Question About Psychotherapy

[IrmaJean]

I'm sorry things are so difficult right now, Sardonyx. You mention that you are still having a hard time getting yourself motivated, but how are you feeling? When I was feeling down and went to therapy progress came in baby steps. I didn't suddenly feel better, but did so little by little. Two steps forward, one step backward. Can you find a small place of good feelings to build on? Do you know where your needs are and what you want from life?

Also, for me, understanding the whys then showed me the errors of my thinking. My whys weren't based on actual truths about who I was as a person, but rather on certain circumstances and life situations which had been beyond my control. Once I was able to recognize this, I was then able to look at things from a different perspective and begin building new truths. I'm still working on that. I also more than anything just needed someone to sit with me and hear my pain. So the relationship was able to give me the comfort and safety I needed to explore this other stuff. How is your relationship with your therapist?

Sardonyx, sometimes finding small moments of pleasure would give me a little boost as well. Does any activity give you pleasure? Reading? Writing? Exercising?

As for the work, if it has been piling up, it may feel overwhelming. Are you able to clean one small corner in your house? Maybe try finding a place to start. I hope things improve very soon for you.

[David O]

Good morning Sardonyx,

I'm so very sorry that this where you are right now. It's been a long time since was at that point. I grew up under a brutal dictatorship, one where we were all beaten, molested, tortured or shot-- and it left the very deepest of wounds. These wounds festered for years and the scar tissue never seemed to heal. And there were many times I just wanted to never wake up again. I hated my life, hated the world and felt unsafe every day. This went on for nearly 17 years-- it was an unbelievable experience and the worst part of it was that things did not end when we moved to the US (I was 14 then).

In our practice we place clients on very strict SMART goals and behavioral plans with lots of homework along the way. One assignment is to buy one of these books (usually we simply give it away):

The Depression Workbook: A Guide for Living with Depression and Manic…

The Cognitive Behavioral Workbook for Depression: A Step-by-step Prog…

Both are excellent self help books that will carry you long after therapy has ended. In addition, we will often loan out:

Feeling Good: The New Mood Therapy Revised and Updated

The SMART goals are a set of highly prescibed behaviors that require action on the part of the client. They are developed jointly with the client so they reflect their needs. The goals would be something like:

• Take a neighborhood walk every day for 30 minutes. Walk in an area where there are others.
  
• On the walk, say good morning/afternoon/evening to no less than 5 people
  
• Invite someone you would like to know better, to a coffee one evening per week
  
• Clean 1/2 of your bedroom today and the other half tomorrow. the 3rd day, do your dishes only and keep your bedroom clean
  
• Clean the other 1/2 of the kitchen and maintain your bedroom
  
• Complete TEA forms daily and bring to session every week
  
• etc., etc., etc.
  

The idea is to force movement that interferes with the ruminations and perseverations that are common with Depression, through both cognitive and behavioral strategies.

If all else fails and you still are severly depressed, consider newer strategies, which many MD's do not practice yet, such as deep brain stimulation, which is specifically designed for treatment resistant depression. See: http://www.webmd.com/depression/news/20080506/deep-brain-stimulation-helps-depression

for a quick read and begin researching the topic. In this case, knowledge is power.

Good luck and I hope this helps.

David

[Endlessnight]

Sardonyx I am so sorry to hear about how you are feeling. I know how debilitating depression can be, and although my form of depression was different to yours, since I cooked, ate, washed, etc., it was as though I were a robot and did everything without really knowing what I was doing as those years are a blank to me. I hope you can find a way to stick with your therapist. I have longed so much to be able to see one because I feel that I am useless and cannot do anything on my own. I want, no, I need someone to tell me what to do and how to do it. I need to be given homework I guess, like trying to complete simple goals such as the ones David has posted. Maybe we should try to make simple goals for ourselves? I do hope you don't give up. Take care.