Let it be said at the outset that there are some depressions that are chemically caused by sheer physical problems ranging from liver difficulties to eye injuries to spinal problems. Further, let it be admitted up-front that pharmaceutical depression-lifting drugs are powerful and do work to lift people up from darkness. Lithium for the by-polar disorder has been a godsend. Therefore, in this first paragraph let it be known to one and all that the following is not a diatribe for those who prefer an un-drugged, non-symptom numbing, natural way to a healthy life. Rather, there are occasions when even the most free among us would be well advised to simply take a pill because of the physical discomfort of some clear bodily situation (or a missing chemical) that demands a pharmaceutical solution.
Having said that, let us now explore ways and means of psychotherapy that can lift one's spirits through sheer talk therapy (the method originally begun by Sigmund Freud).
The first question by those trained in Liberation Psychotherapy is to ask: What are you depressing? This is, predominantly, a feeling question. Quite frequently, the person is clearly holding back on the expression of anger. That is not always the case, but in the larger amount of situations anger is the repressed emotion. The therapist then gives the individual permission to express the anger and may even practice with the person until an appropriate expression is learned.
That last sentence can be said all too simplistically and must be explained. The built-up anger may have resulted from the continuation of a childhood adaptation that is the fault of no one out here in the real world. For instance, a person may have decided as a child to please everyone, be nice, never raise her voice, and be scared of appearing as a person with an identity having distinct boundaries. (By the way, anger is simply a boundary tactic making sure that one's identity and those you love are safe: anger is not violence). Let's call the woman of this paragraph Susie. Susie has been nice, avoided all anger, and is depressed because she is in a marital situation where her husband appears to be a tyrant. She has no notion that she is a tyrant maker due to her continual giving-in on any and all subjects. Bill, her husband, is acting out the anger for two people, and has, out of his own unresolved childhood issues, developed a delusional tactic whereby he gets what he thinks is love by threat.
Okay. Now Susie comes to therapy and is depressed. She responds to the question of What are you depressing? with a dawning awareness of anger. She thinks, at this time, that she is only angry at the jerk she married. Actually, she is learning to discard a childhood adaptation that was based on the reasoning of a five year old. The therapist has a delicate task at this point. Being able to set boundaries by appropriate anger must be learned, but Susie must also learn that she helped create the situation at home by playing her old pleasing role. In accomplishing thinking awareness as well as feeling awareness with the client, the therapist has not only averted a guilt-free divorce by Susie, he has geared up to a new level of freedom whereby the client becomes aware of her invitations to love. In other words, the client now has added an intimacy level beyond just an identity level. Now, Susie knows that she is in charge of her half of making a marriage work. She can continue to be pleasing (and passive-aggressive), or she can take charge of herself and work for real, grown-up love even with boundary anger.
I must remember that this is not a paper on either identity or intimacy, however, and return to the theme of clinical depression. Concentration upon feelings can lead to other areas beside that of present living conditions and childhood adaptations (such as being Little Miss Pleasure). The earliest option is where a child mimics the mother's postpartum psychotic condition. Here, a baby turns inward, unconsciously copying the mother's lifelines, and gets stuck with what has sometimes been called analytic depression. It is a life-embracing numbness and leads the person to observe life in a dispassionate, dissociated manner while, inside, there is a pervading sadness. The therapist must then re-train the person in feeling all the six feelings (sadness, anger, scare, happiness, excitement, and tenderness -SASHET). Further, the client must learn that a baby had a problem due to its ingesting mother's condition. Most of all, it need to be learned that the adult has the capability of changing what an infant began. Unfortunately, due to the theme of this article, the therapy cannot be further explained at this point. Given what has already been said, the process is simply sub-categories of each of the above points.
Depression may well be the person's quelling of natural, buoyant joy. As a child the person was disciplined whenever there was too much (according to the parent) excitement. At each point when Sam got exuberant and joyous the critical parent of either mom or dad laid down the law. Here one thinks of entire religious communities where excitement is made equivocal with sexuality and is thus ruled out of the personality. In individual families, excitement may be forbidden for all manner of reasons ranging from having a dozen kids and managing them in a house with one bathroom to a mother or father who jealously thinks that she alone or he alone should be the one with excitement. This means that, in some families, emotions are doled out. There is Excitement Dad, Mournful Mom, Angry Aaron, Happy and Mindless Mabel, Tender Tom, and Frightened Frances. In therapy, the division of the family pie is examined until the person re-learns the six natural emotions that a child has.
Depression may also be a psychological game. It may be a ploy whereby the person gains phony strokes in a Poor Me exhibition. The therapist must then inquire: Tell me what you get out of being sad all the time. Benefits are explored. What does the sad display get in terms of people response? A beggar, for example, would not have as many coins dropped in the tin cup if he were to be whistling. A mother may get more sympathetic touch and kind words from her children if she appears as a martyr. Finally, a therapist must ask if this is the way the person really is satisfied with mock love and wants to spend life as an actor or actress getting phony love.
Depression also has roots in a re-play of something long ago and faraway. In other words, a person may be mentally experiencing an old situation in the present moment. This is called a Reflexion in Liberation Psychotherapy lingo. The clearest of these is the re-playing of an event that occurred at the same time of year. As an example, the death of a parent on a given date may well trigger a sadness on the same date in future years. Here the therapist simply asks: Was there anything that happened to you at this time of year in the past?
Another kind of Reflexion has to do with serious traumas, those fixating occasions when the person experienced something tragic. A trauma around skiing, for instance, may be triggered every time a person is in the mountains in winter causing a kind of depression. The person re-experiences the old situation that was probably not dealt with in a cathartic way. For instance, the trauma on the ski slope may have been due to a careless teenager who ran over the person. The injured party did not express anger (at the situation), held it in, and thereafter feels depressed whenever around skis, slopes, and snow.
That example is minor compared to repressed anger due to rape, incest, war, pogroms, accidents, deaths, and other heinous things that happen in the course of life. There may have been no path to cathartically dealing with those situations and, thus, the person holds in the feelings across the years. The result is a major depression, a sense of sadness, pervasive to the personality. The way out is threefold: cathartically feeling the old repressed feelings, installing permission for all six feelings, and deciding to live in such a way that love is predominant in their lives rather than hate.
Living in a sound byte world as we do, there is no way a short paper on depression can deal with the complexity that faces a therapist regarding this subject. Reflexions, for instance, are a massive subject. Repressed traumas range over a vast number of options. Each person's story must be heard, understood, expressed in a feeling manner, even as the person is given a new set of thinking and valuational understandings. Taking the fullness of that sentence into account, one should not anticipate a magical solution to depression that can be accomplished in an hour's session.