My Journey Into Less Sunlight, More Sleep

 

The daylight is shrinking. As I drive home at night, it’s as if nature is slowly pushing down on the dimmer switch with each passing day.

Usually, this time of year is a drag for me.  Metabolism becomes more slothful, my brain a bit foggier.  Diet changes. I go from slurpy gazpacho in the summer to the thick stews that made up Buffalo’s winter cuisine. Activity level tanks. Time on the elliptical replaced by sprawling on the couch.

I guess some would call it Seasonal Affective Disorder. I hate that term. We seem to pathologize everything these days.  So what if I tend to be a bit sadder, a tad more slothful. Is that a “disorder?” I think not.

Something seems better this year, however. It’s pretty clear that the more I sleep, the better I feel.  Summer meant seven hours of sleep; now I’m clocking nine.  I go to bed earlier, but wake up feeling fresher, and mentally sharper without the gloom of depression. 

Finding Meaning in the Legal Profession:An Interview with Dr James Hollis

This is my interview with psychoanalyst, James Hollis, Ph.D., author of the best-selling books, “What Matters Most: Living a More Considered Life,” and “Finding Meaning in the Second Half of Life: How to Finally, Really Grow Up

Dan:  What is depression?

Jim:   I think first of all we have to differentiate between depressions because it‘s a blanket term which is used to describe many different experiences, different contexts and different internalized experiences of people.  First of all, there is the kind of depression that is driven by biological sources and it is still a mystery as to how that works.  We know it affects a certain number of people in profound ways.   Second, there is reactive depression which is the experience of a person who has suffered loss and as we invest energy in a relationship or a situation and for whatever reason, that other is taken away from us, that energy that was attached to him will invert as depression.  Reactive depression is actually normal.

We would have to figure out where that fine line is and where it might cross over into something that was more than normal.  When we say that a person is grieving too long or it is affecting their lives so profoundly, that’s a judgment call, of course, but we do know people that have been sort of destroyed by reactive depression because they had attached so much of their identity to the other, whatever it might be: a position in life that they lost or a relationship that was important.

But I think none of us can avoid occasional reactive depressions because life is a series of attachments and losses.  Most commonly, when we think about depression, however,

Travels With George: Depression Takes a Backseat

A year ago, I started to volunteer at a Church on the East Side of Buffalo, the poorest and most segregated section of town rife with a high crime rate, violence, drug trafficking, and prostitution. And right in the middle of it all is St. Luke’s Mission of Mercy.

St. Luke’s was an abandoned Catholic Church twenty-five years ago that had become empty and useless after the Polish immigrants who built it in 1930 left for the suburbs.  Into this void cam Amy Betros, a big woman, with an even bigger smile and hug, who owned a restaurant where college students hung out.  Amy decided, moved by something deep inside her, to chuck it all and do something for the poorest of the poor.

So, she sold her restaurant and together with a guy named Norm Paolini, bought the broken-down church. It quickly became a place where people could go to sleep on the church’s floor to get out of the elements and get some hot food.  But just as important, that got some food for their souls. They got big servings of hope and seconds if they wished.

St. Luke’s has since grown into a huge community with an elementary school, a food and clothing shelter, and one of two “code blue” places where desperate street people can go to find warmth and a cot to sleep in the transformed for the emergency school cafeteria.

Weathering the Dead Zone of Depression

There is a dead zone in a depressed person’s life where nothing seems to happen.

Except for the pain of the absence of everything.

Such anguish is so overwhelming that every other concern is squashed in its wake.  Our capacity for willful actions seems to be gone; we can’t “figure it out.”

We are stuck.  And it sucks.

I have learned a lot about this “zone” over the years, its patterns, and how to handle it.  It’s really like learning to surf a giant, dark wave.  To handle these waves, you need to prepare yourself before the next big ones roll in.

When I’m entering a dead zone, I use positive affirmations I’ve created to “talk back” to my depression. I don’t let the toxic voice of depression drown me out.  It’s important to empower yourself in whatever ways you can during these times because depression will lead you to falsely conclude that

The Ten Best-Ever Depression Management Techniques: An Interview with Dr. Margaret Wehrenberg

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I’m Dan Lukasik from Lawyerswithdepression.com. Today’s guest is Dr. Margaret Wehrenberg. Dr. Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine, Psychotherapy Networker and she blogs on depression for the magazine Psychology Today.

Dan:

What is the difference between sadness and depression and why do people confuse the two so often?

Dr. Wehrenberg:

Because depression comprises sadness. Sadness is a response to a specific situation in which we usually have some kind of loss. The loss of a self-esteem, a loss of a loved one, the loss of a desired goal. Depression is really more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.

