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Page 4 of 6
The operational question is whether you are better off attacking your depression on your own, or getting the help of a professional counselor. The appropriate answer is - a definite maybe.
The help of a counselor clearly can be valuable, as even such self-help advocates as Ellis and Harper agree:
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One of the main advantages of intensive psycho- therapy lies in its repetitive, experimenting, revising, practicing nature. And no book, sermon, article, or series of lectures, no matter how clear, can fully give this. Consequently, we, the authors of this book, intend to continue doing individual and group therapy and to train other psychotherapists. Whether we like it or not, we cannot reasonably expect most people with serious problems to rid themselves of their needless anxiety and hostility without some amount of intensive, direct contact with a competent therapist. How nice if easier modes of treatment prevailed! But let us face it: they rarely do...
Our own position? People with personality disturbance usually have such deep-seated and long- standing problems that they often require persistent psychotherapeutic help. But this by no means always holds true.(5)
But a counselor will only help you if the counselor is well skilled, and has a point of view which fits your particular needs. The chances of finding such a skilled counselor are always uncertain. For one thing, therapists tend to be typecast by their training, and there have occurred "increasingly sharp disagreements among authorities regarding the nature and appropriate treatment."6 What you get depends on the accident of where the therapist studied and which "school" she therefore belongs to; too few are the therapists whose thinking is broad enough to give you what you need rather than what they have in stock. Additionally, many practicing therapists got their training before cognitive therapy had been shown to be clinically effective (as none of the earlier therapies had been).
There is real danger here. Two experienced therapists and teachers of therapists write: "Some people are hurt... by the wrong types of therapists for them...Most people really have no sound basis on which to choose...Most therapists are trained in and practice a particular type of therapy, and in general you will get what that person knows, which may not necessarily be what is best for you."7
Depression is a profoundly philosophical disease. A person's most basic values enter into depressive thinking. On the one hand, values can cause depression when they set up over- demanding and inappropriate goals, and therefore a troublesome denominator in a Rotten Mood Ratio. On the other hand, values can help overcome depression as part of Values Treatment, as discussed in Chapter 18. Helping you deal with such issues requires a depth of wisdom which is not learned in school, and which is too seldom in any of us. But without such wisdom, a therapist is useless or worse.
Depression is also a philosophical matter when it arises from disorder of logical thinking and misuse of linguistic. And starting in the 1980s, professional philosophers have begun to work with depressed people, with some apparent success (Ben-David, 1990). The participation of philosophers is quite reasonable given that cognitive therapy is seen by its creators as being "primarily educative", with the therapist being a "teacher/shaper", and the process as being a Socratic "problem-solving question-and-answer format" (Karasu, February, 1990, p. 139)
But a counselor will only help you if the counselor is well skilled, and has a point of view which fits your particular needs. concepts. The interesting dialogues in Ellis and Harper's A New Guide to Rational Living and in Burns's Feeling Good illustrate how a skilled therapist with a sound grasp of logic can help patients correct their thinking and thereby overcome depression. But few therapists -- or anyone else, for that matter -- have the necessary skill in manipulating logical concepts. All this makes it difficult to find a satisfactory therapist, and provides additional incentive for you to proceed without a therapist.
Furthermore, the computer is not subject to some failings of human therapists: The computer never wears out from fatigue late in the day, and becomes inattentive and therefore useless. The computer never burns out from emotional overload, as is not uncommon with human therapists - because they are human. The computer never becomes involved with the client in a troubling sexual relationship - as occurs in a surprisingly large number of cases, recent reports indicate. And you never feel that the computer is exploiting you financially, which bothers some clients whether or not there is a real basis for the feeling. These are additional reasons to at least give computer therapy a try before seeking a human therapist.
The ill-effects of getting involved with a counselor who is unsympathetic to your particular needs, or does not understand how to deal with your particular mentality, or is temporarily ineffectual or worse, can be great. The encounter can discourage you further, and drive you further into depression, compounded by the pain of having paid your good money in return for being made worse off. Given all this, it would at least make sense to try to work on yourself for a while before seeking out professional help. And even if you do eventually seek out a counselor, you will be better prepared to find one you like, and to work with that person, if you have studied your own psychology and the nature of depression beforehand.
Can You Reach Permanent Bliss?
You can hope to get rid of your depression, and by your own efforts. You can hope to remain depression-free most of your life. But if your depression is more than a passing episode you should not expect that after learning to fight and overcome deep depression you will have the same psychological make-up as nondepressives.
Just as alcoholics who have stopped drinking are forever different from other people with respect to alcohol (though recently there has been some scientific question raised about this), depressives who pull out of deep depression often are different than other people. They must constantly reinforce the dikes and guard against the first incursions of depression in order to keep a trickle from becoming a flood. Consider John Bunyan and Leo Tolstoy. Bunyan wrote as follows: "I found myself in a miry bog...and was as there left by God and Christ, and the Spirit, and all good things...I was both a burthen and a terror to myself...weary of my life, and yet afraid to die."(8) Tolstoy's relevant description of his depression is in Chapter 3.
James wrote as follows about the lives of Bunyan and Tolstoy after their depressions:
Neither Bunyan nor Tolstoy could become what we have called healthy-minded. They had drunk too deeply of the cup of bitterness ever to forget its taste, and their redemption is into a universe two stories deep. Each of them realized a good which broke the effective edge of his sadness; yet the sadness was preserved as a minor ingredient in the heart of the faith by which it was overcome. The fact of interest for us is that as a matter of fact they could and did find something welling up in the inner reaches of their consciousness, by which such extreme sadness could be overcome. Tolstoy does well to talk of it as that by which men live; for that is exactly what it is, a stimulus, an excitement, a faith, a force that reinfuses the positive willingness to live, even in full presence of the evil perceptions that ere- while made life seem unbearable.(8)
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