Depressive Therapy

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The most important condition for depressive therapy is the therapist's creation of an atmosphere of acceptance, respect, and compassionate understanding. People with a depressive type of character are quite attentive to criticism and rejection, catching the slightest confirmation of their fears in the actions of others. Such a person can interpret absolutely any facial expression as rejection or criticism, so the therapist must make a lot of efforts in order to be emotionally stable with the client and make him understand that the attitude has not changed and will not change. This can take a lot of time - sometimes trust is formed for a year, one and a half, two or longer. It all depends on how badly the depressed person is injured.

In sessions, the therapist should pay a lot of attention to the client's internal preconceived beliefs in relation to his fears of rejection, to understand the efforts caused by them to be always and in everything “good” for others. In addition, feelings of guilt and depravity prevail among depressed individuals. It is this, in their opinion, that is the cause of defeats and losses, and a guilty and vicious person is sure to be rejected.

The peculiarity of therapy with this character is that the essence of communication is not important, the main role is played by the regularity of meetings. Thanks to the client's observance of all the conditions of the setting, it is cured. However, there is also a "dangerous" moment - a depressed person in every way tries to please his partner for fear of being abandoned. Therefore, the therapist should monitor the nature of the client's implementation of all the settings of the setting - if everything is observed too correctly and pedantically, this indicates distrust in the therapist, praise and encouragement for this is not worth it. If a person begins to break the setting, it means that he already trusts his therapist and can afford minor deviations from the norm, thus checking the stability of the relationship. In this case, praise will allow the client to understand that he is moving in the right direction, and the path of trust has already been passed. When else do you need to "praise" and in some sense encourage the depressive character? Particular attention should be paid to situations in which a person criticizes the therapist, shows anger and negative emotions towards him. This shows that a depressed person ceases to idealize the psychotherapist and removes the "halo of purity" from him, elevating him to the category of an ordinary person. It is at this moment that psychotherapy takes place. Sometimes expressing anger is quite difficult for many people, so if a person has learned and can show it, at this stage of psychotherapy it is already good. However, there are also reverse situations when the client is capable of displaying such emotions from the first sessions. In this case, you need to work on another demonstration of feelings.

In addition to all the above nuances, it is also important for the therapist to investigate the reaction to separation (for example, the therapist's vacation, cancellation of the meeting for some reason). Depressive individuals can perceive such situations rather painfully, taking directly at their own expense: “You are probably already tired of me and my character. Most likely, this is the reason in me, and I am disgusting to you! My needs are too great for you. You leave me because of my depravity and sinfulness! But in reality, depressed people do not need continuous care and attention. It is important for them to understand that they have the right to get angry and express their indignation, that anger directed at the therapist and any other person does not destroy their relationship, but, on the contrary, strengthens them.

In life, you cannot learn and remember such a lesson without consolidating it in practice, therefore, in this case, separation with a psychotherapist will be useful for a depressed person. This is a new experience that will push you to understand the inner side of relationships - honesty and openness always make relationships an order of magnitude higher and better than secrecy and attempts to restrain your emotions.

Often, depressed individuals engage in self-criticism and self-criticism. How can I help them?

Standard support (mobilization, motivation, reassurance and comfort) does not work for depressed people. For example, if such individuals are told that envy is a completely normal feeling, they will never understand this statement. Moreover, the client's internal reaction will be something like this: “Someone who really knows me would not be able to support me and respond well. I probably tricked this therapist into thinking positively of me. This means that I am a deceiver, and the support of the therapist cannot be trusted, because he is easily fooled and misled."

What can be done? You need to attack the Super Ego, joking kindly: "Yes, you are trying to be holier than the Pope!", "Welcome to the human world!", "And what's so terrible about that?" With this approach, the client will be able to accept the therapist's message, feeling, on the one hand, minor criticism, and on the other, support and acceptance of the situation by the psychotherapist. However, in the first sessions, it will be difficult for depressed individuals to understand good-natured critical remarks; they will be able to correctly perceive and realize the full depth of what the therapist said only after establishing trust. The criticism for people with a depressed character is clear and understandable: "If a person talks to me in this tone, perhaps he really understands me, and there is some truth in his words." And gradually the information will begin to consciously form in their souls.

The decision to end therapy should remain with the client. Why? The formation of a depressive character always includes early separation and frustration at a time when the person did not yet have the resources to cope with the breakdown of attachment with a loved one. Moreover, such people did not have the opportunity to return to an understanding and caring parent - in fact, mom and dad were infantile in relation to the child, so the latter took on the role of an adult and responsible family member. Accordingly, he had no support. That is why, in order to exclude retraumatization of the personality, a person with a depressive character chooses the stage for completing psychotherapy sessions himself. But for these clients, the door to therapy needs to be left open and they need to understand that they can always come back.

The process of completing psychotherapy sessions for depressed individuals can take years. The client leaves and returns, checking the strength and stability of the relationship with the psychotherapist, making sure that they continue to love him, and he has the right to his own separate life. And this is not the case when short-term therapy helps (for example, as in America and Europe, with insurance for 10-15 sessions). With this approach, the opposite situation can occur - the process of retraumatization and exacerbation of feelings of one's depravity can begin. The person becomes attached to the psychotherapist, but the sessions end unexpectedly for him. The reaction of a depressed person is quite predictable: “Well, how is that? It helps others, but everything is so bad for me that nothing can help anymore? " As a result, the person becomes isolated. What is the reason for this reaction? It's all about early separation, when the depressed person had to abandon the mother. Such a client will take significantly more time than 10-15 sessions. Sometimes even 20 sessions will not be enough to interiorize the process of communication with the therapist and absorb it into himself as an object: “The psychotherapist communicates with me, accepting me as I am, and does not condemn me. This means that I begin to talk with my inner self in the same way. At first, my internal dialogue resembles communication with a therapist, and over time it becomes a part of me - a kind positive dialogue."

How can you help friends and family with a depressed disposition? It will not be possible to heal them on your own. The most important point in therapy with this person is rejection and criticism. For a loved one, such an attitude is emotionally perceived rather hard. Moreover, over time, the depressed person may want freedom from the relationship in order to test the possibility of separation, then return to the relationship. For an ordinary person with his own feelings, this whole path will be really difficult. The therapist perceives everything much easier - there is a clear meta-position and understanding that there is no friendship in these relationships, and the person simply learns to live differently, using the psychotherapist as a kind of tool.

However, it is still possible to help a close friend or relative - you need to confront his criticism, raise the level of self-esteem, pointing out the moments of rejection when those around him “consider” him disgusting, bad, vicious and sinful. The tone of communication should be supportive and critical. It is in this case that the depressed person will listen.