Appendix (4): Good Mood: The New Psychology of Overcoming Depression

Good Mood

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Good Mood:
The New Psychology
of Overcoming Depression

Chapter 12 Improving Your Numerator

If you can prove to yourself that you are not as bad as you think you are--that is, if you learn that the facts show you measure up much better than you thought you do--you may take a short and effective route to overcoming sadness and depression. So it makes sense first to check whether you can improve the numerator in your self-comparison Mood Ratio.

People can and do distort the facts about any of the aspects of their lives that are important to them. Consider as an example the case of a

woman who always had a great zest for life, had felt a great deal of pride in herself and in her achievements, and had cared for her children with obvious love and tenderness. [She] became morose and lost interest in everything that had previously excited her. She withdrew into a shell, neglected her children and became preoccupied with self-criticisms and wishes to die. At one point, she formulated a plan to kill herself and her children, but was stopped before she could carry out the plan.

How can conventional folk wisdom explain this woman's remarkable change from her normal state? In common with other depressed patients, she appears to violate the most basic principles of human nature. Her suicidal wishes and her desire to kill her children defy the most hallowed "survival instinct" and "maternal instinct." Her withdrawal and self-debasements are clear-cut contradictions of another accepted canon of human behavior--the pleasure principle. Common sense is foiled in attempting to under- stand and to fit together the components of her depression. Sometimes the deep suffering and withdrawal of the patient is explained away by conventional notions such as, "He is just trying to get attention." The notion that a person tortures himself to the point of suicide for the dubious satisfaction of gaining attention greatly strains our credulity and actually runs counter to common sense.

In order to understand why the depressed mother would want to end her own life and that of her children, we need to get inside her conceptual system and see the world through her eyes. We cannot be bound by preconceptions that are applicable to people who are not depressed. Once we are familiar with the perspectives of the depressed patient, her behavior begins to make sense. Through a process of empathy and identification with the patient, we can understand the meanings she attaches to her experiences. We can then offer explanations that are plausible-- given her frame of reference.

Through interviewing this depressed mother, I discovered that her thinking was controlled by erroneous ideas about herself and her world. Despite contrary evidence, she believed she had been a failure as a mother. She viewed herself as too incompetent to provide even the minimum care and affection for her children. She believed that she could not change--but could only deteriorate. Since she could attribute her presumed failure and inadequacy only to herself, she tormented herself continuously with self-rebukes.

As this depressed woman visualized the future, she expected her children would feel as miserable as she. Casting about for solutions, she decided that since she could not change, the only answer was suicide. Yet, she was appalled at the notion that her children would be left without a mother, without the love and care she believed that only a mother could give. Consequently, she decided that in order to spare them the kind of misery she was experiencing, she must end their lives also. It is note- worthy that these self-deceptions dominated the patient's consciousness but were not elicited until she was carefully questioned about her thoughts and plans.

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This kind of depressive thinking may strike us as highly irrational, but it makes sense within the patient's conceptual framework. If we grant her the basic (though erroneous) premise, namely that she and her children are irrevocably doomed as a result of her presumed deficiencies, it follows logically that the sooner the situation is terminated the better for everyone. Her basic premise of being inadequate and incapable of doing anything accounts for her complete withdrawal and loss of motivation. Her feelings of overwhelming sadness stem inevitably from her continuous self-criticisms and her belief that her present and future are hopeless.1

Imprecise use of language can produce severe numerator problems.

When clients state, "I can't stop worrying," or "I find it impossible to diet", we try to get them to change their sentences to "I can stop worrying, but so far I haven't", and "I find it exceptionally difficult to diet -- but hardly impossible". 1.1

The steps toward improving your numerator are: (1) Direct your attention to negative self-comparisons arising from your numerator. (2) Study your numerator to learn how to bring it closer to the real facts. (3) If there are ways to improve your actual situation that you have thought yourself helpless to bring about, consider whether you are really unable to bring about the improvement, or whether the helpless feeling that accompanies your depression is a false impediment. (4) If your study of your numerator indicates that your assessment is biased in a negative direction because of unsound judgment, develop devices to ensure that your corrected numerator, rather than a biased numerator, affects your mood. Let's consider these steps individually.

1. Aim to reduce negative self-comparisons. The first step in improving your numerator is to understand that you must try to reduce negative self-comparisons, and thereby improve your Mood Ratio. People have known about self-comparisons before. But this key insight never has been integrated with the rest of our psychological knowledge in order to develop a systematic approach to the cure of depression.

2. Study your numerator in order to correct it. You are a journalist, say, and you think of yourself as sloppy and insufficiently disciplined. What are the facts? Are you really less careful and disciplined than others in the same work conditions, with the same talent? Or are you really quite careful and disciplined, and your criticism of yourself in this respect is not well-founded?

3. Improve your numerator if it can reasonably be improved, not letting a false sense of helplessness hold you back. You're still a journalist. After looking at a set of your articles as dispassionately as you can, you conclude that one more re-writing would improve your work considerably. Ask yourself why you don't give it that extra re-write. If you tell yourself that you just can't do it, you just can't force yourself to re-write one more time, that it is hopeless, the re-write won't matter anyway, you just don't have the energy and discipline to re-write again, blah, blah, ask: "Is it really so? Maybe I'm not as helpless as that. Maybe I can force myself to the effort of re-writing again." And if you do muster the resources to do the additional rewrite, you may be able to improve your numerator enough to have your self-comparisons no longer be negative.

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