Reframing Depression
“What if this depression you are experiencing is helping inform you about your life? What if we listen to it together, it may give us some clues about what is going on with your life. Maybe it will give us some direction about what kind of changes we need to make.”
If you were sitting in session with me listening to someone share about their depression, you would hear some form of the above statement. The way that I say it to each person is unique, always keeping in mind that when someone is suffering from depression, even the slightest attempt at reframing their suffering can be met with disbelief or a sense that they aren’t being heard.
But as we sit together over time I try and communicate to a person with depression that we could begin to reframe it as an opportunity for growth. Though some are skeptical about this suggestion, most are excited to believe that depression could ultimately be reframed in such an amazing manner. I first thought of this idea when I was thinking about my anxiety, and when I penned those words in my book The Anxious Christian: Can God Use Your Anxiety for Good? But it was author and educator Parker Palmer who left an indelible impression on me about viewing depression from this angle. He has been helpful to me in his description of learning to reframe his ongoing struggle with depression as an act of grace. In his book, Let Your Life Speak: Listening for the Voice of Vocation, Parker writes this about the theological reframing his therapist offered him in the midst of depression:
“After hours of careful listening, my therapist offered an image that helped me eventually reclaim my life. ‘You seem to look upon depression as the hand of an enemy trying to crush you,’ he said. ‘Do you think you could see it instead as the hand of a friend, pressing you down to the ground on which it is safe to stand?’
Amid the assaults I was suffering, the suggestion that depression was my friend seemed impossibly romantic, even insulting. But something in me knew that down, down to the ground, was the direction of wholeness, thus allowing that image to begin its slow work of healing me.
I started to understand that I had been living an ungrounded life, living at an altitude that was inherently unsafe. The problem with living at high altitude is simple: when we slip, as we always do, we have a long, long way to fall, and the landing may well kill us. The grace of being pressed down to the ground is also simple: when we slip and fall, it is usually not fatal, and we can get back up.” (pp. 66)
Ways to Navigate Depression in Order to Reframe It
First, find a helpful metaphor to help reframe the depression in a way that resonates with the person you are working with.
Since almost all my clients come to my office in some form of transportation, mainly cars, I find that the vehicle they drove over provides a helpful and accessible metaphor for how to think about their depression. I might say something like the following to a client:
“You drove over in a car right? And that car has a bunch of gauges on the dashboard that let you know what is going on with the car, especially inside the car. For example, you have a light that comes on to let you know that you may need to fill up gas soon because you are running close to empty. Or you might have a light come on that lets you know when the oil needs to be changed, or air needs to be put in the tires. The dashboard lights let you know all that is going on with the car, whether things are going well, or if something is going wrong with the car. And when the gauge indicates to you that something is going wrong with the car such as engine problems, or the lights come on to let you know that it needs to be serviced soon, you have a choice to make. Do you pay attention to the lights and go get the car serviced? Or do you ignore the lights and keep on driving? One will leave you broken down and stranded on the side of the road, the other will allow you to continue to drive safely down the road without any problems.”
As I share this metaphor I can often see they are tracking, but still wondering where I am going with it. I continue:
“Depression is the same way. It is the internal workings of our life letting us know what is up, and what is going on with us. Depression is like the lights coming on to the dashboard of our life and saying to us, ‘pay attention, pay attention, pay attention’, and to the degree that you do or don’t pay attention, will determine how you handle depression and navigate your way through it in a healthy way that will lead to healing and transformation. Most of our culture tells us to ignore these lights going on in our life, but I’m encouraging you to pay attention and listen to them.”
This is a helpful metaphor for me, but you may have one that works best for you, or that you feel will resonate the most with the people you are working with.
Second, think about questions that may help open up conversation around the depression that will lead to some insight about what it is communicating to the person.
Some of the questions that I find most helpful in reframing depression are usually the most simple ones, such as:
- Why is depression showing up right now?
- What have you experienced recently that may have triggered the depression?
- What could depression be teaching you about your life right now?
- What is God trying to teach me in the midst of my depression?
- Where is God in the midst of my depression?
I find that simple questions like these help empower the person to think about their depression, rather than simply being a passive observer of it, which often puts the responsibility on the counselor or pastor, or friend to be the one to help manage the person’s depression.
Third, externalize the depression and have a conversation with it.
There are several ways to do this, but a few that I like for example are: a) the counselor becoming depression and having the person ask questions of the counselor as it they were depression itself; b) using an inanimate object in session to be the depression (i.e. like a pillow on the couch, or a chair), and have the person talk to the inanimate object, asking questions about the depression, and even answering back. Though this may sound weird as you read about it, there is something really powerful when a person externalizes their depression. They often don’t feel like depression is them, but instead is just something that happens to them. That distinction is very empowering in terms of creating change.
Fourth, and possibly the hardest, is encouraging people to sit in their depression for a bit, rather than just trying to escape from it, or numb it out.
By sitting in it, I simply mean being aware of the depression, and choosing not to automatically cope with it in unhealthy ways. And when this can be accomplished, there is an opportunity to see what may come up in the midst of sitting in it. And what may come up is the realization of what feelings are truly underneath and triggering the depression, as well as some helpful insight on what changes to make.
