The current trend amongst the medical profession is to recommend Cognitive Behavioural Therapy CBT for depression usually in combination with medication. For reasons which you can read elsewhere (the Great Depression Con?), I am not a fan of anti-depressant medication, but if you are already taking some, do NOT just stop. Talk to your doctor.
Whilst well controlled research trials into the efficacy of CBT have demonstrated that it has some success I am concerned that this is relatively limited in extent and duration. To me CBT provides a set of coping strategies rather than a solution. People clearly do benefit but others seem to just get hooked on the drugs and become resistant to any other form of therapy.
Actually the specific form of therapy is of less significance in successful treatment of depression. What is important is the quality of the relationship between the therapist and the client, combined with the therapist’s ability to adapt their approach to the unique needs of the individual.
‘Decades of research indicate that the provision of therapy is an interpersonal process in which a main curative component is the nature of the therapeutic relationship. Clinicians must remember that this is the foundation of our efforts to help others. The improvement of psychotherapy may best be accomplished by learning to improve one’s ability to relate to clients and tailoring that relationship to individual clients.’1
Finding a good therapist can be a challenge and to be honest until you try one out you will not know whether you can work with them. That is why I always offer a free initial consultation; so you can find out before you commit. It is also a good idea to check your therapist has professional indemnity insurance, some credible qualifications and that they are also able to explain their approach to depression.
For example, there are still hypnotherapists out there who think that their job is to take control and to fix you. It isn’t. The job of a hypnotherapist is to facilitate the process of you taking back control of your own mind, your own body and your own life. I would not let anyone control me and if you are depressed neither should you! Passivity is the enemy of recovery when it comes to depression. What we want is to promote a proactive and positive state of motivation and hope.
I can only really talk about my approach which is essentially rooted in neuro-linguistic programming (NLP). My first step is to help you to find some vestige of a positive sensation or focus. Even the most depressed individual is not depressed every second of every day although some will argue that they are. The point is to help the individual begin to build a sense of resourcefulness. This can take time and it is important not to reinforce feelings of helplessness by taking this too quickly. I find that getting clients to laugh at themselves makes a big difference to some. Others do require a more subtle and supportive approach but it is equally important not to slip into over-empathising. Depression can feed on itself and simply going along with it is as bad as dismissing it.
Once I have a little trust and confidence that we can make a difference my key question comes from NLP: how are you making yourself, or how are you keeping yourself depressed?
I know this is provocative to those who suffer from depression and have bought into the ‘illness’ model because my presupposition that you are unwittingly causing or at least exacerbating your own discomfort challenges you to take some responsibility for your condition. I accept that this is quite genuinely tough for some who are really deeply depressed. But it is the beginning of the answer. Until we begin to look for the choices that are available to us we will probably stay stuck. Different people will of course have different choices and not everyone will believe such choices exist for them personally.
Behind every thought pattern, every repetitive emotional cycle and every dysfunctional behaviour there is a dysfunctional habit. My question is really designed to start the exploration of what the depressive habits consist of in terms of thinking, feeling and behaving and then to help you to redesign the habit. This is standard NLP so far, no hypnosis required.
Secondly I will look for the triggers to depressive episodes.
Once I have elicited the habitual patterns, the triggers and the exceptions, then and only then might I start teaching you how to hypnotise yourself and how to run alternative patterns when exposed to your triggers. I will utilise your hidden positive resources and experiences as well as your own imagination to help you build a map of the world in which you continue to expand rather than diminish the range of choices available to you.
Commonly, but not always, depression is rooted in past events and anxieties or even trauma. Withdrawal into a depressed state where feelings are numbed is often actually a way of escaping from the pain of such memories and anxieties. To really give clients confidence that they will benefit from getting back in touch with their feelings they have to know that there is an escape from the pain of the past. This often means using hypnotherapy to help people re-visit the past and to re-frame it from a more resourceful perspective. In addition I am now using Dr Ronald Ruden’s Havening ADT techniques to support this process, minimalizing and even eliminating past traumas and anxieties.
This is a simplistic overview and just a start. There is often a lot more work to be done, for example on belief systems but this gives you some idea of my basic approach.
Of course there are many other potential contributory factors such as hormone imbalances, diet, previous or current drug abuse, alcohol, smoking, physiological illnesses, injuries, family and life events. The list is endless.
Early treatment can save a huge amount of distress later on. If you have been feeling down for more than a few weeks and if your feelings are out of proportion to normal life events, or simply without any obvious cause, come and see me. Please do also talk to your GP so that they can rule out or take account of any other physiological causes.
If you have been struggling with depression for years without real progress I guarantee I will adopt a very different approach and go on experimenting until we find the approach that works for you.