Taoist Cognitive Therapy: Treatment of Generalized Anxiety Disorder in a Chinese Immigrant Woman

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Abstract

This case report describes the application of Taoist cognitive therapy (TCT) to a 32-year old Chinese (Fujianese) American immigrant woman with generalized anxiety disorder (GAD). TCT is a manualized adaptation of an indigenous psychotherapy developed in China (Zhang & Young, 1998; Zhang et al., 2002). Mrs. Liu received 16 sessions of TCT administered in Mandarin by a Chinese American social worker in conjunction with psychopharmacologic treatment. Sources of data included case notes, transcripts of session recordings, client thought records, and a battery of standardized measures. Mrs. Liu presented with significant guilt regarding her perceived failures to fulfill her filial obligations postmigration, which resulted in constant worry about family members’ health, reassurance-seeking, and controlling behavior. Her anxiety and worry were conceptualized as the result of rigid attachments to beliefs, goals, and desires that are not reflective of the natural order of the universe (Tao). Mrs. Liu was guided in reevaluating stressful situations from the perspective of 8 Taoist principles that promote collective benefit, noncompetition, moderation, acceptance, humility, flexibility, wuwei (nonaction), and harmony with the laws of nature. Clinically significant reductions in anxiety, worry, and experiential avoidance were observed after 16 sessions. However, results were attenuated by the 4-month follow-up due to acute stress surrounding her husband’s deportation proceedings. This case highlights how immigration-related stressors, including transnational family separation and cultural values, can shape the experience and expression of GAD. Further, the positive treatment response provides some evidence of the acceptability and applicability of TCT to Chinese immigrants with GAD.

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