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Wrong therapy for depression?

Posted by tabitha on May 22, 2004, at 12:35:47

I found this article about depression and it's sounding mighty compelling to me. What do you think?

http://www.clinical-depression.co.uk/learning_path.htm

If anyone doesn't want to read the whole thing, I'll summarize. It says that the root cause of depression is emotionally arousing rumination, or negative rumination. (I know there were studies on that, it was in the book "Learned Optimism", which found a correlation between depression and the combination of rumination+pessimism. It didn't say there was a causal relationship though. Correlation doesn't prove cause, right?) Then it goes on to say that the emotional arousal results in too much dreaming, which disturbs sleep, leads to fatigue, which leads to more distorted thinking, which leads to more negative emotional arousal, and somewhere in there serotonin gets depleted as well. So it says the key to stopping it is stopping the emotionally arousing rumination. There's a bunch about cognitive therapy, about reframing things so they don't cause such a reaction (I've seen that idea before too, in the "Feeling Good" books). Somewhere they also said that all the negative rumination results in neglecting basic needs, so you have fewer pleasurable experiences, further lowering serotonin.

I noticed the thing they said about seratonin syndrome was b.s., where they implied that it's evidence for long-term damage from ADs. But ignoring that, the whole theory is compelling. I've noticed I just spend so much time focusing on upsetting events, going over them, they become huge, meanwhile I neglect everything else. The frustrating thing is my therapy and group therapy right now seem to trigger this more than anything. We're taught that it's important to trace stuff back to childhood, which just leads to me dwelling on painful past events more. I don't seem to get resolution and relief from doing that. The article says psychodynamic therapy is bad for depression, since it encourages dwelling on past pain, which depressed people do too much of already.

Basically my therapy doesn't seem to be helping now, and when that's happening I start trawling the web looking for some alternate approach. I need to talk to my therapist about this. Maybe she doesn't expect me to go home and dwell on stuff so much. I also want to gripe to her about one specific thing. When I exaggerate, she seems to totally discount what I've said. She says she won't validate black-and-white thinking. Fair enough, but can't she help me restate it instead of tossing it out? I can usually come up with an acceptable way to say it. Like for instance we've been arguing for months about me saying 2 of the group members don't like me. Once I said they just haven't warmed up to me. She seemed to accept that, and almost agree, not quite. I got frustrated because I think I've put it that way before. All this time she's been rejecting my notion that they don't like me. But that's just my exaggerated way of saying they haven't warmed up to me. Couldn't she have helped me get to that instead of getting into this head-butting argument for so long?

Last session I told her it just wasn't working. I'm trying to accept her alternate ways of thinking, but my old ways keep popping up. I keep leaving the group sessions, going home, and getting extremely upset by them. She said I need a medication change. That's so frustrating. What I hear is, if therapy isn't helping, it must be my brain chemistry. Can't possibly be the therapy. Aaargh!

I don't want a med change. I know my depression is higher now. It seems to me to be a result of all the upset from the group and the conflict with my therapist. I'm going to try adding more exercise. And maybe I can interrupt all this 'emotionally arousing rumination' somehow. Step 1 would be to stop believing it's useful. I keep thinking I'll get to the root of my pain and it will be healing somehow. It isn't happening. I'm just spinning my wheels.

 

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poster:tabitha thread:349651
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