Clinical Vignettes
22 cases, 156 formulations — see how different modalities understand the same client
Panic & Avoidance
Maya, 29, marketing manager
Three months of escalating panic attacks: heart racing, derealization, chest tightness, fear of dying. The first one hap…
Treatment-Resistant Depression
Sofia, 38, software engineer
Four years of persistent depression unresponsive to two SSRIs, one SNRI, and 16 sessions of CBT. Functional but describe…
Men's Masked Depression
Marcus, 36, firefighter
Referred by physician after elevated blood pressure and insomnia. Wife says he's 'angry all the time' and threatened to …
Late-Life Depression & Meaning
Harold, 74, retired engineer
Six months since wife Margaret's death after 48 years of marriage. Not eating well, losing weight. Stopped going to his …
OCD & the Meaning of Obsessions
Nathan, 26, seminary student
Intrusive thoughts of blasphemous images during prayer: vivid, unwanted, sexually violent content involving religious fi…
Complex Relational Trauma
Darius, 34, Black veteran, currently unemployed
Nightmares most nights: combat scenes that blur into childhood memories. Hypervigilant in public: sits with his back to …
Dissociation & Fragmented Self
Lena, 41, social worker
Loses time: hours or occasionally full days with no memory. Colleagues report personality shifts: sometimes competent an…
Personality & Long-Standing Patterns
Reese, 31, non-binary, barista and part-time artist
Referred after third psychiatric hospitalization in two years for suicidal gestures following relationship breakups. Int…
Suicide Loss & Traumatic Bereavement
Elliot, 37, software engineer
Found his partner David dead by suicide in their apartment eight months ago. Still sleeping on the couch: cannot enter t…
Substance Use & Ambivalence
Carlos, 38, electrician, self-referred
Drinking 6-8 beers nightly, more on weekends. Two DUIs in three years. Wife gave an ultimatum. Says: 'I don't think I'm …
Eating Disorder
Ava, 22, college senior
BMI 17.8, restricting intake to ~800 cal/day with compulsive exercise. GPA 3.9. Reports feeling 'in control' when restri…
First-Episode Psychosis
Aiden, 21, college junior
Three weeks of increasing paranoia: believes classmates are surveilling him, hears a voice commenting on his actions. Sl…
Couples in Distress
James (42) & Priya (39), married 8 years, two children
Escalating conflict over the past eighteen months. The pattern is locked: Priya raises a concern (about parenting, about…
Child Trauma & Behavioral Problems
Marcus, 8, referred by school
Aggressive outbursts at school: hitting peers, throwing objects, defying teachers. Nightmares 3-4x/week. Wets the bed. C…
Adolescent Identity & Family Conflict
Zoe, 16, high school junior
Increasing withdrawal: stopped seeing friends, dropped out of theater (previously her passion). Grades slipping. Irritab…
ADHD, Shame & Underperformance
Jordan, 29, law associate
Diagnosed ADHD-Combined at 27 after a lifetime of 'not living up to potential.' On Adderall, which helps focus but not t…
Late-Diagnosed Autism & Burnout
Sasha, 35, data analyst, they/them
Diagnosed autistic at 33 after a workplace burnout that led to three months of medical leave. Now back at work but strug…
Chronic Pain & Somatic Distress
Diane, 58, retired teacher
Fifteen years of chronic low back pain following a car accident. Multiple surgeries, opioid dependence (now tapered), on…
Chronic Illness & Health Identity
Nora, 39, civil engineer
Diagnosed with multiple sclerosis at 26 after an episode of optic neuritis. Three major relapses since, each leaving inc…
Disability, Identity & Invisible Grief
Maren, 34, graphic designer
Born with spina bifida (myelomeningocele, L4-L5). Uses a wheelchair full-time since age 14 after progressive loss of amb…
Existential Crisis & Loss
Tomoko, 52, architect
Six months after her mother's death, Tomoko walked into her firm one morning, looked at the models and renderings coveri…
Religious Trauma & Deconstruction
Elena, 34, bisexual woman, former missions coordinator
Left a nondenominational church network at 31 after her divorce revealed a relationship with a woman. Parents, both elde…