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Tuesday, June 11, 2013


Some Insight and Thoughts on Depression and Therapy:

Depression is a confusing and even paradoxical-contradictory disorder. A woman, who by all means is beautiful but suffers from depression, may say she wants or needs to get plastic surgery in the belief that she is ugly and unhappy with her looks; a very competent school teacher may conclude that their teaching methods are worthless. Severely depressed people may seek punishment, humiliation, and death by suicide despite outward signs of achievement and social success. Yet, unless suicide intervenes, the chances for the depressed person's recovery are excellent, and complete remission of an episode of depression occurs in seventy to ninety-five percent of cases, although common, there are recurrences.

My thoughts and reasoning on depression have changed radically over the years. For example, not too long ago a well-known veteran came to me for a consultation regarding his depression. When I told him I admired and looked up to his work, he broke down into tears, I asked him what was going through his mind and he said “I was just thinking, ‘oh shit, I got him, too. Even he doesn't know how worthless my military career was.’”

Earlier on, in my mental health career, I would not have accepted such thoughts at face value. (I would've not thought much about them.) Instead, I would have moved immediately to researching underlying emotional conflicts such as a repressed hatred as a cause.

However, over the years with much more education and research studies, I have come to the conclusion that such negative interpretations of positive statements and events as well as exaggeration of negative occurrences are responsible for keeping others depressed.

My current ideas and thoughts of the distorted thinking, or cognition, in depression evolved from a variety of sources (both educational and research oriented) - clinical materials, the Beck Institute, Harvard Medical School, St Louis University (Dept.of Psychology), the many reports of feelings of clients in psychotherapy, control experiments, and a mountain of depression studies.

My present theory represents the end product of a crisscrossing-corkscrew series of investigations, formulations, and reformulations. I started by trying to validate Freud’s theory that depression was caused by the patient's turning anger inward. The findings did not support this position. I concluded that the cognitive model made more sense out of what patients told me and what I had found in my many research studies.

I have discovered that in their dreams, early memories and in projective test, depressed people see themselves as “failures” - some deprived, frustrated, humiliated, rejected, or punished in some way. The psychological cause of depression did not appear to be buried deep in the unconscious mind but was related to this type of mistake in thinking.

The emotional, motivational, and behavioral changes in depression seem to flow directly from the depressed person's belief that they are “worthless”, “the world is empty”, and “there is no bright future” - no matter what efforts they make to improve their situation.

It is my opinion as well as with others that, Cognitive Behavior Therapy (CBT) is an outgrowth of this theory. This style of approach to treatment uses a variety of techniques that directly or indirectly to correct the depressed person's faulty thinking. Through controlled studies at the Center for cognitive therapy of the University of Pennsylvania and worldwide, they have found cognitive behavior therapy is an effective treatment for depression.

The idea that emotional problems are caused by faulty thinking is not new. Early Greek philosophers argued that it is situations that upset people with their interpretations of the situations. Many writers have been saying essentially the same thing ever since.

The cognitive theory approach is that it is more detailed. The exact thinking errors that lead to specific emotional problems are spelled out. This leads to direct ways you can correct your emotional problems. The other approaches were to global and did not allow for specific ways to correct the errors.

Interestingly, you do not have to to buy the theory completely to get over your depression. But what you must do is to use the method that grew out of this theory. You must change the mistake in thinking that brought on the depression in the first place. But the symptoms of depression can be so painful and distracting that you can't think of much else. For this reason, you have to get control of your symptoms before attacking underlying causes. In the long run, it's more important to get better then to feel better, but in the short run, you must feel better before getting better.

I cannot state the important role your wrong thinking plays in bringing on a depressive episode  Thinking errors are the pitfalls and quicksand that lead down into depression. While in therapy, my clients practice sidestepping these mistakes and pulling themselves up if they slip. I encourage you to take charge over your thinking. This is the best way to get out and stay out of the grip of the depression.

If you're depressed, you believe these fictitious negative ideas and will go on believing them unless you actively naturally challenge them. You need to learn how to confront these thoughts head on. You can teach yourself to do this.