Sunday, March 27, 2011
Whenever I’ve looked for depression treatment, I’ve always wanted help with one basic thing: Stop the pain! And that’s what most therapies for depression try to do. They focus on what’s wrong and try to get those symptoms into remission. If it works, and you feel a lot better,...
This is one of those things where I say, "Now why didn't I think of that?" Because despite how many journal entries I made about feeling bad, I don't know that I every wrote any about the good things that were in my life. Granted there may have only been one good thought or activity during the day or even the week, but they were there hiding under the dark cloud...with me. The good was with me, the bad was with me, but I didn't look for the good and wasn't at all ready to look for it. But now that I look back, I can remember buying an exercise bike when I was very depressed and I started riding it for 15 minutes a day (the longest 15 minutes of the day!) And I was proud of myself for that small accomplishment. I can remember dreading the experience of my once-a-week food bank volunteer work, but each week, I felt better afterwards because I had ministered to someone else's needs. I also remember making choices that bolstered my well-being, like refusing to eat at the table with my father or ride in the car with him. He was very negative and complaining and always made me feel I was somehow unacceptable...however or whatever I happened to be. I felt so much better eating alone, although I admit it was hard bucking the family meal time.
I have not heard of WBT, but it sounds great. At this point, I have become my own WBT coach, which is best of all when you can swing it. But maybe I would have gotten well even earlier if I had used this method of finding the good things that were there and building on them.
Hi, Donna -
I think so too. Usually when someone simply tells me to look on the bright side, I'm insulted and angry because all they're saying is get a life and you'll be fine. WBT, on the other hand, comes out of careful research and conceptualization over a 20 year period. It's a disciplined method and fits me a lot better than the purely rational approach of Albert Ellis. WBT also demonstrates equal or greater effectiveness than straight cognitive therapy in the studies that have been done so far.
WBT would be a good tool for me at this stage where I need to keep working all the same to deal with residual symptoms. I doubt, though, that there are very many therapists out there who have been trained in this method.
John
Why do you suppose most therapy is about looking at all the crappy stuff that happens in life? Do you think it is just human nature to think about what's wrong instead of what's right? Or do we just want to unload as our major objective? Or have we just been "trained" that this is what you do in therapy?
Hi, Donna -
I think we're all trained to deal with disorder and disease as a matter of stopping symptoms - especially doctors and mental health providers. Psychiatrists and therapists respond to the problems you bring in the door and see their role as helping you to feel better. They mostly operate by an illness and disease model without a corresponding model of health - except in terms of functionality. Returning you to a state of good physical functionality by treating what's wrong with your heart is definitely what you want. Even the healthy lifestyle advice for recuperating heart patients is framed as a preventive against recurrence.
When you translate this to mood and anxiety disorders - short of psychotic behavior - it's more limiting to focus on functionality. We don't have standards of "normal" that everyone agrees on - except for behavior that causes some sort of harm (that is, the bad stuff - symtpoms). What a therapist or psychiatrist wants to hear is I feel fine because I'm not doing any of the things that have caused me problems - being functional and feeling healthy are defined by each of us subjectively.
I can't see therapy that only reinforces what's right as the full answer, but I think it should be a part of all therapy. It strikes me as most important - and feasible - after you've gotten rid of the worst symptoms and are ready to go the next step to focus on well-being.
Anyway, that's my rambling rant -
John
Right. I went through empty motions of trying to see the good things in my life long before it actually happened. Like the "list 5 good things in your life each day, and be thankful for them." It didn't work. I had to tell myself it was for my own good that I did volunteer work (in a manner of speaking.) I had to force myself to take the meds and attend therapy. But once I began feeling better, that subjective "recovering" point, then the good became more obvious and I felt more thankful for it. Now, I no longer have to work at it. But I still have the occasional days of depression where I can't see anything good...or it's only a blurry form in the fog. So I see that you can't just "go for the gold" the way you would strive for an Olympic gold metal with one mind and one purpose; it is more of reconciling each day with the unknowable way the mind works. A kind of preparation for the best but satisfied with just a little bit better.
WBT sounds very similar to the principles of "wellness and recovery" that encourage people to go beyond just reducing/managing symptoms to try to lead a full life by pursuing activities in all 8 dimensions of wellness: social, occupational, mental/emotional, intellectual, spiritual, environmental, financial, and physical. I started part-time work recently with a mental health peer collaborative agency (Collaborative Support Programs of NJ) which teaches and promotes these principles. This seems to be a growing trend, and people find it helpful. The principles are often taught by peer educators.