Reframing is Ultimately About Hope
When someone comes into counseling they are looking for help. And ultimately, I believe they are looking for hope. They are wanting to know that life is not over for them, and that there is an opportunity out of the depression that they are experiencing. If they weren’t looking for hope, then why go see a counselor? Why go talk to a pastor? Why meet a friend for coffee to talk about it? The why is because they are looking for hope. And as a person in a position to help someone with depression, you are in a position to provide hope.
What great hope to offer someone about their depression than to give them the opportunity to see their depression as an opportunity to grow and learn. In the book Depression and Hope: New Insights for Pastoral Counseling, Howard Stone writes the following:
“One way to build upon people’s strengths is to show them hospitality. The counseling session needs to be a place where counselees are welcomed, encouraged, and complimented for what they are doing well, not where their past wrongs or present pathology is dredged up….Showing hospitality has for centuries been one of the vital tasks of pastoral care.” (Depression and Hope: New Insights for Pastoral Counseling, 61).
I think that this quote is a great example of the type of hospitality that is encountered between two people in the act of counseling, whatever form it may take. It is in that encounter that hope can be reframed as depression, and as Palmer wrote above, depression can be seen as an act of grace where we can come into contact with a new and healthy way of living our life anew.
Part of the opportunity that awaits the counselor and client in the encounter is to help the person struggling with depression to listen to where God is, and what God is doing in the midst of their depression. For if one believes that depression can truly be reframed as an opportunity to grow, than it would make sense that God is at work in this process. And if God is at work, how can we truly listen to what God is up to, so that not only the counselor, but the client can participate in that collaborative and redemptive process. I love the words of the psalmist in Psalm 40:1-3:
1 I waited patiently for the Lord;
he turned to me and heard my cry.
2 He lifted me out of the slimy pit,
out of the mud and mire;
he set my feet on a rock
and gave me a firm place to stand.
3 He put a new song in my mouth,
a hymn of praise to our God.
Many will see and fear the Lord
and put their trust in him.
Part of helping a person sit in their depression as I referred to above, is being able to wait patiently for the LORD to respond to our cry, and to help transform our very depression. And as a counselor, pastor, or friend, what a beautiful opportunity we have to join in that work.
Action Flows from Insight
As we begin to help someone reframe their depression as an opportunity for growth, and we even get to the point to help them sit in their depression, then it’s about waiting and discerning about what action steps to take next. I want to suggest several key tools that I think can help not only you as the counselor and pastor what action steps to take next, but also help the client identify what action steps to take next as well.
One, start with the ways I suggested above to navigate depression. Those specific steps will begin to open up the conversation about depression and will lead to some great insight. Just helping a person talk about their depression and externalize it will lead to some great discernment about next action steps.
Two, a great exercise is a 3×5 card exercise that will help a person narrow down on what specific aspects of their depression they want to focus on. When they can narrow this down, then it’s easier to draw on specific action steps. For example, when a person comes into my office and talks about depression, it may be hard at first for them to identify where their depression is coming from. I will often have them write down on 3×5 cards what they think is depressing them. Sometimes they have only one card because they are very clear about the cause of their anxiety. Sometimes they have a few cards. And other times they have 10-15 cards as depression has affected many areas of their life. I will then lay down all the cards on the floor and have the person walk around and through the cards, just noticing what they are feeling as they come into contact with each card (i.e. by contact I mean, what they feel when they read and see and feel what has been written on the card by them). And one by one I have them remove cards that don’t seem the most important, until ultimately they are left with 1-2 cards. And then I will ask them what aspect of their depression do they feel like they have the most energy and excitement to work on. This aspect of energy is important as depression can often leave people feeling very lethargic and tired about making any changes. So for example, if a person says they feel most depressed because they feel a disconnect in one of their relationships, then we will draw some action steps to create change in this area.
Three, I believe it is very helpful for a person to start journaling about their experience with depression. Though I know that a lot of people have never journaled, and may not even like to journal, I think this is a great exercise to engage in. I recommend a person starting off by just journaling a few words, or sentences to a 3×5 card as a beginning step, and if they choose to progress to extended writing, then they can move to writing an entire page, or several pages. But the journal acts as a great reflection tool, providing not only the act of externalization, but also eliciting insight, which will help one create some helpful next action steps. Action steps are best discerned when someone can reflect on what is going on with them, and then has insight about themselves.
When you can reframe depression, and provide hope to people you are working with, then you are in position to come alongside of them and create lasting transformation. And as you do this, focus on some of the simple ways and tools that I have talked about above that can aid you in the process of this collaborative work between God, you, and the client.
Rhett Smith is a Licensed Marriage and Family Therapist in private practice in Plano, TX. He specializes in helping people struggling with anxiety find new opportunities for growth, as well as spending a majority of his week with couples as they navigate relational issues. He is the author of The Anxious Christian: Can God Use Your Anxiety for Good? and What It Means to Be a Man: God’s Design for Us in a World Full of Extremes. Rhett lives in McKinney, TX with his wife Heather and their two children. You can discover more about Rhett’s work through his writing and podcast at rhettsmith.com
