Appendix B

Other Approaches

Viktor Frankl's Logotherapy offers two modes of help. One mode is a philosophical attempt to help a person find meaning in his or her life which will give the person a reason to live, and to live with the pain of sadness and depression; this has much in common with Values Treatment as discussed in Chapter 18, and is discussed there. Another mode is the tactic Frankl calls "paradoxical intention". The therapist offers the patient a radically different perspective on the patient's situation, either the numerator or the denominator of the Mood Ratio, using absurdity and humor; this is discussed in Chapter 10. Frankl has successfully trained others in the use of his techniques, and he reviews studies showing success. Both patients and therapists can surely find his tools useful in a variety of thought contexts.

Substitutions and Combinations of Methods

Even a simple procedure like that of Coue' could achieve good results with some sufferers by operating on just one aspect of the process in an uncomplicated fashion. Such a single view of a depressive's thinking is just the opposite of the complex view of the process in my explanatory diagram in Appendix A, which looks like spaghetti. But complexity offers opportunities for many kinds of interventions and adjustments that are obscured from the sufferer and from the therapist by a focus on a single procedure.

Self-comparisons Analysis makes clear that many sorts of influences, perhaps in combination with each other, can produce persistent sadness. From this it follows that many sorts of interventions may be of help to a depression sufferer. That is, different causes--and there are many different causes--call for different therapeutic interventions. Furthermore, there may be several sorts of intervention that can help any particular depression.

In short, different strokes for different folks. In contrast, however, each of the various schools of psychological therapy--psychoanalytic, behavioral, religious, and so on--does its own thing no matter what the cause of the person's depression, on the implicit assumption that all depressions are caused in the same way. Furthermore, each school of thought insists that its way is the only true therapy despite the wise remark of Greist and Jefferson quoted earlier that because "depression is almost certainly caused by different factors, there is no single best treatment for depression" (1984, p. 72). As a practical matter, the depression sufferer faces a baffling disarray of treatments, and the choice is too often made simply on the basis of chance.

Self-comparisons Analysis points a depression sufferer toward the most promising tactic to banish the particular person's depression. It focuses first on understanding why a person makes negative self-comparisons. Then it develops ways of preventing the neg-comps, rather than focusing on merely understanding and reliving the past, or on simply changing contemporary habits. With this understanding one can choose how best to fight the depression and achieve happiness.

Self-Comparisons Analysis Compared To Other Cognitive Therapy on "Rationality"

A key difference between Self-comparisons Analysis and both Beck's and Ellis's cognitive therapy is their belief that depression is always the result of "disabled or "irrational" thinking. Self-comparisons Analysis differs from Beck and Ellis in not considering depressive thinking as irrational by definition.

In my view, everyone's thinking is bent and twisted, especially in matters that affect one personally. Everyone's perception is biased in various ways; it is never unbiased, not just in psychologically-charged issues but in all kinds of cognitive thinking and judgments in business, science, politics, and everyday life. The question is not who sees the matter "correctly" and who does not, but in what fashion the thinking of each person is inclined away from what might be a "true" view.

Let's agree that unsound thinking either causes or is involved in many cases of depression, and improving one's thinking can therefore help fight against depression in those cases. But as I see it, this is not an appropriate or "rational" treatment for all cases of depression.

Underlying cognitive therapy is the value (belief) that it is silly and childish and irrational to be depressed, that depression is proof-positive that one is not thinking rationally.

There are some people who are depressed yet who are not at all irrational in their thinking--at least not in the sense that Ellis and Harper use that term. Consider the following example of Ellis's, with special attention to the last sentence:

...the case of a person who, as a child, is contin- ually criticized by his parents, who consequently feels himself loathsome and inadequate, who refuses to take chances at trying and possibly failing at difficult tasks, and who comes to hate himself more because he knows that he is evasive and cowardly. Such a person, during his childhood, would of course be seriously neurotic. But how would it be possible for him to sustain his neuro- sis if he began to think later in life, in a truly logical manner?

For if this person does begin to be consistently rational, he will quickly stop being over concerned about what others think of him and will begin to care primarily about what he wants to do in life and what he thinks of himself. Consequently, he will stop avoiding diffi- cult tasks and, instead of blaming himself for making mistakes, he will say to himself something like: 'Now this is not the right way to do things; let me stop and figure out a better way.' Or: 'There's no doubt that I made a mistake this time; now let me see how I can benefit from making it, so that my next performance will be improved.'