Depression’s Call

“It’s actually a good thing you’re feeling depressed”, I find myself saying to clients more and more lately. Of course, I don’t mean this comment literally, this is not an expression of some sadistic joy at another’s suffering — and I must immediately expand upon what I do mean by it. This is what this post will be about — something I truly believe about depression and something that seems to go against the grain of much of the social media’s portrayal of it. There is much being said and done for helping people speak up about depression, to be more open about it rather than hiding it as some terrible personal failing. This is a much-needed, welcome turn of events.

However, the thinking still seems to revolve around seeing depression as an intruder, an unwelcome guest that must be eradicated. Yes, coping with the day-to-day experience is something that one needs to figure out when the weight of depression won’t let her or him get out of bed, or go to work, when the fatigue and the self-loathing seem to take over the entire awareness of the person’s existence. But to me, the goal of this coping is not to find a way to slay the monster, to “beat it”, and to return to life as normal. Coping skills are important for the sake of being able to function, but actually addressing depression means something else entirely. Whether or not medication needs to be involved (and medication can indeed be crucial), depression has a message coming from deep within the individual, that needs to be truly heard and heeded in order to truly work it through.

This is why I titled this post “Depression’s Call”. It is not meant to minimize the immense suffering that depression often entails. And, it is not meant to minimize the importance of finding ways to take care of oneself, through small daily actions, therapy, and possibly medication. But depression has within it a deep call. It is a message, being delivered from the psyche and the body, that something needs attention. In my experience both personally and as an analyst, this “something” is not conscious. Depression becomes a kind of symbol, a symptom that points to something unconscious that needs to be addressed and brought to light. More often than not, it’s an entire constellation of issues, reaching back to childhood, or possibly to a trauma or a loss years ago. When not fully dealt with (or, as the case often is, when never seeing the light of day at all), it sits within our psyches and bodies underneath the surface, and colors the world around us.

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It takes a great deal of energy to contain our inner experience. When growing up, one’s experience is not held, mirrored, and validated, the child internalizes all kinds of messages that then become part of her or his “template” for how people and the world are seen. For a typical and not seemingly traumatic example, when, say a father says to his daughter to “stop moping” when she is upset about her friend moving away, she learns that her feelings are too much for others to handle, that she is overwhelming to others, that she needs to shut off her natural response in order to take care of important others in her life. As children, our parents are our whole world, so we will form a template that doesn’t take into account the idiosyncrasies or personality issues of our individual parents — the template becomes wholesale. And so, to continue with this little girl who has been told to stop moping ( likely over and over and over in many other instances), her template will contain this complex message that her feelings are bad, wrong, overwhelming to others, and a nuisance to be gotten rid of. She will unconsciously begin to do as she is told, in order to maintain the connection to important others in her life. This takes immense amounts of energy to live this way, even though this energy is expended unconsciously.

Enter depression. The now-adult little girl’s psyche and body are exhausted from this labor of suppressing her true feelings. By now she may not even know she’s doing it, and how long she has been doing it, or why. All she knows is that she is depressed. And this is why I see depression as an important messenger.

Heeding depression’s call means looking deeper, beyond one’s current circumstances, and beyond finding ways to feel better as soon as possible. She may not feel better right away in a literal sense, but when finding that thread of discovering the ways in which her psyche has been working so hard to maintain the kind of self that’s been required of her, she may feel a sense of relief, a direction to follow, a way through. Suffering is torture, it can be near-unbearable for some. Suffering needs compassion, support, mirroring, and humanness, a “True Other” (Winnicott’s beautiful term referring to the presence of someone who truly sees and resonates with the person, relating to them in an authentic way that feels like exactly what they needed in a given moment.) But depression also needs more. It calls us to go deeper, to look beyond the immediate, to go deeper, and, essentially, to transform.

