ABSTRACT

The Cold-Blooded Businessman (married, age 58) came to therapy complaining of depression and high levels of anxiety, which had been precipitated by a move and had been on-going for the past 12 years. He reported experiencing anxiety as “a lot of physiological inner turmoil”, with persistent diarrhoea, sleep disturbance, erectile dysfunction, and work inhibition. In fact, enquiry revealed that most of his anxiety was around the issue of performance—both at work and in the bedroom. Depression was experienced as dysphoric affect, low energy, and a helpless/hopeless attitude towards life. He was so despondent, in fact, that he had a detailed plan for suicide if this therapy did not work.