Because she did not have any close friends who lived locally, she arranged to have her sister attend the third session by conference call. She was surprised at how supportive her sister was. The sister indicated that she was aware that Ann was suffering a great deal but had not known how to help and was “afraid

to make things worse by saying the wrong thing.” She agreed to text Ann every day and talk with her twice a week, including the evening of her therapy appointments. Ann initially had difficulty with imaginal revisiting. At the beginning of session 4, she asked a lot of questions about the rationale and procedures for the exercise; most of these were the same questions she had Inhibitors,research,lifescience,medical asked during session Inhibitors,research,lifescience,medical 2. The therapist PKI-587 order normalized her concerns and praised her willingness

to do something painful to help resolve her grief and come to terms with the loss. Because Ann was so hesitant to begin, the therapist also told her only to spend 2 minutes during the first exercise. Ann did so and was, as she expected, very distressed. During the debriefing process, Ann sobbed as she expressed her guilt over having slept through her husband’s passing Inhibitors,research,lifescience,medical and her agony at not knowing whether she could have saved him had she been awake. She also expressed anger toward her husband’s primary care doctor, who had performed routine annual physical examinations but had never diagnosed cardiac problems. She was able to perform the visualization

exercise aimed at putting the story away and reported a decrease in distress Inhibitors,research,lifescience,medical to manageable levels. Although she agreed to listen to the tape between sessions and scheduled a telephone check-in with her therapist after completing Inhibitors,research,lifescience,medical the exercise the first time, when the time came, Ann told the therapist she was not yet ready. After doing the imaginal revisiting exercise again in session 5, Ann reported that it was still very distressing, but she was willing to try listening to the tape at home. She and the therapist talked about ways Ann could reward herself for Histone demethylase her hard work. She decided she would try to play her guitar, which had always been very pleasant. This time, she was able to complete the imaginal revisiting several times during the week and reported that although it was painful, it was less hard than she had imagined it would be. Throughout the next 6 sessions, she continued to engage in exercises and spent most of the debriefing time focused on the issues of guilt, uncertainty, and anger, which Ann and the therapist agreed were the key factors contributing to her CG. In contrast to the imaginal revisiting, Ann took a great deal of satisfaction from the situational revisiting, which began in session 5. She began by dining in a few of her husband’s favorite restaurants that she had not visited since his death.