Seen in this light, depression’s call is a gift — hence that strange statement at the beginning of this post that I have said to clients. The fact that one recognizes she is depressed is an inordinate potential. So many walk through life without being aware of being depressed — getting through the day, binge-watching TV shows, even going out and seemingly having fun, while the psyche suffers under the pressure of those childhood templates. But when one becomes aware of depression, it can become a catalyst for discovering these templates, for challenging one’s patterns, perceptions of oneself and the world, and for truly embodying one’s True Self. The journey is not easy, and my goal here is not to deify depression — my hope is to share the deeper, urgent call that it represents and the potential it holds.

“Can You Feel Me Here With You?”

I have recently attended the first level of training for Accelerated Experiential Dynamic Psychotherapy, or AEDP. The experience transformed me profoundly, and its tendrils will continue to flesh out into my work going forward. During the 5-day experience, I struggled with integrating the model into my psychoanalytic understanding of doing therapeutic work — which makes sense, given how deeply psychoanalysis has impacted me as both analysand and analyst. Psychoanalysis is the deepest kind of psychotherapy I know, and yet I was looking to go further, particularly in the area of technique and presence with clients.

One of the things I struggled with as an analyst was how heady the work can be. One can have all kinds of deep, intense, and even necessary insights about oneself, but experiencing them directly is not a given, and there was very little training on how to help clients have that more direct experience — both within themselves and with the analyst. As someone who is both very intellectual and very deep-feeling, I longed for more training and language for bringing the experiential dimension into the room with my clients. That’s why I was so thrilled by the description of AEDP — not as something to displace psychoanalysis, but as something that could enrich it.

There is so much I gleaned from this approach that I could write about, but I am choosing just one element, something that perhaps hits right into the core of AEDP’s healing intention, which is “undoing aloneness”. One of the simplest, yet most profound interventions of the model (and there are many, many others) was the phrase that became the title of this post: “Can you feel me here with you?” Since AEDP is an attachment-based model, it strives to focus on and flesh out the experience of attachment within the therapeutic relationship itself. Clients will bring all kinds of issues to work on — which manifest out of unconsciously-running internal pathways established long ago. In psychoanalytic work, the goal is to bring those pathways into conscious awareness (and I’m very much condensing this here!). While doing this work with clients (pre-AEDP), I have watched them gradually becoming aware of ways they unconsciously enact their lives over and over, and these patterns slowly beginning to change as a result of that awareness.

What AEDP has offered me is the attachment piece that psychoanalysis does not explicitly bring into the therapeutic technique (although it is certainly aware of it in terms of human development and within the therapeutic relationship). At least in my own understanding of it, psychoanalytic theory in general tends to attempt to avoid “wish gratification” — and the idea of a “corrective emotional experience” has been very controversial in this field as well. So, it was a great surprise to me to discover that AEDP works to explicitly bring the therapist into the relationship as a warm, holding other, and that this is reflected upon by both parties.

And when I say “explicitly”, I mean with phrases such as the title of this post — “Can you feel me here with you?” What I realized throughout the course of the training (and continue to realize afterward) was just how difficult it is for people to receive caring, attention, and support. We may say that it’s all we ever want, but the reality is that actually taking it in is a very different story. AEDP is the only model I’ve encountered that explicitly addresses this phenomenon. Asking this question (or others along the same lines) turns out to be an incredibly emotionally intimate and challenging experience — most people do not expect for someone to be this present.

Explicitly sharing with the client that the therapist is right there — in whatever form — usually makes her/him/them squirm. It’s suddenly very real and very hard to accept. Even if the person can say that yes, they can feel the therapist’s presence, they’re likely struggling to fully trust that presence. And therein lies the work, which can be done experientially in the immediacy of that squirmy feeling, rather than reflecting on it at an intellectual distance.

I will share my own experience of this phenomenon that I had at this training. We were practicing the AEDP techniques with one another, and had an assistant teacher nearby to help guide the therapist. When it was my turn to be the therapist, I felt vulnerable being watched (i.e. fearful of being judged!) by the assistant, so the exercise took a lot of courage for me to do. A few exchanges into my practice session, the teacher put her hand on my shoulder, and whispered in my ear something that I could say to the “patient” at that moment.

