Harmony Unveiled: A Case Study on Transformative Stress Reduction Through the Combination of Psychotherapy and Movement

It is not uncommon for patients to come to therapy with concerns of feeling overwhelmed with their stress levels and not knowing where to start. Psychotherapy and physical exercise can be used in combination to exponentially increase each of their benefits related to stress reduction and emotional release. In this blog, we will dive into a case study of how one patient saw the interaction between the two shift their ability to cope with stressors in her life and recognize factors contributing to the build up that has left her feeling burnt out and defeated. The patient, referred to as Sarah, sought help for her symptoms, which included anxiety, irritability, and difficulty coping with daily life stressors.

Disclaimer: This is a fictional case that draws from clinical experience, it is meant only to give an example of what treatment can look like.

Background:

Sarah, a 32-year-old marketing professional, has been experiencing chronic stress due to work pressures, relationship issues, and a recent personal loss. Her boss often assigns projects with vague and unrealistic expectations that have her working late into the night and on weekends. Her partner complains they are not spending enough quality time together. She reports feeling like it is impossible to meet everyone’s expectations of her and is reporting symptoms of anxiety that impact her overall well-being and functioning, both in her professional and personal life.

Treatment Plan:

Sarah’s treatment plan involved an integrative approach, combining psychotherapy and physical exercise. The psychotherapist employed a cognitive-behavioral therapy (CBT) framework to address negative thought patterns, coping mechanisms, and emotional regulation. Additionally, a certified personal trainer collaborated with Sarah to design a tailored exercise program focusing on aerobic and strength training.

Psychotherapy Sessions:

Sarah attended weekly psychotherapy sessions to explore the underlying causes of her stress and develop healthier coping strategies.

• Using CBT, she gained insights into automatic negative thoughts and learned to challenge and reframe them.
• Through cognitive restructuring, Sarah utilized tools to reframe stressful situations, promoting a more adaptive response.
• Together, they explored her history of setting boundaries and holding herself to unrealistic standards regarding meeting the expectations of others.
• Sarah began to recognize how to communicate her needs and limitations, prioritize recognizing and expressing her emotions, while giving herself grace throughout the process.

Brief example of session dialogue:

Sarah: I’m so afraid to let people down. I always end up letting them walk all over me.

Therapist: It may be helpful to explore where these expectations you have for yourself come from and whether they are realistic.

Sarah: I think I’ve always had a hard time setting boundaries with people.

Therapist: How were boundaries modeled for you by the adults in your life growing up?

Sarah: My mom was always a people pleaser, so I guess I kind of picked that up from her.

Therapist: Let’s think about where you see those tendencies coming up in your day to day life.

Therapy sessions helped her build a tool kit of mindfulness and relaxation techniques, reducing the impact of stressors by fostering present-moment awareness. Mindfulness practices enhanced emotional regulation and provided a sense of control over stressors. The therapeutic relationship gave Sarah a safe space to identify her personal triggers and confront her stressors.

Physical Exercise Program:

Sarah and her therapist identified exercise as an area of focus to begin implementing self care into her routine. She began to follow a structured physical exercise program three times a week. The program included a combination of cardiovascular exercises, such as jogging, and strength training using weights. The exercise routine was designed not only for physical fitness but also to encourage the release of endorphins, the body’s natural mood lifters.

• Regular aerobic activity helped to reduce cortisol levels, a hormone that the body produces in response to stress.
• Strength training exercises helped alleviate muscle tension that Sarah had been carrying associated with her stress.
• As Sarah continued to train, her improved muscular strength contributed to a sense of physical empowerment, reinforcing a positive connection between physical and mental well-being.
• As she learned more about mindfulness in therapy, she incorporated yoga sessions into her program which provided a holistic approach by combining physical activity with mindfulness. Yoga’s focus on breath control and gentle movements contributed to relaxation and stress reduction.
• Sarah would reflect on how the exercise was helping her in therapy sessions, reinforcing the new healthy habits.“I would talk with my therapist about how exercise helped me relax, etc, and over time I began to recognize the importance of physical activity, which reinforced the rationale behind doing it regularly (WHY I do it).”

Results:

After a period of combined and consistent psychotherapy and physical exercise, Sarah reported significant improvements in her overall well-being. Specific outcomes included:

Stress Reduction: Sarah experienced a noticeable reduction in her stress levels. The combination of psychotherapy and exercise provided her with effective tools to manage stressors and cope with challenges more resiliently. Lifting weights not only reduced muscle tension but also instilled a newfound confidence. This empowerment positively influenced how Sarah approached and managed stressors in various life domains, including reflecting on and communicating her boundaries with her employer and romantic partner.

Emotional Release: Engaging in regular physical exercise allowed Sarah to release pent-up emotions. Taking 30 minutes out of her day, 3 days a week to focus on movement that she enjoyed allowed her to recognize the impact of taking even a short portion of her day to prioritize her own well being. The endorphin release from exercise, coupled with insights gained through psychotherapy, helped her express and process emotions in a healthier manner – both at work and at home with her partner.

Conclusion:

This case study highlights the synergistic benefits of combining psychotherapy and physical exercise in the treatment of stress and emotional distress. The integrative approach proved effective in addressing both the psychological and physiological aspects of Sarah’s well-being, fostering a holistic recovery. The collaboration between mental health professionals and fitness experts showcased the potential for a comprehensive treatment plan to enhance the overall quality of life for individuals dealing with stress-related challenges. Throughout this process, Sarah became better equipped to face challenges with a balanced perspective, and the positive habits formed through therapy and exercise became integral components of a sustainable stress management strategy.