People who are looking for help with depression sometimes question the need for psychotherapy. With so much information available online, why spend the time and money? We’re talking with Dr. Jane Rubin about why the information about depression available on the internet is not usually an effective substitute for psychotherapy and how depression therapy can help you feel more positive about your life.
What are the Pitfalls of Using the Internet as a Resource for Depression Therapy?
There is a lot of useful information about depression on the internet. Reading it can often help people understand what depression is and figure out if they’re experiencing it. The internet also has a lot of good practical advice about things like the importance of self-care for depression sufferers.However, a lot of online advice about how to counteract the symptoms of depression, like self-criticism and feelings of hopelessness, is not particularly helpful, in my view. A tremendous amount of online advice focuses on techniques for questioning negative thoughts. The underlying idea is that negative thoughts are irrational. For example, you may be feeling bad because you don’t have any friends. Many online writers encourage you to question the idea that you don’t have any friends. Is that really true? The idea is that it’s not true and that, once you realize that it’s not true, you won’t feel so depressed. These writers encourage people to question every negative thought—that they’re not attractive, that they can’t be successful, etc.—and to recognize that these thoughts aren’t based on their actual experience.
What is the Real Core Issue with Depression?
I think these recommendations get things backward. People aren’t depressed because they’re having negative thoughts. They’re having negative thoughts because they’re depressed. We can see this dramatically when people who start anti-depressant medication begin to experience its effects. Before the medication begins to work, they feel that everything is hopeless-- their relationship is bad, their work is bad, etc. As soon as the medication begins to take effect, the very same relationship and the very same job feel fine.Not everyone who is depressed needs medication. Many people don’t. But what people’s experiences with medication can teach us is that the most important thing in treating depression is to treat a person’s depressed mood. Our moods are like the weather. They color everything we experience. If we’re in a depressed mood, everything feels bad. The clouds don’t lift. When the depressed mood lifts, it’s as if the sun has come out. The very same things that felt dark and gloomy now feel light and hopeful. In my experience, the single most important factor in overcoming depression is having a relationship with an empathic, supportive therapist. To extend the weather metaphor, that relationship creates a different atmosphere that gives you a new sense of hope and possibility.
Do You Have an Example?
I do. I had a patient who came from a family that experienced a great deal of trauma that went back several generations. Because of all the suffering my patient’s family had endured, he felt it was foolish to hope that he could ever find satisfying work or a satisfying relationship. Whenever I expressed hope for him, he would become angry and dismissive. However, at the end of his therapy, when he was feeling much better, he told me that what really made a difference to him was that I never gave up hope for him. What I took from that was that my attitude towards him, as much as anything we talked about, allowed him to experience himself and the world in a new way. When he did everything he could to try to convince me that his situation was hopeless and I never gave up hope, he was finally able to have hope, as well.Click to learn more about depression therapy and treatment with Jane Rubin, Ph.D.Jane Rubin, Ph.D., is a clinical psychologist in Berkeley, California. She works with individuals in Berkeley, Oakland, the East Bay and the greater San Francisco Bay Area who are struggling with depression and anxiety. She also specializes in working with people who are trying to find meaning and direction in their lives.