I squirmed. Yes, there was the struggle of being watched and being told what to do — that’s never comfortable for me (and can be a bit stilted, interrupting the immediacy of the encounter). But upon reflection, I realized that the real reason for my struggle was that the teacher cared about me. She cared enough to want to help me learn, to hold space for my process, and to offer me immediate tools rather than just watch me struggle and then tell me what I could have done better/differently. It turned out that my habitual fear of being judged was actually a “comfy” go-to as a way of avoiding an even deeper experience, that of being supported and cared about.

It continues to be a paradox — both for myself and my clients — how often this is the deeper struggle, how hard it is to really receive “the good stuff”, as the AEDP’s founder, Diana Fosha, says. When one grows up adapting to and subtly taking care of the feelings of the very important figures in her or his life (usually the parents), the deeply-ingrained lesson held in the psyche-body is often that one cannot truly trust the world enough to be able to relax and just receive. And if there is also trauma where one’s vulnerability was taken advantage of, this lesson is reinforced even further. The person learns that being loved and cared for is not a given, and does not come freely. It can feel like it’s never real, or that it must be earned, or a multitude of other feelings around it. Therein lies the work of analysis.

I am so deeply grateful that AEDP has honed in on this paradox and offers tools to explore it and shift it for people. There is so much more to this model that I found immediately useful and deeply applicable to psychoanalytic work — which I look forward to sharing here in future posts, as well as living out in my life and work. For more information about the model, use this link: https://aedpinstitute.org/about-aedp/

The Map versus the Territory

I’d like to share with you an idea that has helped me gain a greater understanding of both life and the therapy process — the analogy of the Map versus the Territory. I learned about it from the author and Buddhist teacher Reginald (Reggie) Ray. After I describe the idea, I will share with you a personal experience that will hopefully illustrate it in an authentic way.

The territory is our direct experience of something, experience that includes the body. You are in a concert hall and are swept up in the flow of music, your heart beating to the rhythm of the music, your soul singing along, time disappearing altogether. Or, you are with someone who is spewing forth a great deal of anger, and you feel your body contract and your breath becomes shallow, perhaps you become triggered and regress, or you feel your muscles tense and get ready to act. You may or may not notice all these details, because noticing them may mean you’ve stepped out of the experience and are naming and labeling its various component parts. The territory is the totality of embodied experience, before words or ideas come in. We may call it presence, assuming that you are indeed there to experience it.

On the other hand, the map is a set of concepts and labels that describe something, whether it be an experience or a person/place/thing or anything else in existence. The map can be immensely important. For example, laying out the map of one’s childhood and learning its ins and outs helps one become increasingly comfortable with the details of what happened. However, I have discovered that most of us (myself included) tend to cling to the map and avoid the territory. The realm of ideas and logical processing can feel a lot safer, especially when one grows up in an atmosphere where exploring one’s authenticity was unwelcome or even actively prohibited. The head can be a safe place to escape to, and to still have the sense of sanity and even productivity. In analytic/therapy terms, we call this dissociation. That in itself is not necessarily something that does damage — dissociation is a necessary defense we all have. If we did not dissociate the certainty of death, for example, we might not be able to function on a daily basis. What I am pointing to is more subtle, and to areas where we might dissociate even though the actual present situation does not warrant it — and in that case, dissociation is damaging in that it keeps us from living fully. For example, one might sit through that same glorious concert and stare at her phone or be completely preoccupied with her To Do List and thus dissociate the awareness of the music altogether.

