Depression

Clients are rarely depressed when they leave my office. This is not because I am a brilliant psychotherapist but simply because we have just had a lively 70-minute conversation. You were depressed on arrival and it took 45 minutes to describe your situation, how you feel, and what you think about it all. At this point I ask if you are still depressed, right at that moment sitting there on my couch and talking to me so energetically. You are a bit surprised to find that you are actually not depressed at that moment, but you assure me that the feeling will return shortly. I grant that it probably will, but not while you are in my office. I assure you that your temporary remission is normal and I point out that during the course of our conversation there has been no change in the depressing situation you have just described. Yet you are not depressed at this moment, so it must be that the relationship between your situation and your depression is not as direct as you have presumed.

Before you leave my office we leap on the opportunity that your temporary relief affords to make some small but constructive decision regarding your situation. This token cements your engagement with the resolution of your dilemma, which leads to the actual change and permanent relief you seek. It is usually not difficult to identify the knots of circumstance and perspective that are vexing you. The Cognitive Triad of Depression is the combination of an unacceptable situation, a sense of powerlessness to change it, and the fear that it may go on forever. Removing any of these elements relieves depression. It is not rocket science and it works. Once the paralyzing haze of depression has lifted you can turn your attention to understanding and managing the composition, direction and quality of your life. Trust me. Call me.