Biography

Dolly Tejaswi Yalamanchili was born in Vijayawada, India. Currently working at Priory Hospital North London. She has a Master of Arts in Psychology and is registered with the HCPC as a Practitioner Psychologist. She has significant experience in counselling adults, children and adolescents with depression, suicidal ideation, anxiety and engaging in behavioural management for personality disorders. Also patients with physiological issues benefitting from therapeutic intervention. She is currently working in a private mental health facility in London. Her broad area of interest in the field of psychology is towards personality disorders and in particular Borderline Personality Disorder. She finds it extremely intriguing to gain a deeper knowledge of the intricacies and nuances of the complex thought processes of individuals and to understand their motive. She considers herself an agent of change and her approach towards therapy is influenced by Carl Rogers ideology of “unconditional love”. She believes that the essence of life is to be explored.

Abstract

The current paper will discuss in detail, a complex case of emotional dysregulation. A sixteen-year-old young person, female, was admitted to an acute ward with a presentation of suicidal ideation, non-suicidal self-injury and feelings of emptiness, emotional dysregulation and difficulties with interpersonal relationships. Family environment was described to be chaotic where the young person felt that her voice was not heard. She often displayed black and white thinking and interpersonal relationships were fraught with extreme emotions. The young person expressed fear of abandonment, the need to engage in impulsive behaviour in order to fill the void and the urge to self-harm. The repetitive patterns of manipulative thought accompanied with impulsive behaviour are especially observed with relation to sabotaging herself. Given the level of emotional dysregulation and with the other dysfunctional behaviour, the working diagnosis is of the Emerging unstable personality disorder. Taking into consideration her presentation and significant past events the case formulation at a therapeutic level is of identifying the core elements of the maintenance cycle and managing the behavioural aspects. The intervention was delivered as a synthesis of pharmacology and integrated psychotherapy. The study would present the intensity of the urges to engage in self-harm and suicidal ideation pre and post the therapy sessions. It is further a review of the progress the subject had made with respect to integrated psychotherapy including CBT, DBT and existential therapy in individual therapy sessions as well as the group therapy sessions. Although it is observed that the young person may appear to regress at times, evidence suggests that there is a significant refinement of thought processes indicated by the substantial ongoing positive changes in the condition of the subject after each session, accompanied by greater self-reflection.