In an analysis/psychotherapy, we work to discover and fill out the map of one’s life leading up to the present. Every detail that one recalls and pieces together throughout the work — that is, the map — becomes more complete and the person begins to own that narrative more and more fully. However, this is only part of the work. In a therapy that explores the map alone, the person will likely come to feel stuck and largely unchanged. (This was the challenge of psychoanalysis when it was first born – people came to learn all about their defenses and neuroses but did not actually change their patterns and ways of being.) The other, more difficult part, is exploring the territory of that map, fleshing it out. To me, this is the very kernel of psychoanalytic work. Exploring the territory is terrifying if you have never been encouraged to feel, to express yourself, and to explore your depths. If you grew up being shamed for your body, for your expressions, and indeed for who you are, you have necessarily grown to dissociate from yourself. Facing the territory of that experience is the only way to process it in a way where you can own and integrate it rather than fear it.

Facing that territory can literally feel like walking into a dark wilderness filled with snakes, spiders, and dangerous animals. This is where you need a guide and a witness to your process, someone to hold your experience without withdrawing from it, and someone to help make the forays into that wilderness feel safe and manageable. This is why it is nearly impossible to change at a deep level when doing the work on your own (and I’ve tried!!). On your own, you might be able to put together a pretty decent map, although you may avoid parts of it anyway. But when it comes to facing the territory, you are that much more likely to simply dissociate what really needs your attention, indeed may be clamoring for it.

As Reginald Ray says, you need an “other”. We need to find ourselves reflected in another person, emotionally held. This begins at birth and remains true for the rest of our lives. The ascetics who retreat to the forests or the mountains find themselves reflected in nature, or in their own bodies. But we are always in relation. Recently, I became aware of the truth of this experientially (i.e. in the territory) while meditating at home by myself. I reached a place of stagnation, and began to cry. I noticed that I suddenly felt alone and wanted my analyst to know I was crying. Even though on a conscious level I might say that I wouldn’t want to be seen while crying, I felt a deeper, more primal part of myself. I was like the infant left alone for a while, who cried and wanted – needed even – to have my cries heard and responded to. Of course, I am also an adult and could obviously survive not having anyone there to witness my crying in that moment. But this experience led me to touch – this time in a much safer way – the territory I’d dissociated from previously. Also, I was able to go to this place within myself while alone only because at this point I have deeply internalized my analyst.

It feels vulnerable to share my experience above. In fact, this whole post feels more vulnerable than I expected it to. Many voices are clamoring that it is somehow unprofessional or inappropriate, that it will be misunderstood or judged. This is where I tend to constrict, where the territory becomes challenging to be in/with — sharing something deep and delicate about my personal experience. And I can easily delete the preceding paragraph, but I want to share with you not only the experience but the difficulty of being with it. That is the difference between the map and the territory.

Links to Reginald Ray’s work:

His book, Touching Enlightenment

His YouTube channel, Dharma Ocean Teachings

If you got this post via email, please click here to view the post on the web and leave comments (at the bottom of the page).

Talking Heals (Go figure!)

It’s ironic that as a therapist at the tail end of formal training I still forget the fact that just talking is healing. I recently had the opportunity to present at an event at my institute, and my preparation for this presentation had really illuminated this point. I had a lot to say and a limited amount of time, so after I wrote out what I wanted to say, I rehearsed the presentation by myself at home. I was all alone and talked into the air, while imagining that I was addressing an audience. Suddenly, I felt very vulnerable, even though there was no one to actually hear me and judge me. (Hello, transference!) Over and over, I stumbled over my words, stopped talking altogether in a total freeze, and laughed anxiously and apologetically to the walls in my apartment who were clearly not happy with my performance.

I realized even then, that talking through my presentation ahead of time was helpful in making sure that what I had written sounded right, that it was relatable rather than dry and mechanical, and that it actually hung together well. This was the first time I’d prepared for a presentation in this way, and it felt vulnerable but also very helpful in being able to look at the audience and not keep my nose glued to the written material on the page. And once I was actually up there at the podium, with all the eyes on me, I felt that much more confident having already imagined and practiced that moment several times at home. Don’t get me wrong – I was still nervous, and even worried that the audience could see my hands trembling a little as I gripped my printed outline. But having projected onto and apologized to the walls at home, I’d already felt and processed the feelings involved and was not so gripped by them when the moment of presenting actually came.

