Out of the Blue: Six Non-Medication Ways to Relieve Depression (Norton Professional Books) (16 page)

Now, how do you help create a hopeful future with someone who is so caught up in the painful present or the troubled past? Most people don’t have the resources or spontaneous future creation skills that Frankl had, or a friend who can hold out the promise of a haven as my friend did for me. We have to approach the task of restoring or creating future-mindedness in smaller increment. I will offer four techniques for doing this.

Language Is a Virus

Writer William Burroughs (1962) once wrote, “Language is a virus.” I’ve noticed that I am influenced by the language my clients use and that they are influenced by my language. People in cognitive therapy begin to use cognitive phrases to describe their experience. People in psychiatric, medication-oriented treatment start to describe their situation in biochemical terms.

Since language is a virus, we can use language in a deliberate way to shift the way our clients think about and describe their situations. One of those ways is to deliberately seed hope and possibility. In the next two sections, I’ll detail two methods of seeding the virus of the future through language with people who are depressed. These comprise the first two Future Pull techniques.

Problems Into Preferences

Because people who are depressed tend to be focused on the negative, the first language virus method uses language to shift the person’s attention from the present (or past) problem to what he would like to have happen in the future instead. I call this method Problems Into Preferences.

When the depressed person talks about problems—things he doesn’t like or that are sources of suffering—your task is to reflect those concerns back to him from a place or time in the future when things will be better. In this way, you are moving him from focusing on problems to focusing on what he wants or longs for.

So, if the depressed person says, “I don’t have any energy,” you could reply, “You’d really like to have more energy.”

As you can see, this move shifts the attention from:

1.
The past to the future

2.
What the person doesn’t want to what he does want

In other words, it shifts the conversation from his problems to his preferences.

At first, the depressed person is still going to be focused on what he doesn’t like and doesn’t want, but ever so gradually, as you continue to reorient him to the future, the future will begin to enter his language more and more. The future virus will start to take hold. And as he speaks more and more about the future, it will pull his energy out of “problem land” and into the realm of hope and possibility.

The main way I come up with my responses is by finding the opposite of the problem the depressed person is talking about and then reflecting what he’s saying as if he’s already articulated that preference. For instance, if the person says, “I just feel numb,” I might respond with, “So you would like to feel your feelings, feel like you’re alive in a way you haven’t while being depressed and on the medication.”

Let me give you a few more examples of this method in action, and then I’ll invite you to try it out yourself.

Client:
I’m afraid I’ll never come out of this abyss.

Therapist:
So you’d like to have the sense that you will get out of the abyss someday.

Client:
Yes, but right now I can’t imagine how it will ever happen.

Therapist:
So, when you see some evidence that you’re starting to climb out of the abyss, you will start to feel some hope that it will happen someday.

Client:
Yeah, I guess. That would be really great.

Therapist:
And as you got a little more hope, that will probably give you more ability to see over the edge of the abyss.

Client:
Seeing anything over that edge will be a major thing.

Note that by the end of this dialogue, the client is talking about a possibility-filled future more than the pain-filled present.

Here’s another sample dialogue:

Client:
I’m afraid my boyfriend will just give up on me since I’m such a drag to be around when I’m this depressed.

Therapist:
You’d like him to stick around.

Client:
Yeah, but I really can’t blame him if he wants to leave.

Therapist:
You’d like to still be with him when you come out of this depression.

Client:
Yes, I would. I think we could be really good together if I can get back to being myself.

Therapist:
So, when you are out of this depression, you two will be getting along and feeling close.

Client:
I miss feeling that close. I have felt so disconnected, and I know he feels it.

Therapist:
You two being together in the future is something that calls to you.

Client:
Yes, I can see us getting married.

Again, notice that it takes a few back-and-forths, but in the end, the client begins speaking more about the future and what she wants more than she speaks about her worries and fears about the present or the future.

Of course, each dialogue is different, and sometimes this method doesn’t work—which is why I’ve provided other methods in this chapter and other strategies in other chapters. Nothing works for everyone all the time. But assuming that you can learn this method and that it helps at least some portion of the depressed people with whom you work, give it a try.

Now it’s your turn to practice. As before, I will provide the opening statement from the client and leave a space for you to imagine or write in your response using the Problems Into Preferences method. I will provide a possible response at the end, so cover it up before you think of your own answer.

Depressed person:
I feel like ending it all.

Your response:

[Possible response: “You’d really like to get out of this pain and find the strength and willingness to live.”]

Here’s another sample opening from a client. Give your response before checking out my suggested Problems Into Preferences response.

Depressed person:
I’m so weak. I should just be able to lift myself up by the bootstraps and get going. I don’t add anything to anyone’s life.

Your response:

[Possible response: “So you’d like to feel like you’re contributing something and being of value.”]

Positive Expectancy Language

The second of the language virus methods is to use language that presumes that a positive future will happen. I first learned this technique while listening to Milton Erickson, my psychiatrist/hypnotherapist mentor whom I mentioned earlier.

