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.

Keywords

Epilepsy; Stress; Drug-resistant seizures; Seizure trigger; Psychotherapy; Cognitive–behavioral therapy

Citation: Michaelis, R., Andrews, D. J., Reiter, J. M., & von Schoen-Angerer, T. (2014). Resolving cognitive dissonance by acquisition of self-organizational skills may decrease drug-resistant seizures—A case report. Epilepsy & Behavior Case Reports, 2, 64–66. https://doi.org/10.1016/j.ebcr.2014.03.003