But here is something I didn’t realize until after I’ve presented. I got a lot of feedback from those who attended that not only did I look confident, but that I seemed to know my material really well. I hadn’t thought of the fact that my talking through the presentation also helped me to get really comfortable with what I was sharing. This is what surprised me, that this was a kind of “by-product” of talking through my presentation. Writing it out (no matter how plainly and conversationally) and talking it through were completely different experiences. Talking it through somehow helped me own the material that much more solidly, it helped me know it on another level than I did when I only wrote about it.

And this is why I began this entry the way I did – it’s ironic that after seeing clients for now several years, I’m surprised by the simple truth that talking heals. What I was always solidly connected to was that it’s healing to share your story (in words, and also art, music, dance, and whatever other nonverbal means that still intend to communicate meaning) to another person, because you can be heard and validated in your experience. But what I’d somehow forgotten (and I have to wonder why I had) is that just articulating your story, just speaking it out loud, has deeply transformative effects. This is why someone who has been through trauma might struggle to talk about it – it becomes more real, more embodied that way. But once they do access the courage to find the words and talk through their experiences, they own them in a way they could not previously.

Much has been said about the symbolization of experience – and words are symbols – so I won’t go into it here. I simply wanted to share with you this realization. I am amazed that one could study so much theory and technique, process the work on so many deep levels, and yet return to these very simple (and of course, at the same time, extremely complex) truths about why psychotherapy really does work.

Channeling Trauma

When I travel, one of the pleasures for me when buying souvenirs is buying from real people, with real stories. Sometimes I get to talk to the vendors and find out about their lives and how they came to sell what they are selling. Most recently, I was in Nova Scotia, in the village of St. Martin, where I went into a little shop. I didn’t intend to talk to the owner, but I’m so glad that I did – so glad, in fact, that I would like to share her story because it speaks to a deep kind of healing.

It was the cutest little shop, maybe 15 by 15 feet, in a stand-alone little wooden house. When several people entered the shop, the owner, a woman in her late 50’s warmly greeted us and let us know to be careful with the uneven floors. I gravitated toward a wall with unusual-looking jewelry, as did several other people. The owner came up to us and started telling us that she made this jewelry herself – several pieces were made from old silver serving trays, and several from pieces of China that the owner’s mother used to own. I was really drawn to one of the silver pieces (a pendant), and brought it up to the register. As she wrapped it up for me, I commented on the beauty of the jewelry and her creativity in repurposing the silver and the China. She looked at me with a very alive, warm gaze, and spontaneously volunteered this story: “When I was a little girl, my mother would make me polish the silver. I had to do it for hours, and it was awful. And I vowed that when I grew up, I would never have to do it again. So when my mother died, I took the silver and cut it up to make jewelry.” She had a really joyous smile on her face (as she handed me the credit card receipt), and I couldn’t help but join her. “What a creative way of changing your past”, I said to her, realizing immediately that I misspoke. You can’t change your past, my inner voice reminded me. But both the shop owner and I knew what I meant.

I was very moved by this. I don’t know whether this woman realizes the depth of this act on her part, or whether this was an intuitive path she followed. As a child, she felt trapped in this really tedious chore. As I imagine it, maybe her mother was tough on her, possibly criticizing the quality of her work, and maybe making her do it until the silver was polished to the mother’s liking. To a little girl, sitting for hours, possibly alone, and doing this chore, was grueling and painful. To make a vow to oneself at a young age means both encountering something traumatic, and also having a sense of hope and a powerful will to heal and find one’s own life, away from the source of the trauma. So when this little girl grew up, she changed her story. She channeled this trauma into a creative experience and even a way to make a living. Thus, she was able to separate from her mother (at least in this way), probably also channeling her anger into the act of cutting up the silver (and breaking those China dishes, too). She got to “get rid” of all that tedious silver, but not by selling it and pushing it out of awareness – she repurposed it with her own creativity, in her own way and no one else’s. I feel so grateful to have heard that story and to now own a piece of this very healing act.