Female Shift Worker Experienced Heart Palpitations and Lost Consciousness without Clear Medical Reasons
Insomnia was the Culprit — Dream Analysis Reveals the Root Cause
Insomnia is a common phenomenon arising from a hectic urban lifestyle. Many think that being sleep deprived is not a major concern if their work is not being affected, and that they could make up their “sleep debt” during the weekends and holidays. We may think that such a mentality is highly commendable as it reflects the hardworking and resilient strengths of Hong Kong people. However, having this coping mentality does not mean that we can truly cope with sleep deprivation, without it affecting our psychological well-being. A 20 something female shift worker suffered from sleep problems but thought that she could cope with it, thus did not address it. During a vacation, she experienced sudden heart palpitations and thought she had a heart attack. This turned out to be a psychological symptom related to her insomnia.
The Consequences of a Disrupted Biological Clock
Dr. Vinci Cheung shares a case of a 20 something year old woman. This client did shift work which disrupted her biological clock. She frequently experienced difficulty sleeping and often was awakened by the alarm during deep sleep. Although these disruptions were quite unbearable, she did not pay much attention to them as the recognition she received at work for her performance overshadowed her sleep problem. The client went on vacation about a year after she had been experiencing insomnia. At the start of the trip, she had sudden heart palpitations and lost consciousness. The client thought she had a heart attack and did a comprehensive medical check once she got home. However, her medical report indicated that she was in good health. As she ran out of options to uncover the causes of the palpitations and her loss of consciousness, the client looked to psychotherapy to find an answer.
After eliminating possible biological causes for the client’s insomnia, Dr. Cheung asked her to record her dreams. Through dreams analysis, it was found that work was the root cause. “Dreams analysis revealed that the client was not able to adapt to the shiftwork which caused the insomnia, but instead of addressing the problem, she just tolerated it. The tipping point took place when she was able to relieve her tensions during vacation, and led to the surfacing of her dissatisfaction with her work. This manifested physically in the form of heart palpitations and loss of consciousness.” The key to psychotherapy is to identify the root cause of one’s concerns. After several counselling sessions, this was achieved as the client realised that her deepest fear was being unable to cope with the frequent disruptions to her biological clock and its effects on her physical health. Upon the realisation, the client had to make the right decisions for herself, such as adjusting her lifestyle as per her own limitations in order to improve sleep quality and achieve work-rest balance, instead of living with the fear of sudden loss of consciousness.
Develop “Immunity” to Triggers
Counsellor Amoy Ong points out that when we experience trouble in sleeping, we should reflect on events that happened during the day or on recent days to identify any possible causes. If we are unable to identify possible causes, it is best to consult a counsellor. Other than pinpointing the trigger/s to overcome or alleviate the sleep problem, knowing the triggers through the counselling process will also improve our resilience in coping with similar situations, hence boosting our ‘immunity’ to them. It is also important that once we notice the physical signals sent by our body, e.g. having trouble sleeping, we should address them promptly to avoid further aggravation of the problem. We are usually oblivious to the triggers or causes that affect our mental well-being. It is only through the guidance of a counsellor that these factors will become apparent. When clients gain clarity on their triggers, many of them can easily find a solution themselves. Finally, Amoy also wishes to emphasise that just as we go to a gym regularly to improve our physical health, we should also regularly invest in time and efforts on our mental wellness to lead a happier life.
Therapies for Insomnia
- Cognitive behavioural therapy (CBT-I), which focuses on one’s thoughts, behaviour and emotions to address insomnia. Research has proven this approach to be effective.
- Emotion-focused therapy, which is based on understanding one’s emotions, followed by transforming and redefining them.
- Traditional or Ericksonian hypnotherapy.
- Dreams analysis.
- Practising Mindfulness.
Note: There are many other therapies (not listed above) that can also be employed as interventions for insomnia. Clients should have a detailed understanding of the approach used by their qualified counsellors to ensure that it suits them.
The Companions
Amoy Ong
Counsellor
