Thursday, June 14, 2007

The importance of feeling anger during depression (How my therapist prevented me from feeling and expressing my anger and rage)

A few days ago, one of my friends told me about her decision to take a break from therapy. When she informed her therapist that she wanted this break, the therapist's reaction was highly unprofessional and, in my opinion, grounds for revoking the therapist's license. She (the therapist) not only cried, but also became aggressive. "Who do you think you are to take a break from therapy" was just one of the things she said while lashing out at my friend, and drawing attention to her shortcomings and unresolved issues. After listening to my friend's horrible experience, I started thinking about the time I decided to end psychotherapy. I will share those experiences with you in the next paragraphs because I believe there is a lot that can be learned in terms of how unresolved therapists can contribute to our depression. When I use the word unresolved, I am specifically referring to the therapist's unconscious fears which they project onto their clients. I hope this will become clearer as you read on.

I quit therapy about 7 months ago. I tried quitting twice before that after having spent about 2.5 years in therapy, but my therapist convinced me that I wasn't ready to quit yet. He did it in a more tactful and matter-of-factly manner than my friend's therapist though. He didn't make a big scene out of my desire to quit. When I told him I will quit the third time around, he accepted it without further ado. He just said that I should feel free to come back for a "refresher session" as he called it, and that I did some very good and consistent therapy work. So what's the problem, you might wonder.

It all started when in late August and early September of last year I fell back into a severe depression that rendered me incapable of working for several weeks. After almost three years of therapy, and after significant improvements in my emotional well being I couldn't believe the emotional state I was in. Leading up to this depressive phase, I had received a letter from my mother in late July, which had made me furious and outraged. At the same time I also had some email exchanges with my sister and my uncle which added to my anger. I discussed these events with my therapist, and I was determined to answer in particular my mother's letter, in which, among other things, she had accused me of her feelings of guilt, the pain she experienced at my birth, and the fact that she emotionally neglected my two older siblings after I was born. I was full of rage and anger and I knew that I had to express that anger towards the person that had caused it; my mother. Initially, my therapist didn't take a stand as to whether I should send it or not, but I was quick to infer that even though he never said it, he was against sending an angry letter to my mother or to any family member for that matter. He made it clear to me that he favored reconciliation and acceptance of different "points of view". He even pointed out the - in his view - positive aspects of my mother's letter, which I can't see to this day.

So, even though I had already written a long letter addressed at my mother, I didn't send it, and so,
once again, I didn't allow myself to feel and express the anger and rage that was a logical consequence of these events. I should add here that I am convinced that being aware of one's anger, feeling it, and expressing it is a necessary part of one's healing process. The real danger is the repression of anger, one's unawareness of it because in the long run it will surface and under such circumstances it is mostly directed toward innocent scapegoats such as one's partner, one's children, or other innocent victims as well as toward oneself in the shape of substance abuse or physical and mental illness.

Around August of last year my therapist and I discussed how I should position myself toward my abusive parents as an adult. I felt more and more that I didn't want to have a relationship with them at all. But I was still uncertain at the time. My therapist didn't take a clear stand. On the one hand he did a wonderful job in helping me see and understand what my parents did to me and how that affected my life, but on the other hand, in particular when I told him that I seriously entertained the thought of severing all ties to my parents, he came up with such lame arguments as: "Not having a relationship with your parents will take away a sense of rootedness and origin in you life," or "this might have negative consequences on the relationship between your children (which I don't have and I don't know I will ever have) and their grandparents. When I inquired what he meant by the former example, he couldn't give me a clear answer. He was hesitant and uncertain. He did say that he felt it was ok not to have a relationship for now and maybe a few more years, but he said that in the end I should reconnect with them. I haven't spoken to my parents in 2 years now and I feel better with every day that passes. I can take care of myself, and I don't need my parents in my life anymore. Besides, I can't see the point in having a relationship with someone who constantly hurts you, abuses you, puts you down, and only feels sorry for him or herself, even if that someone are your parents. To stay in a relationship with people like that is pure self-betrayal, and I would suffer the consequences in the form of depression or some other physical or psychological symptom, like I used to in the past. My parents are in their mid sixties and they won't change anymore. Maybe when they are lying on their deathbeds they might realize what they have done, but then it will be too late.