Erickson used an indirect approach to hypnosis and change. I once heard him do a hypnotic induction without telling the person to go into a trance. Instead, he
presumed
she would go into trance. He said things like, “I don’t want you to go into a trance too quickly. After you go into trance, I’m going to want to talk to your unconscious mind about doing something good for you while you are in trance.”

This kind of talk, which I call Positive Expectancy Talk, can move people to a future with hope and possibilities without their doing anything. If they go along with the presumption and expectancy that is loaded into the language, they are pulled into a future with hope and possibilities without even noticing it.

I sometimes call this the Moving Walking method, after those moving sidewalks or walkways one finds in airports. Without taking a step, these walkways move you closer to your next destination within the airport—that is, if you’re heading in the right direction. And that’s why I’ve named this technique
Positive
Expectancy Talk
.

There are many futures one could presume with language, and not all of them are positive; some of them are neutral and some of them are negative. The futures we want to expect with this method are those that lead to positive developments and change and results. The words and phrases we can use to create this expectancy include
yet
,
so far
,
when
,
before
,
after
,
while
,
as
,
will
, and so on. They can be delivered in reflections, statements, or questions.

Let me give you a few examples:

•
“When you get better, you’ll feel like spending more time with friends, then?”

•
“When you come out of this depression . . .”

•
“So far, you’re not feeling better.”

•
“The medications haven’t worked yet.”

•
“Before you start exercising, how much more energy will you be feeling?”

•
“After you start to climb out of your hole, who do you think will notice first?”

•
“As you continue to feel better, what other changes will you make, do you think?”

•
“While your inner self is working out some things, what is your conscious mind doing?”

•
“As you body and brain start to clear out whatever brought you down, what kinds of things do you think you should focus on in the next week or two?”

•
“How quickly do you think you’ll be back to exercising as this depression starts to lift?”

The way to come up with things to say is to imagine what you and your client would dearly love to have happen (seeing him have more energy, come out of the depression, find a reason to live, feel more hope, etc.) and then presume that it will happen and speak from that certainty. Wrap that positive future in one of the phrases or words that create expectancy.

And take care not to presume negative eventualities, such as “the next time you get depressed” or “when you get suicidal.” It’s not that you can’t talk about the possibility of negative things occurring in the future; just make them more conditional by using of words like
if
. For example, you might say, “If you got suicidal again, what kinds of things could or would you do this time to make sure you weren’t at risk for acting on that feeling?”

Let’s have you try this Positive Expectancy Talk a couple of times to get used to using it. I’ll again give sample client statements, and you can fill in the blanks before looking at my possible responses.

Depressed person:
I sometimes wish I could just get hit by a bus accidently to end this pain but not be blamed for killing myself.

Your response:

[Possible response: “When you are no longer in such pain, these fantasies of accidentally dying will probably diminish or disappear.”]

Depressed person:
I just want to pull the covers over my head and never come out.

Your response:

[Possible response: “Before you come out of this depression, you just feel you can’t face the world or others.”]

Letter From the Future

Another Future Pull method is to encourage the depressed person to write himself a letter from a future in which he has emerged from his depression. This is not a future in which his is still depressed or worse, but in which he has come out of his depression and gotten better. It is a letter from a preferred future.

In this letter from the future, the person is to write about what is happening in that better future and detail crucial decisions and realizations or turning points that helped him change for the better. Suggest that he give himself some encouragement or compassionate advice from that future self. The following questions may be used to guide the letter writing:

What have you learned and gained perspective on since back in [fill in the present date/year]?

What things were you worried or frightened about in those days that seem trivial or far away for you today?

What problems seemed overwhelming or insurmountable in those days that you did eventually resolve or overcome?

What made the difference in helping you recover or get better?

What crucial thing did you realize that helped you come out of the depression?

What do you now know about depression that you couldn’t know or fully understand while you were in the middle of it?

From the perspective you have now of being through and beyond the depression, what kinds of things do you think you could have done to hasten your recovery from depression at the time?

What sage advice would your future self give to your present self?

What comfort or reassurance would your future self give to your present self?

What were you troubled by, frightened by, or concerned about that now doesn’t matter as much?

Here is one letter from a depressed person as an example.

Dear Sandra,

I am glad you are reading this. This is Sandra from the future. I am writing this from five years from where you are now. It is now September 2019 and life is good.

I know that may be hard for you to believe, given how depressed and miserable you are right now, but that is why I am writing this letter. To give you hope and to tell you that
you will get through this
.

Things started to get better after you turned the corner in your therapy. You began to feel just a little more energy, started getting out more, and even began light jogging. I now, I know, that seems impossible from where you are now, but here’s the thing: You did it.

You started to reconnect with friends. Those friends were crucial in your full recovery. They made you laugh, they gave you love and convinced you that you weren’t such a bad person. They
liked
you. They
loved
you.

You found work you liked and found meaning in. You used part of your salary to make a difference in the world. You contributed to a charity that saved lives. So, you see, you need to keep going because your life matters. It makes a difference in the world.

I remember those nights spent in misery, wondering whether or not to go on. Trying to find the courage to end it all.

But that isn’t our fate. We were meant to live, to thrive, to be happy. To love and be loved.