Out of the Blue: Six Non-Medication Ways to Relieve Depression (Norton Professional Books) (10 page)

Client:
Well, maybe I could ask my wife to pray with me at night. She’s not very religious, but I think that if the two of us prayed together, it would help give me strength and hope.

Obviously, such a dialogue would be different with each person. The name of the problem and the nature of the client’s strengths and resilience would be different as well, as would the time and amount of conversation it would take to extricate the person from his identification with depression. Here I have offered condensed versions of conversations that sometimes spanned several sessions.

This externalizing method derives from an approach called narrative therapy, and there is an extensive body of literature on it if you would like to explore it further. I have only scratched the surface of the approach here. I recommend starting with a book by my friends, colleagues, and narrative practitioners Jill Freedman and Gene Combs, titled
Narrative Therapy
(1996).

EXTERNALIZING, VERSION TWO

There is another kind of externalization: physically embodying the troubling feelings that come with depression and then doing something to shift one’s relationship to them.

A colleague of mine had a client with persistent depression that was difficult to treat. After a number of sessions, he suggested that she find a large rock, one as big as she could find that would still fit in her purse. She was to paint the rock black and carry it around until her intuition told her it was time to get rid of it. She carried it for some weeks and complained that it was making her shoulder hurt to carry around such a heavy object. She finally decided that she would leave the black rock at her father’s grave. She found her depression lifting noticeably after this.

Another client made some dark fudge brownies and put black cherries on them. She then let the brownies sit in her kitchen for a while, and one day, when she was getting very weary of her depression, she dumped the whole thing down her garbage disposal. Somehow, putting her depression into a physical form and then taking some symbolic action helped shift her depressed feelings.

How does this work? Well, it’s difficult if not impossible for people to directly change unpleasant or depressed feelings. Telling themselves to feel better or cheer up doesn’t yield any results. But giving them something to do can somehow give them an ability to indirectly influence those intractable feelings and experiences.

The way to do this, if it’s not obvious from the examples above, is to help the depressed person find, create, or identify an object that could or does represent her unhappy feelings. Then have her find a way to imbue that object with her depressed or unwanted experiences. Sometimes that just involves having her keep it around while she’s depressed. Then have her do something to symbolically get rid of or jettison that object—burn it, bury it, throw it away, give it away, or whatever is appropriate.

DEVELOPING OR INCREASING SELF-COMPASSION

A common experience in depression is self-loathing or self-criticism. Clients get down on themselves for feeling the way they do. They decide that they’re a despicable human being, or weak, or fundamentally flawed. One way to shift clients’ relationship with their depression is to bring self-compassion to bear on the situation.

Obviously this is easier said than done when someone has been hijacked by the almost automatic self-loathing that often accompanies the depressed experience. So how does one do this?

One of the easiest ways I have found is to invite the person to imagine that one of his dear friends or children or other precious loved ones is going through a depression right now and is feeling the same way he does. How would he view that friend or loved one? What kind or comforting words would he say to the friend or loved one to help her through such a tough experience?

Most depressed people can come up with some very compassionate words, and of course I then ask them to apply those same comforting or kind words to themselves. If one of my clients can’t do this, I ask him to imagine the person who has been his greatest supporter or comforter coming to him and saying those words.

You may discover some other inroads that you can make to help the depressed person connect with or increase his self-compassion and decrease his self-criticism, harsh self-judgment, or self-loathing. Apply whatever method you can to accomplish this as another way to shift the person’s relationship with his depression and help him find some purchase for climbing out of the pit of despair.

VALUING DEPRESSION

I want to be careful in this section, in that I want to be clear that the suffering of people who are depressed is painful and unwanted. I don’t mean to disregard the depth of that suffering or minimize it. However, I offer this way of shifting one’s relationship to depression as a means of reducing the suffering attached to it.

One of the sources of suffering in depression is to see it as only bad. Some people who have survived an episode of serious depression, while they wouldn’t want to revisit it, find that they have been changed for the better for having gone through it. “I hated being depressed,” writes Andrew Solomon, “but it was also in depression that I learned my own acreage, the full extent of my soul.” (2002, p. 24).

Solomon says further,

I think that when you’ve had a depression, you really have to come to a new understanding of who you are. Depression feels while you are in it, and is while you’re in it, a bleak, empty, barren experience. But in fact, when you come out of it, there are many lessons that can be learned from depression.

It’s an enormously intense experience. It involves a kind of emotion that you don’t necessarily experience anywhere else in life and part of what I would like to do is to help people to find, in retrospect, whatever richness or whatever depth can be extracted from depression. (2001)

When Solomon was asked what he had learned or took away from his depressive experiences, he replied, “I feel like I became a kinder person because of the depression that I’d been through. I became more empathetic. And in addition, I think I discovered a joyfulness about daily life.”

As my story and Andrew Solomon’s report indicate, more compassion toward other sufferers, more patience, and deeper self-understanding are common in the wake of depression.

William Styron, in searching for the roots of his major depression, began to think deeply about the loss of his mother in his childhood, and this investigation led to the writing of several books that many consider to be some of his best work.

What I am suggesting here is that another way to shift one’s relationship to depression is to mine it for value. Let it be your teacher and change you.

Here is what one sufferer, Sarah, said about her depression: “Depression is a teacher about the dark side, and if you can weather it and find your way through it, there’s a deeper safety on the other side. A deeper safety and strength. I now feel less afraid” (Kennedy, 2013).

I mentioned in the first chapter that I had an episode of serious depression when I was a young man. In retrospect, this depression led almost directly to my becoming a therapist (and to my writing this book).

