Discerning Depression
I have written extensively on anxiety, especially on my own anxiety, focusing on the roots of it and how Restoration Therapy has really helped me transform it into a life-giving force. But when it comes to depression I have not written as much on the topic because it is something that I am still deeply exploring. I am exploring it not only for the work that I do with clients, but in an attempt to better understand the role of depression in my own life.
In many ways I think anxiety is much more readily identifiable for people, partly because of the way that anxiety often makes someone feel. People can talk about how their heart races, or their chest feels tight, or how they might notice biting their nails. Or they can identify how an upcoming experience is creating a sense of worry and stress. But because depression often numbs someone from their own sense of self, that is to say, it creates almost a disassociative experience, where people often have a hard time describing how they feel. They can talk about feeling down, or tired, or even use the language of depression, but it sometimes can put someone asleep to their own feelings.
I tell you all of this because I think depression has been a big part of my own life, but I was more unaware of it than anxiety. Anxiety was easy for me to locate, and when my stuttering started happening after the death of my mom at age 11, anxiety was even more present in my life each day, because I literally feared going to school, and was stressed about what might await me later in the school day, especially if it involved reading out loud. But what I am now just really coming to grips with is how depressed I really think I was during the time. I remember struggling with sleep each night, especially on Sunday nights, knowing that a new week awaited me. Was that anxiety? Yes for sure. But depression was also mixed up in there because I think I was asleep to my own sense of self, my own physical body, and I often experienced a more flattened affect emotionally, rather than some heightened state I would get in with anxiety.
Early Attempts to Work Through Depression
As an adolescent and young adult I really didn’t have any tools to work through my depression, partly because I really didn’t know what was happening to me, and I had also developed some really clever coping behaviors that helped me survive those difficult years. In fact, I probably would never have even said I was depressed if someone had asked me, but the more I reflect on my earlier life and work with clients and their depression, the more I know just how clever we are as people in masking what we feel. And often we just don’t have the language or tools to identify that depression is actually happening to us. There is literally know frame of reference.
So without this frame of reference I just worked through my unacknowledged depression the way that probably most people do. That is, I got really good at distracting myself with friends and experiences, and I tended to just push it farther and farther below the surface. I did have a sense at 21 that the only way forward in my life and through the grief I had experienced at the death of my mom, and the ensuing depression that brought on, was that I had to go through things to get to the other side. I remember when I was a senior in college (1996), getting some cloths and cleaning spray, and heading to the cemetery where she was buried. It was the first time I had been back since the graveside service 20 years earlier. I remember having an old map of the graveside location, but I primarily just wandered around for an hour or more until I found the grave. I thought if I could just sit at the graveside and let my emotions out, I might be able to heal myself of the grief, and the depression that was lurking around. But I sat there and nothing really happened. And so I went on.
I continued to do the grief work, knowing that if I could get healing, then the depression (and anxiety), might potentially go away. So in those ensuing years since that graveside experience at 21 I had friends try and counsel me about it, and I made an attempt at therapy (5 sessions) at the age of 23. The one insight from that experience was that the death of my mom brought on depression and anxiety, and the trauma from the loss, really hindered my personal relationships, especially those with people I was dating. So I continued on, seeing an amazing therapist weekly in Pasadena, CA for 3 years. This was happening during the first few years of my marriage, all the while I was in graduate school to become a marriage and family therapist. I was definitely aware of the fact that my depression had to be dealt with. But I still didn’t feel like I had that breakthrough yet.
Finally, in 2010, while living in Dallas, I started seeing an amazing new therapist. And a few sessions into our work I had an amazing experience in therapy. I have talked about this at length in other writings, but I will share briefly what happened. My therapist started asking questions about that first day back at school, a couple of weeks after my mom died. “What was that experience like for you coming back that day?” “I wonder what the other kids were thinking?” “I wonder if you wondered what the other kids were thinking?” Etc, etc. Then he switched gears suddenly, though as a therapist now, I know he was probably working to get me to this experiential moment at some point in our work. He asked me to close my eyes and imagine me back in that classroom on that day. “I want you to get into that 11 year old version of yourself”, he said. “What was Rhett feeling at that moment, sitting in that classroom?” More and more questions ensued, slowly, but intensely. And finally, he says, “I want the Rhett sitting here today to walk into that classroom and sit next to the younger Rhett. And I want you to tell Rhett what he needs to know in that moment.”
