EPILEPSY AS A PSYCHO-SOCIAL DISEASE: WHERE COUNSELING HELPS

“Karen is one of the best examples of the importance of counseling. Karen had her first seizure when she was about ten. It was a tonic-clonic seizure, and then she had a few complex partial seizures later. Medication controlled these for about two years, but when she was about twelve she again began having seizures and first came to Hopkins. The doctor wanted to change Karen’s medicine but was also very concerned about the fact that things were going poorly for her in school and thought the cause might be a problem with the school’s acceptance of her seizures. The doctor asked me to see Karen and find out what was going on.

“Karen was a very shy young lady, and during our first visit all she did was cry. I couldn’t get her to talk at all. So I asked her to keep a journal, to go home and write down her thoughts about everything she felt, so that when she came back we could talk about them. What we discovered was that the problems weren’t in school, they were at home. The major problem was a father who blamed Karen for all of the family strife, arguing, and financial problems.

Eventually we asked her family to come in to talk. Her father never would participate. He was a very domineering type, her mother a rather meek lady. The counseling, which went on weekly for over a year, helped Karen gain control and do better in school. This may have had less to do with understanding epilepsy than with the fact that the family situation changed. Her mother, who ostensibly came to counseling to understand more about epilepsy, gained insight into her own problems. She ultimately decided to divorce Karen’s father. This led to an additional need for family counseling as they readjusted to a single-parent family.

“It took a long time for Karen to realize that the problems were really not due to her but to the dynamics of her family. She finally realized that she was not responsible for having epilepsy. She learned that her medical bills were not the cause of the family’s financial problems. She eventually saw that her father was just using the epilepsy as an excuse and that she was suffering from his blame and her own feelings of guilt.”

“So what you’re saying is that the epilepsy wasn’t Karen’s problem, is that right?”

“Well, not exactly. Karen’s seizures were not a major problem, but she had no education about epilepsy. She was surrounded by all of these family arguments and strife, and she said to herself, ‘Hey, I’m the only one who is sick. I’m the only one who is different. Therefore, all of this must be my fault.’ This also led to her doing poorly in school, which made her think that she was dumb, which she attributed to her epilepsy. All of these things contributed to a terrible self-image. So we had to work on these issues. We also had to work with her brother and sister, who were jealous that she was getting a disproportionate share of attention. They needed to see that Karen was the victim not the cause of parental discord.

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EPILEPSY AS A PSYCHO-SOCIAL DISEASE: WHERE COUNSELING HELPS”Karen is one of the best examples of the importance of counseling. Karen had her first seizure when she was about ten. It was a tonic-clonic seizure, and then she had a few complex partial seizures later. Medication controlled these for about two years, but when she was about twelve she again began having seizures and first came to Hopkins. The doctor wanted to change Karen’s medicine but was also very concerned about the fact that things were going poorly for her in school and thought the cause might be a problem with the school’s acceptance of her seizures. The doctor asked me to see Karen and find out what was going on.”Karen was a very shy young lady, and during our first visit all she did was cry. I couldn’t get her to talk at all. So I asked her to keep a journal, to go home and write down her thoughts about everything she felt, so that when she came back we could talk about them. What we discovered was that the problems weren’t in school, they were at home. The major problem was a father who blamed Karen for all of the family strife, arguing, and financial problems.Eventually we asked her family to come in to talk. Her father never would participate. He was a very domineering type, her mother a rather meek lady. The counseling, which went on weekly for over a year, helped Karen gain control and do better in school. This may have had less to do with understanding epilepsy than with the fact that the family situation changed. Her mother, who ostensibly came to counseling to understand more about epilepsy, gained insight into her own problems. She ultimately decided to divorce Karen’s father. This led to an additional need for family counseling as they readjusted to a single-parent family.”It took a long time for Karen to realize that the problems were really not due to her but to the dynamics of her family. She finally realized that she was not responsible for having epilepsy. She learned that her medical bills were not the cause of the family’s financial problems. She eventually saw that her father was just using the epilepsy as an excuse and that she was suffering from his blame and her own feelings of guilt.”"So what you’re saying is that the epilepsy wasn’t Karen’s problem, is that right?”"Well, not exactly. Karen’s seizures were not a major problem, but she had no education about epilepsy. She was surrounded by all of these family arguments and strife, and she said to herself, ‘Hey, I’m the only one who is sick. I’m the only one who is different. Therefore, all of this must be my fault.’ This also led to her doing poorly in school, which made her think that she was dumb, which she attributed to her epilepsy. All of these things contributed to a terrible self-image. So we had to work on these issues. We also had to work with her brother and sister, who were jealous that she was getting a disproportionate share of attention. They needed to see that Karen was the victim not the cause of parental discord.*221\208\8*

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