Anti-Depression Online Directory

Oedipal Children

admin — Thu, 28 Aug 2008 14:50:02 +0000

If the Oedipal child feels remote from your experience, consider Peter (in chapter 4) as his wife was dying. Despite the fact that he had already decided to divorce her, despite the fact that her illness made her a vengeful, raging harridan, Peter didn’t let himself feel a wish that she would die—yet he still felt guilty. All his tender ministrations and self-sacrifice during her illness couldn’t undo his guilt. Or look ahead to Sharon’s story in chapter 14. Sexually abused as a child, she couldn’t allow herself to experience normal sexual desires. She had to make the men in her life the sexual aggressors, then feel guilty, dirty, and ashamed for letting herself be seduced again. It is a guiding principle of everyday life, but one we’d like to forget about—we feel guilt about feelings and desires without being aware of the feelings and desires themselves.
Now, people with depression hardly let themselves feel any emotion at all. Instead of the normal fluctuations of happiness, sadness, disappointment, joy, desire, and anger that most people cycle through many times a day, depressed people feel a kind of gray neutrality that translates into subterranean tectonic shifts in mood. But even though they aren’t aware of the emotions, they still get to feel guilty about them. When the meek, depressed wife of a bullying husband doesn’t consciously feel angry at his treatment, she will still feel guilty about her rage without even experiencing it. If a man is unaware of his attraction to a coworker, but instead treats her badly out of reaction formation (a primitive defense in which we do the opposite of our wish— what little boys do to little girls they like), he still feels guilty about unacceptable impulses. If my drinking interferes with my ability to work, even though I’m in denial about my drinking, I can still feel guilty. This is one of the great secrets of depression. The depressive is full of guilt about feelings, desires, and impulses he’s not even aware he has.

Psychotherapy Of Emotions

admin — Thu, 28 Aug 2008 14:48:52 +0000

When the therapist and I talked about Alex, we found that psychotherapy had many ways of explaining why he’d gone back to his old ways. It was “resistance” - there was a part of him that wanted to get well, and a part that didn’t, and the two parts were at war. His old pattern was a “security operation” designed to make him feel safe in a threatening world. Or perhaps he was misdiagnosed - he wasn’t really depressed, he was suffering from a “personality disorder of the schizoid type.” Perhaps he needed behavioral coaching - the specific ways to act, to talk to people, weren’t in his “behavioral repertoire.”
Though there may be something helpful for the therapist and patient in all these ways of looking at the problem, I think they miss an important point - Alex teas afraid of feelings he couldn’t control. When the affair was only taking place in his imagination, he wrote the script. Everything that happened, including the final rejection, was a product of his own mind. But if he got close
to a real person, he wouldn’t be in charge anymore. He placed himself in danger of feeling real feelings. What if someone else really loved him? To be loved is heady stuff. Alex spent his life avoiding extremes of emotion.
In order to learn any new skills that will help overcome and prevent depression, it’s essential to start with emotions. Depres-sives fear feelings. Other self-defeating habits that will be explored in the following chapters - in how we think, act, communicate, and view ourselves - are essentially ways we have developed to help us not feel certain things. Unless we understand first that these emotions are not to be feared, we won’t be able to change our other habits.

The Self

admin — Thu, 28 Aug 2008 14:46:43 +0000

Depressed people don’t have inner resources of self-esteem that help them get through trying times. We look to others to replace those resources but know that such wishes are unfair and unrealistic; consequently we are consumed by shame and guilt. We want desperately to be loved, but feel we are unlovable. We haven’t been able to determine principles and values for ourselves, nor to guide our lives by rational priorities, because we’re so guilt-ridden that every detail seems important; we can’t afford any mistakes. We can’t feel good when we accomplish a meaningful goal because all goals are the same;
making a ousy dinner iee s as li it can undo our pride about graduating from college. We need to leam how to set priorities, to take pleasure in our accomplishments, and to integrate that pride into our selves. We have to cultivate detachment, to learn patience and discrimination.
The next five chapters review how depression affects our functioning and how our altered functioning in turn reinforces depression in each of these five areas of living. By stepping back from ourselves and seeing how we do depression, we can also perhaps see how to undo it. The reader may not need any more from this book than an altered perspective. But most people with depression need more—they need specific advice about how to change, they need specific techniques, skills, or habits that they can leam to replace the self-defeating skills of depression. So I’m providing these as well. I’m going to be concerned that the depressed reader will be overwhelmed by this section, concluding, “Oh God, I have to remake myself from the ground up. I’ll never be able to do all this. I’d better just go back to bed.” What I want to say is, Relax; take it easy. You don’t have to do it all at once. You can start anywhere to undo depression. Any chapter, any suggestion, may be enough to get you started on a self-reinforcing cycle of healthy behavior. But you do have to start.

Emotions

admin — Thu, 28 Aug 2008 14:45:58 +0000

Thought processes. Cognition, the way we think, must be changed. Jerome Frank talked about our “assumptive world,”1 the set of beliefs that we all have that explain how life works. We get some assumptions from our parents, we develop others as we grow up, and we continue to add to and revise our beliefs
about what makes things tick into adulthood and old age. Depressed people tend to have certain assumptions in common, which are self-perpetuating and not corrected by experience. We think that we are responsible for the bad things that happen to us, while the good things are just accidental. We are pessimists, thinking that things left alone will usually go to pieces rather than working out for the best. We think that we have to be in control of things at all times, and if we’re not, disaster will happen. These habits of thinking are largely unconscious. They must be brought out into the open, challenged, and changed for the depressive to recover.
Relationships. Relationships with other people are always difficult for the depressive. We walk around with a vast hurt inside and long for someone to heal it, but we’re also ashamed of feeling that way, so we don’t let anyone know. We care too much about how others feel and think about us, but we’re afraid to let them know we care; consequently we’re almost always disappointed. Always expecting rejection, we may reject first as a defense. Our boundaries are too permeable, so that we often assume others know how we feel, and that we know how they feel. Despite the fact that we’re wrong about this so often, we don’t learn from experience and stop making these assumptions. We have to learn specific techniques of communication that will establish boundaries and stop the confusion.

Support

admin — Thu, 28 Aug 2008 14:44:29 +0000

Another essential element is emotional engagement and support. The patient does not usually communicate the depth of his pain and fear to those closest to him. It may be that he wants to protect them, it may be that he fears they will reject him; regardless, he “stuffs” his feelings, to borrow an AA term. He bites back on his feelings and tries to pretend they aren’t there. If he shows them at all, he usually gets advice from those around him that is less than helpful. Others are quick to give advice because they, like the patient, are afraid of the need and pain. The good therapist, at this stage, doesn’t give advice. He shows by example that the feelings are not to be feared; in fact, he probes and goes deeper. He lets the patient know that depression is a process that has a life of its own, that there is good reason for hope because depression does end, but that feelings are important. Sometimes all the therapist can do is hold the patient’s hand, as it were, while they wait together for the medication to work. Often there is no one else in the patient’s life who can do this.
Once trust and support are relatively stable, the healing work of psychotherapy can begin. Many aspects of the individual’s functioning can change with treatment. I have grouped these into five major areas: how emotions are experienced; patterns of behavior; thought processes; relationships with others; and how the patient feels about himself. Each of these aspects is explored in depth in the coming chapters, but here is a brief overview.