So as I’m sitting there in that moment, I begin to silently, in my head, tell the younger Rhett what I so desperately want him to know. For those of you who have never been in therapy, or who have never been through an experiential moment like this, it may sound crazy, but I have to tell you it’s one of the most powerful experiences one can have. In that moment I told Rhett that he would be okay, and that things would get better. Each time I tell this story my memory tends to bring up different words and rememberances. What is important is not the details, but the overarching experience, which is, I communicated to Rhett in that moment a truth that I wanted him to know.
And then my therapist asks me to open my eyes, and as I do, he asks me what I said to Rhett. And as I began to tell him, I just start bawling my eyes out. It was the most freeing, cathartic experience I may have ever had in terms of working through the grief brought on by the death of my mom from breast cancer. And in being able to be in that grief, allowed me to then begin to access and work through the depression (and anxiety) that I had been living with for so long. I walked out of session that day in 2010, called my wife, and told her that my life would never be the same because of that experience.
What I had been doing all those years were attempts to work through my depression, but with little understanding of how to do it, and no clarity around what a helpful process might be. I had wonderful therapists who helped me work through the depression, but as I sit in my own therapy practice now, I have come to appreciate the ability to provide a helpful roadmap, with some specific practice steps for clients, when they are dealing with depression. And though depression doesn’t usually follow a roadmap, clear steps can give us helpful guidance as we navigate the difficult times that depression brings on.
Using the 4 Steps of Restoration Therapy to Practice Through Depression
“Deliberate practice is a behavior, and flow is an experience.”
Grit: The Power of Passion and Perseverance by Angela Duckworth
I love this quote by Duckworth, as it expresses something I believe and try to practice in my own life, and encourage my clients to do as well. When you and I can gain insight about our lives that is wonderful, but insight alone is usually not enough to create change and lead someone to transformation. What we need are tools, steps to help us take that insight and put it into practice, in order to get to that transformation.
It’s possible that you have been working through depression on your own for a lengthy period of time without any sort of formalized process. That working through depression could be talking to a friend about it, reading books, prayer, journaling, and I’m sure many other possible forms. But what if the process could be clarified in such a way that would help give you confidence in tackling something as difficult as depression?
I believe that Restoration Therapy provides not only an unique opportunity, but the right skill set to help someone do just that.
I first came across the 4 steps in the Restoration Therapy model when I was on staff at The Hideaway Experience in 2010. I first started as a curious observer of this model, sitting in on some marriage intensives, before I realized how powerful this work was and wanted to go on staff.
In the Restoration Therapy model there are 4 steps that go as follows:
- Say what you feel
- Say what you normally do
- Say your truth
- Say what you will do differently (and many of us add to the reminder… “and do it”.)
In Step 1 the person practicing the steps is to say out loud the underlying feeling they are experiencing in that moment. I discussed in an earlier post why this is so important. Because depression is not a feeling, but rather a response to an underlying feeling. Of course, we can feel depressed, but to properly get to the roots of depression, we have to dig deeper and understand what feelings trigger the depression, and then realize that depression is a response to those feelings. Failing to acknowledge this distinction will have one simply chasing after and treating the symptom (i.e depression), rather than working at identifying and healing the root issues. When I am experiencing depression (that is, doing depression), I tend to feel alone, not good enough, inadequate, abandoned. Primarily the same feelings that trigger anxiety for me. These are the core underlying feelings that I have identified in my Pain Cycle. So Step 1 is simply saying the underlying feeling out loud to someone in a conversation that you are having with them, or often out loud while you are alone. Many times I’m in a situation where I can’t say it out loud (i.e. in a conversation with someone I don’t know well — which might make the conversation a bit awkward for some people. Though I would say that there are times when saying this out loud can actually enhance a conversation, even with someone you don’t know well), so I simply say it out loud in my head.
