A Case Example of Depression Treatment in Two Sessions

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Just then, she told me that she had a flash of what she was like in high school. She reported that she was miserable at domestic with her verbally abusive parents, but that as soon as she arrived at school, she was happy and crammed with confidence. I wondered why and asked how she made sense of the difference. She told me that she was getting excellent grades in high school and the editor of her year book. She reported it was the best time in her life she had felt confident, and that her confidence had lead to having a great deal of friends. When I asked when it went away, she reported that she had always felt horrible at domestic. She told me that when she went to college, she visited a counselor to try to work out some of her issues with her family and that he had put her on a serious psychiatric drug. She had very bad facet effects from it and was no longer able to excell in her classes, which had a strong impact on her confidence. We paused for a while to grieve that terrible mistake.

Self esteem, self accpetance and a sense of self esteem are vital to feeling happy. When we lose the sense that we are worthy or loveable, it is clean to turn into depressed. In this example we find that a lady's depression is rooted in either seeing herself as worthless, and in wanting to avoid engaging with the world. We also find that in discovering her hidden purposes for being depressed, they are no longer compelling and she straight away recovers.

I then brought us back to her function in calling me -- relieving her depression. I asked her to don't forget what is was like to arrive at highschool and go from feeling depressed to confident. I asked her to try to graphic herself simply as the change was happening in the morning and waited for her to do so. When she was there, I asked her to say, "The thing that is different now is..." and to finish that sentence. She reported, "The difference here is that of us think I'm special." and commenced to cry. At this point, I felt like I was beginning to understand. It seemed to me that when of us were treating her like she was special, she felt good about herself, and when they were not she felt bad. I wondered if that was still true.

I wondered why her self-talk was so unkind, so I asked her to imagine what it would be like to really know that she was a good person and deserved love. She tried, but could not even imagine what it would be like. She reported, "I simply can't go there. It's simply not real." I sat with her for a minute or so simply connecting with what it would have to be like to be unable to even imagine seeing yourself as a good person. Then I asked her to try saying, "I am unwilling to even imagine seeing myself as a good person because..." and to finish that sentence without pre-thinking the finishing.

A Case Example of Depression Treatment in Two Sessions

I asked to try imagining herself in high school and saying, "When I feel bad about myself, it is because of us are treating me like I don't matter. When I feel good, it is because they are treating me like I'm special." When she repeated those sentences, she reported they felt powerfully true. I asked her to try saying them again as her adult self. She did and cried more, realizing how rarely of us ever treat her like she is special any more. With simply a choice of minutes left, I asked her to write down those sentences and spend at least five minutes with them twice a day. When scheduled our next session for three weeks later to give her time to process wha we had uncovered.

Mary had two distinct purposes for being depressed, and each and every of them only needed to be partially discovered with the intention to change. First, she learned that she felt bad about herself not because she was a defective person, but that she felt that way when of us were being unkind to her. Her function for seeing herself as deserving the therapy she got could have been to avoid abandonment, feel like the world is a place with justice, or any choice of others. However, when she realized that it changed depending on how she was being treated, she realized that it did not mean she was inherently defective, and it no longer felt as true. Second, she realized that being depressed had always been a way to avoid "having to do anything." I'm unsure if her depression had served as secure hiding place or a way to get of us to do things for her, but when she experienced it as something she did for a function, it was no longer something out of her control.

At the start of our next session, Mary told me she was feeling much better than she had in a long time, but she was very adamant that she was not entirely better. She reported that she was now able to make sense out of her low self esteem, and that it no longer felt like something that was intrinsic to who she was. She reported that her depression was much better but that it was evidently still there.

That made sense to me, because I still didn't understand exactly why she would feel bad about herself when other of us were uncaring to her, as opposed to getting angry, trying to please them, or any of the other feasible responses of us have. I find that it is important to discover the sense to all of these questions for the deepest kind of change to happen.

I asked her to imagine herself when she would first turn into depressed, and I asked how old she was. She was seven, and I asked Mary if she could try to turn into that little girl for a while so I could talk to her. When she was ready I reported hello and asked the little girl if she receives depressed. She reported she does because her mom is really mean and calls her names. I told her I was sorry that her mom did that. Then I asked if she knows grown-up Mary, and she reported she did. I asked her to tell grown-up Mary what she ought to do when of us are mean to her. She reported, "What ought to she do when of us aren being mean to her?" and fell silent for a choice of moments. She reported, "If you get depressed, you do not have to do anything." and paused a long time. She continued, "If you get depressed, you can simply sit around and you do not have to do anything." Judging by her tone of voice and the long drawn out pauses, I knew that she was in a deep place and I let her have as much time there as she needed. We spend the rest of the session saying those sentences and letting them feel true. When we ended, she thought she would need a month to process what had happened. However, she called a choice of days prior to her appointment and cancelled saying that she had fully recovered and was working again.

Mary, a social employee from Portland, OR, had been unable to work for three months prior to calling me because of severe depression. In our first session she shared about her strongly damaging self-talk. She had a environment friendly inner-critic and try as she might, she had been unable to stop thinking this way.