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Friday, January 13, 2012

Challenging my Depression (4)

Much has been written about Aaron Beck’s cognitive triad within depression – that ‘I’m no good’, that ‘the world is no good’, and ‘none of that is going to get better’. OK I know there is much more to the theory, and that Beck’s work goes much deeper into how our minds control emotion, so what I am about to write may seem superficial to some purists, but who cares?
Let me start with our world. Whichever way you look at it, and whether you are depressed or not, our world is looking very shaky and subject to immense and rapid changes that appear to be out of control. The recession we are not quite out of keeps threatening to reappear, and seems to have been caused (as so much is) by greedy people thinking they are really clever, and needing so much more than a few million dollars to live out the rest of their empty lives. Countries all over the world are billions, if not trillions, of dollars in debt, and politicians seem to have little ability to control further increases. There has been a shift of power from the west toward the east, that is India and China, who seem to be able to engender growth, maintain better stability, and (at least for the moment) lend money to the profligate west. Look, the shift may be a good thing. Let’s face it western countries seem to have made such a mess of things – perhaps someone else should have a try. And eastern countries are based much more on the family as the unit of importance rather than the individual focus – me, me, me – of the west. That might be a really good thing.
I don’t really have a view about some of these things. I watch the television news, which is always skewed towards death and destruction – “Ooh isn’t it awful?” (and then has a heart-warming story from somewhere close geographically, about 20 minutes from the end, just to make us all feel better). I can’t influence any of that. For instance the changes going on in the middle east are cataclysmic, but there is nothing that I can do to influence the path of peace. I have to watch from a distance and contain my worries about escalation to world conflict. I don’t believe ‘my vote’ has any currency or any influence. You wonder how countries run themselves when all politicians do is argue every day, often on fatuous grounds, until they all end up looking like raving loonies. I don’t have a voice in this country; I certainly don’t have a voice in any other country.
Well hang on.... My world is not just about the fact that everywhere seems in self-destruct mode. Actually my world is about my family – my extended family - and how they are coping with their lives. In particular its about how my wife and I manage our day to day lives, continue to love and support each other, and maintain some patterns of life that keep us reasonably happy. Its about my work – my clinical work and how I bring my experience to bear to help others make the changes they want, my teaching and how this might influence clinicians to become the best they can become, my research programs and how these might create new knowledge to help those who struggle with despair, my staff and how we can help them to become better clinicians, teachers and researchers for the next generation, the journal I edit and how it can publish new thinking on prevention of ill health, wellness, and mental health promotion.
You see what I have done here... I can’t change things I can’t change. But I can influence things around me. I can use the best skills I have with my patients. I can think hard about the essence of our work, and teach people in the best way I know how. I can think through the implications of our research, make sure we publish what we can, and then work out where to go next. Within my own little world, I can do... So, I will do...
If I thought of all the big stuff that is going on, I would get really depressed. It IS awful, and I wish it were not. It IS depressing, but I refuse to let it wreck my little circle of life. In challenging my own depression, I have to keep that world stuff out of my mind as much as I can. Well, how do you do that while you are watching the evening news? You have to be clear that other people’s (or peoples’) problems are theirs. They have to take their own decisions, do the best they can for their own people and their own country. And the politicians? Actually they make me laugh. I find their wriggling antics highly amusing. They are all grandstanding, strutting stages that are often too big for them, always looking for some clever angle to ensure they stay in power next time. I enjoy watching them just to see what silly things they get up to next. Its always good for a laugh – and laughter is very good medicine to help me challenge my depression.


  1. I heard bits of your interview on conversations with Richard Fidler yesterday. You mentioned that you use mediation to help manage your chronic pain, but there is no evidence for its effectiveness. I disagree. I am just beginning to try to accept that my back pain is as good as it will get, and a collegue pointed me int he direction of mindfulness-based stress reduction. Being a psychologist, I of course wanted to know about its evidence base. There is a growing base of evidence that mindfulness and mediation are quite effective in helping people manage their pain.

    1. Yes, I have been a meditator for the last 30 years having trained in TM with my family. I guess in the interview I was being tongue in cheek about evidence. There has been solid evidence for 20 years about meditation and pain management, but it may not be at the stringent level that western academics accept. They tend to ignore 5000 years of history in favour of poorly constructed randomised controlled trials paid for by pharmaceutical companies.