who suffer with GAD, like Randall, have many options to follof to live out more balanced, fruitful lives.