Problems in therapy came from three areas: Ann, her environment, and her pathology. Although her depressive episodes were less frequent and lasted a shorter time, whenever Ann became depressed, she was unable to cope. At these points, therapy shifted back to the "basics" or to Ann looking at her self-talk, how she was perceiving life experiences, and what meaning these events had for her.

A particular sensitive area was Ann's wish to see and to spend time with her son. Because this would involve the risk of speaking to Tom, then contacting Brian, Ann's negative predictions were catastrophic and global. By dissecting her fear, Ann was able to take a structured, stepwise approach to effecting a change.

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