William Thompson looks like a jovial person as evidenced by the spontaneous smiles and the jokes he cracks but these smiles appear like a cover up of some deep-seated pain within him which can be traced back to some dark experiences that he went through in the past. As he states towards the end of the clip, he suffers from PTSD which can be related to the loss of his house after he was unable to service the mortgage loan which forced him to move back and stay with his brother. A keen look at him can reveal symptoms suggestive of PTSD as classified under DSM-5. For example, he momentarily appears to have flashbacks of the sad memories which distract him from the conversation. The use of ‘anyway’ in his speech also shows that he is still struggling to forget the sad ordeal of losing his house and divorcing his wife. Since the sad moments have a trigger which is losing his house and having to divorce his wife and the fact that the sadness is prolonged, this qualifies his condition to PTSD as outlined in DSM-5.
I would manage this patient by use of behavioral therapy and use of medications. The behavioral therapy of choice in this case would be the cognitive processing therapy which is a 12 session psychotherapy used to treat patients with PTSD with each weekly session lasting about 60-90 minutes. It involves the patient expressing himself to the therapist and explaining how the events occurred. The patient might also be required to jolt down every step of the occurrence of the sad ordeal. After this is done, the psychologist evaluates the circumstances surrounding the occurrence of the event(s) and tries to point out various contributors that were beyond the patient’s control (Asmundson, et al., 2018). This helps to calm the patient down and makes them to stop blaming themselves for whatever happened. Over time, the patient learns to accept that it was not their fault and slowly the guilt fades away and they are able to live with the situation without having to blame themselves. During the psychotherapy sessions, I would put the patient on an antidepressant such as paroxetine which would help to reduce the depressive symptoms thus complementing the psychotherapy in dealing with the depressive symptoms (Kučukalić, Bravo-Mehmedbašić, & Džubur-Kulenović, 2008). This drug has been shown to help with faster resolution of symptoms of PTSD. With these two therapies, I would expect that the patient would stopping thinking too much about the painful memories of the past and instead figure out ways of how to move on with his life and get another house for himself, get another wife and simply forget the past events.
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References
Asmundson, G. J. G., Thorisdottir, A. S., Roden-Foreman, J. W., Baird, S. O., Witcraft, S. M., Stein, A. T., … Powers, M. B. (2018). A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder. Cognitive Behaviour Therapy , 48 (1), 1–14. doi: 10.1080/16506073.2018.1522371
Kučukalić, A., Bravo-Mehmedbašić, A., & Džubur-Kulenović, A. (2008). Paroxetine in the Treatment of Post Traumatic Stress Disorder: Our Experiences. Bosnian Journal of Basic Medical Sciences , 8 (1), 76–79. doi: 10.17305/bjbms.2008.3002