In early September of 2006, I told my wife about my increasing frustration with my therapist. What upset me was that I felt pulled in two opposite directions by him, like I described above. I remember exactly how angry I got as I started telling my wife about this situation. We were in the car on the way to the gym, and I was fuming. I was fuming because I knew I had to send this letter to my mother and I let my therapist raise doubts in me. At that moment it also dawned on me why I was so depressed. I was depressed because I didn't allow myself to feel and express my anger and rage. I already felt a sense of relief right after my outburst in the car.

In mid-September of 2006 I really hit rock bottom. I had a complete breakdown in therapy. I cried because I was so frustrated and depressed (after 3 years of therapy). This was the first time I had ever cried in front of my therapist.
I thought I had done everything right up until that period, because I had felt quite good before (when I wanted to quit the first and second time). When I asked him why he thought I was so depressed he just said that it was because of my mother's letter and the sense of loss I felt as a result of the situation with my family. I didn't really buy that but I didn't say anything.

I think it caught him by surprise that I cried, and what surprised him more was my insisting that I knew I had to send this letter to my mother. On the one hand he said that if I felt the need to send this letter to finally cut the umbilical cord, I should do it, and that he stood 100% behind me and supported this action. But then he inquired why it was so important to me to send this letter. It seemed that it was inconceivable to him why I would want to do this. I remarked that I wanted my voice to be heard. He responded that this is not something I can influence, which is true to the extent that I cannot influence how my mother would interpret this letter. It will go through her own filter, and she will not read it the way I want it to be understood. But that was fine with me. I didn't care. The important thing was for me to say what I thought. After that session, I finally mailed the letter to my mother which had been sitting in my drawer for weeks. I felt a great sense of relief.

But the bottom line is that my therapist's advice and opinions, which I trusted,
for many weeks prevented me from feeling and expressing the justified anger and rage that I felt towards those people who had caused it, and this was the real cause of my depression at the time. He was sending me mixed signals: "Go ahead and send the letter," "But explain to me, why do you want to send the letter?" This was not the only time he would send these mixed messages.

I increasingly felt that my therapist had reached his limits. He was very helpful in many respects, but he wasn't able to go all the way. In a meeting with him I kept insisting that my depression had other reasons, probably my repression of feelings connected to my childhood. He quickly steered the discussion away from my childhood. At one point he even said that we had discussed my childhood long enough. At the end of each session we always said our goodbye's in a very warm and heartfelt manner, but after that session I was very frustrated and I think so was he. That was apparent when we said good bye that day, and as I walked out of his office I knew that this was going to be my last therapy session, which it was.

I hope it is clearer now how my unresolved therapist contributed to my depression. The question that remains to be answered is what my therapist's mixed messages and uncertainty as to how I should deal with and position myself vis a vis my parents reveal about himself. I can now see that he must still be afraid of expressing his true emotions - in particular the so-called negative ones like anger, disappointment, rage, etc., towards his own parents. The little boy in him is probably still afraid of the consequences he might face if he did so. He transferred his fear onto me. On his blog he recently wrote: "My incentive [not to watch TV for a year] would have been that it would have pleased my parents (a big issue for me that, only in the last few years, has begun to dissolve)." He obviously is aware of his fears to some degree, but I wonder if he is aware how this issue comes to bear in his practice as a psychotherapist. He has three children of his own, and even though he and his family live far away from his parents, he obviously wants his kids to be close to their grandparents. He is afraid that a rift between his parents and himself will have negative repercussions on the grandparents-grandchildren relationship, and he acted this fear out on me.

To close I just want to reiterate that once I allowed myself to feel and express this anger in the shape of the letter to my mother, the depression lifted. I felt a great sense of relief. I was able to function again. After I told him that I had sent the letter he never inquired into the contents of it. When in late December of 2006 I emailed him my with my decision to quit, he didn't offer any resistance anymore. I'm sure he was relieved because this way he didn't have to confront his fear of his parents any more. Unless of course, some other client comes along and forces him do so.

Sunday, April 15, 2007

Relapse into depression

Healing from depression does not happen over night. In my experience it is a gradual process, a bumpy road, and very often that road goes downhill, right back into depression. I have fallen back into depression many times and I still do. That has been very frustrating for me because I know what it is like on the other side. I know what it is like to be self-confident, optimistic, full of joy and energy and creativity. But then, all of a sudden for no apparent reason, my mood changes drastically and I feel insecure, have no hope, feel like a total failure unfit to be in this world. When it gets to this point I am totally paralyzed, can't work and just sit in front of the TV all day long.