In Step 2 the person practicing the steps is to say out loud what the coping behavior they normally engage in is, based on the underlying feelings they just said out loud in step 1. Since we are talking about depression in this latest string of posts, the prevailing coping behavior is depression, though there are nuances to depression that can help one understand their depression at even deeper levels. For example, when I move into depression I tend to withdraw and shutdown, sometimes isolating myself, which is a very different movement than when I am doing anxiety. Depression is my primary behavior, but it comes with other attached behaviors as well. So Step 2 is simply saying what you normally do out loud. What I have been taught and read and experienced first hand is that when we say something out loud it works in our brain in a powerful way. I also know that when I say out loud that what I normally do is become depressed, I am just much more aware of the feelings that lead to the depression, and the behavior itself, therefore, making me less likely to engage in it. Why? Because I have now moved my coping behavior from this automatic unconscious response that I have been doing most of my life, to a conscious thought that I am choosing to work on. I spent a lot of my years with varied amounts of depression, during different seasons of life, and most of the time I was asleep to it. It wasn’t until I started to practice my depression and saying things out loud, did I start see powerful changes in my depression.
In Step 3, the practice is to begin saying your truth out loud. This may be one of the hardest aspects of Restoration Therapy for people who are struggling through depression. Why? Again, I find that depression often makes us feel numb to our own sense of self, as well as numb to those around us. And when we are numb, and asleep to ourselves, it can be very hard to connect with a truth, whether that truth come from within oneself, or outside one self. A truth in Restoration Therapy is the belief one has about themselves, or that they have heard others say about them. A truth is also what we believe that a higher power or spiritual source thinks about us. For example, within the tradition that I grew up in in and continue to practice (the Christian tradition), one might say that they know they are loved based on what they read in the bible and what they discern in prayer. I mentioned the late Catholic priest and writer Henri Nouwen in an earlier post, and I think as you read through most of his writings, especially those where he is wresting with his depression, the truth that he is loved is such powerful truth. One might also know the truth about themselves in the community they worship in as people may communicate those truths to them over time. But perhaps the most powerful truth is one’s ability to anchor themselves in a deep truth about themselves, because God or a friend can communicate truth all day long, but if one doesn’t believe it themselves, it often doesn’t take root. So for me, the truth that I have been working on all these years is that I am good enough, that I am adequate, and that I am not alone and haven’t been abandoned. Whether it is depression, anxiety, or some other mental health ailment, these are the core truths that I continue to meditate on and practice both day and night. Step 3 can be a very difficult step for many because they don’t always fully believe what they are saying, but part of that is the practice. I may not fully believe something at first, but overtime I am learning to rewire my neural network and belief system.
The apostle Paul in Romans 12:2 writes the following: “Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will.”
That is, we are transformed by the renewing of our mind, by beginning to think the truthful thoughts, and to allow those thoughts to shape who we are and who we become. And it can take time for those thoughts, for those truths, to make the journey from our heads to our hearts. But you can even see that in this text there is the sense that practice is required as Paul asks the readers to test and approve.
In Step 4 the person practicing these steps is to say out loud what they will do differently (and then to do it). That is, they are to identify what action they want to take instead of depression in this case. For me it has been a constant practice of saying out loud to myself that I will work towards not being depressed, and that when I’m not depressed I will work towards withdrawing, shutting down, or isolating myself. Instead, I will work towards staying engaged in the relationships around me, striving to be more and more present and open with others.
Look for Opportunities to Practice
My encouragement to you as you begin to work through your depression is to continually look for opportunities to practice it. Be intentional each day to be observe yourself and be aware of when certain feelings are getting triggered that move you into depression. There is no perfection in doing this, but instead a continual practice that will lead to more and more progress over the years. And as you progress, you will begin to notice that you may eventually be more in control of managing and working your way through your depression than you had anticipated.
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