I grew up in a big, Irish Catholic family (eight kids) living in a suburb of Chicago. My family had sort of an unwritten rule: When you were eighteen, you left home to go to work or to college. But I was the runt of the litter, always small, shy, and lacking in competence and confidence. I got into a university thousands of miles away from the Chicago area, just outside Phoenix, Arizona. When I arrived there, I was a bit overwhelmed. My classes were large, often with hundreds of people in them.

I made a few friends, but being so shy, not many. So I spent a lot of time alone, a big contrast to my constantly social life back home (my family alone was like a little village). It was also a turbulent time in the USA, and like many members of my generation and age group at the time, I got caught up in rebelling against and questioning the values of the “establishment.” I became a hippie (actually, since the hippies were gone by the time I came of age, we called ourselves “freaks”).

This newfound freedom was also overwhelming to me. I didn’t have to do anything I didn’t feel like doing, and I stopped attending classes and started spending more time isolated and alone. I began to take mind-altering drugs, which not only discombobulated me but led me to question reality itself. If a few micrograms of an ingested substance could change reality radically, how substantial was that reality?

Gradually I began to lose all meaning. (Taking existential philosophy classes pushed me further down this path of meaningless—I do not recommend reading Camus and Sartre as you’re descending into depression.) I began sleeping many hours a day. My nutrition was atrocious; I was eating very little due to poverty, and what I did eat was the typical university student’s fare, devoid of nutrients.

Gradually I began to wonder, “Why should I get out of bed?” and “Why does anyone bother to get out of bed?” Then my thoughts ran to the future, and I was filled with anxiety and dread. Life was hard enough now, in the relatively protected environment of the university. No one expected much from me. But what about when I had to leave this sheltered environment and make my way in the wider world? How could I possibly hold down a job? I didn’t believe in the American Corporation, which seemed to me morally bankrupt and evil. Even if I did come to believe in it or I sold out, I couldn’t get up and make it to work. I didn’t have the wherewithal to make it in the workplace.

Being around people was painful as well. I was extremely shy and would sit mutely, trying to work up the confidence and courage to say something but sure I would make a fool of myself if I did manage to utter anything. I was desperately lonely, and being around others only accentuated this painful feeling of being alone. As far as I could tell, the future only held more of the same suffering or worse.

I finally decided to kill myself. But still I had enough civility and concern for others that I couldn’t just leave my friends without explanation. So I resolved I would say good-bye to them before I did myself in.

The first few friends I visited were about as unhappy as I was, and they understood and accepted my decision. One of them even admired me for having the courage to face death, which he lacked.

But the final friend I visited wasn’t so cavalier—she was upset. “Why would you do such a thing? You can’t kill yourself!”

I explained that I felt as if I had no skin—everything that touched me hurt: being around people, being alone. I was too sensitive for the world, I had decided. Plus, the future was more grim than the present, which was bad enough. All I wanted to do was to write poetry, not work, not be around people, and be out of pain.

She listened and then said, “Look, I think this is a mistake. I have a plan, and I want you to consider it.

“I have three elderly aunts in Nebraska. They have never married or had children. I am their favorite niece. They’ve told me that when they die, I inherit every-thing.

“They’ve invested in some farmland; the farmers have sold out and moved to town. On these farms, there’s usually an empty farmhouse. If you promise me you won’t kill yourself, I promise you that when one of those aunts dies, you can live rent free in one of those farmhouses the rest of your life. You won’t have to be around people, you won’t have to work, you can grow your own food and have enough to eat, and you can write poetry as much as you like.”

Well, that seemed like a possibility. I could escape or at least minimize the pain of living. I didn’t really want to die; I just wanted out of the intense pain I was in.

So I agreed. (Little did I know that those aunts would live many more years and that my friend would never have to deliver on her side of the bargain. By the time they died, I was long recovered from my depression and had found meaning and purpose and had even become less shy.)

Instantly I wasn’t suicidal. I had a future to live toward (more on that in Chapter 6). I was still depressed, but I wasn’t hopeless.

I became obsessed with learning how people found meaning and purpose in their lives, how they got along with others, how they overcame shyness, and so on. This obsession led me to the field of psychology and ultimately to the field of psychotherapy, in which I found a number of answers and paths to solution for many of these issues.

I became a psychotherapist. And a very optimistic one, I might add. Since I was such a basket case myself and eventually came to a happy life filled with love and purpose, it’s pretty hard for a very discouraged client to convince me that there’s no hope. Such optimism also led me to study with Milton Erickson, whom I’ve mentioned before. Erickson’s approach to change was infused with both optimism and Midwest pragmatism, so his unorthodox methods resonated with me, unlike the sometimes discouraging models and methods that pervade much of psychotherapy.

I also developed a deep empathy for those who were suffering, especially from disturbances of mind and emotion. The most challenging and “irritating” client doesn’t move me to frustration or judgment. I become very Buddha-like while doing therapy. This unshakeable kindness and compassion was borne from the intense suffering of my earlier depression.

So, as I said earlier, having been depressed led me directly to becoming a therapist. And to writing this book. And to being a kinder person.

The key phrase in that last sentence is “having been depressed.” This opportunity to mine depression for its value is only available after the fact.

So let’s examine the possibility of mining the value from depression.

First, think about this. Why would evolution (or God, if you don’t believe in evolution) have made depression so prevalent in human beings? Estimates are that a little less than 10 percent of us experience depression. Why would we be prone to such terrible suffering and paralysis? What possible survival value could depression have, and how does it help us as a species?

Well, psychologists have come up with some ideas about this.

1. Depression may help people become more realistic and give up positive illusions (Schwarz & Bless, 1991).