I keep asking myself why this happens. Why these relapses? For one I think that my body is trying to tell me something. I think that it is his way of reminding me to allow myself to feel the pain the little boy has suffered. As a child I had to care for my parents while they never cared for me. This is outrageous, and I need to allow myself to feel this rage, this anger, this injustice that had been done to me. I have a very good intellectual understanding of what has been done to me and of the consequences these experiences had on my development, but allowing myself to access these FEELINGS and to express them is something else. I will try to be more mindful of those feelings to see if it makes a difference.

The other reason why I believe that it is easy to fall back into depression is because certain connections in my brain do not exist, or are not strong enough yet. It's like a river that has carved its way through the landscape for thousands of years. Trying to re-route that river into a new river bed is not easy, and will take a lot of time and work. Similarly I believe, certain neurons in my brain are not used to shooting in new and different directions. They much rather follow the old paths that they are used to. I know this is a very unscientific explanation, but I hope to have conveyed my point.

What do you think?

Sunday, April 8, 2007

Can medication heal depression?



I have never used medication to treat my depression. At the beginning of my psychotherapy, my therapist referred me to a psychiatrist who was willing to prescribe antidepressants to me, but for some reason I chose not to. But I think I had some kind of intuition telling me that if I wanted to get at the true source of my depression, medication was not the way to go.

I am not against medication per se, because low serotonin levels in our brains have been associated with depression, and antidepressants have been shown to raise the serotonin level. I also want to stress that I am not advising anyone to stay away from medication, because in severe cases I believe that it can save lives. However, in the long run I think that it prevents you from being able to be cured. I think so because for me it was essential to feel some of my most painful childhood and adolescence events and memories, and medication prevents you from doing exactly that. It contributes to the cover-up, and it helps you further repress childhood trauma.

Like I alluded to in my previous posting, I can say from my experience that this journey into my past was absolutely necessary in the healing process. This was however not just an intellectual understanding of what had happened to me. I had to learn how to communicate and empathize with the child in me that was deeply hurt. This child was "trained" by his abusive parents to always put their needs ahead of his own. This child was never taken seriously or listened to by his parents because they were always caught up with their fights. This child was told by his parents that he is the reason that they can't divorce, and he took all the blame on him. This child constantly comforted his mother because he saw how much she suffered in her marriage, and this child was afraid to loose his mother for his survival dependent on her. This adolescent's father threatened him with suicide if he was going to tell his mother that he had caught his father in one of his many extra-marital affairs. This adolescent comforted his parents during his brother's fight with cancer and after his brother's death, while he was not comforted by anyone. And when this young man finally had the courage to confront his parents with these and many other stories, his parents showed him the cold shoulder, and again only saw their own suffering, and not their son's, who had become a young man. This child, this adolescent, this young man, had never received any empathy from his parents, and he never will. I had to learn to treat him with understanding, empathy, respect. I had to learn to nurture him for he was never nurtured by his biological parents.

My therapist was instrumental in helping me achieve this. At the very beginning of our therapy sessions he suggested that I keep a picture of my child self close to me and that I communicate with this young little boy. I found this suggestion very strange at the beginning, and I only realized much later how important this was for me in my healing process.

Monday, April 2, 2007

Depression is NOT the result of our present life's circumstances

Very frequently you will hear people say that they are depressed because they just broke up with their partner, lost their job, are stressed out, failed an exam, lost a loved one, don't have enough money, and the list goes on. I was no exception to that. When I was around 25 years old, I started having marital problems, I had problems in grad school, and I started feeling very lonely, lost, hopeless, afraid of the future, simply not fit for life. I started with group therapy, but soon my despair was growing even more. At that time, and many times later, I contemplated ending my life, or simply getting away from it all, on some remote island, free from the pressures of "modern" life, which I thought had caused my misery.

Yes, the current events have most likely triggered my feeling depressed, but the roots of my depression were much deeper. It took years of therapy and reading for me to realize that, and this realization was the key to my freedom from depression. My depression was rooted in my childhood experiences, a childhood during which I had been severely emotionally abused by my parents. The abuse was however not the sole cause of my depression. The deeper reason for my depression was my denial (as an adult) of the abuse I had suffered. I will expand on this in future postings. For now I am going to leave it at that, and will add that I didn't come up with that incredible insight on my own. I am deeply indebted to Alice Miller, a swiss psychologist, who wrote an article entitled "Depression - Compulsive Self Deception", which opened my eyes in this regard.