Dan:

What causes depression? Sadness, as you say, is an appropriate response to loss.  What is depression a response to?  What are the causes of depression?

 Dr. Wehrenberg:

Over the course of my career, I’ve developed the idea that there are four potential causes to depression.  This comes from working with people for forty years; it comes from reading a lot of research.

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The first part is genetics. You are born with a brain that is going to tend toward depression because of the function of neurotransmitters in your brain. It’s a genetic predisposition towards depression. With poor self-care, poor nutrition, you may end up stimulating or starting that feeling of low energy, of low interest in the world around you. Then if you pull back from the world around you, now you start to have fewer experiences that keep you interested in the world.

Another possible and probable cause is with people who are experiencing situational stress that goes on, and on, and on. That could be the stress of not being able to earn enough money, and you’ve got two jobs, and kids, and a life filled with stress. It could be the stress that comes on while caring for someone in your family circle who’s got a disability, or a chronic illness; that increases with severity over time. So, you’re stuck in stress, and you deplete yourself. And you can become depressed.

The state of the depression is a lot like the state of being sick. If you had the flu, you wouldn’t feel like sitting around eating and drinking; you wouldn’t feel like playing a round of tennis. If somebody says, “Let’s watch a really interesting T.V. show” and you say, “No, I want to go to sleep instead,” that’s pulling back from the world is healing.  People have the same feeling when they’re depressed, but those feelings don’t lead toward healing because they’re persistent.

Two other causes that people would certainly be aware of are trauma or coming from early childhood adversity where early in your childhood you were not treated well, you were neglected, had some other abusive situation, and those two very difficult situations can lead people to function in a depressed way.

Dan:

Let’s talk about the issue of stigma. As a person who’s had depression for the past 15 years, it’s something that I’ve had to deal with. Why is there so much stigma surrounding depression?

Dr. Wehrenberg:

Part of it is because we have this mentality in this country that you should be able to pull yourself up by your bootstraps. And we look at people who are low energy, who aren’t completing tasks, and we judge them as doing it on purpose. People who aren’t depressed are of the impression that you could just decide to do it differently.

I was speaking with a 21-year old client of mine the other day who said, “I can’t make myself do the work, and I hate it that I am that lazy.” So, he judges himself as lazy, even though it’s the depression that’s robbing him of energy and mental tenacity. So, even depression sufferers judge themselves to be wrong, lazy, and bad and believe they should do better. So, I think the cultural expectation that you should be more productive. Also, people don’t see it as the medical problem it is. It’s just that it’s not a very “visible” medical problem.

Dan:

In the past 40 years or so that you’ve been a therapist and have treated people with depression, what have you observed about the rate of depression in our country and our understanding of it?

Dr. Wehrenberg:

I think the rate of depression, everybody would agree, is growing. More and more people are suffering depression.

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There are different reasons why when we look at this.

Culturally, one of them is that American culture is a highly stressed culture.  But it’s stress not over life and death, but that’s certainly the case for many living in poverty who have to worry where their next meal is coming from, but usually, what we look at is the stress of always needing to be more, to do more, to get more status and money. That’s not a very good way to feel good about yourself because there’s a limit, a human limit of time, a limit of money, a limit of talent or ability, a limit to resources or access to achievement.

Dan:

Following up on what you just said earlier, you talked about some possible causes of depression including genetics and family of origin issues. Now you’re talking about American culture and its connection to depression. What is the connection?

Dr. Wehrenberg:

We have a culture that values productivity, money, and status, and not everybody can achieve goals of status or financial success and it gets depressing to see how valuable those seem to be in our country.

We don’t value something everybody can do. Like, be a person of good character. We value how much status you’ve got, which is very different.

Dr. Andrew Weil, who is a real guru of physical health and mental health, says he thinks that stress equals inflammation in your whole body and that inflammation is a trigger for depression.

Dan:

Why did you write the book, “The Ten Best-Ever Depression Management Techniques?” It’s a great read. I recommend all my listeners and readers at lawyerswithdepression.com to pick it up.

Dr. Wehrenberg:

I wrote it because I believe both consumers and therapists need ideas for what to do right now other than to investigate, in some more general way, a life history, what do you do today that will make you feel somewhat better, to start you moving out of the depression. I wanted to present as many practical ideas as I could that would help people start to lift out of depression with the help and advice of a therapist and also for the general public that could read this book and say, “Oh, there are things I can do that would make me feel better.” And they’re simple; they’re not complicated.

Dan:

Can you share with our listeners some of the techniques you recommend in your book?

Dr. Wehrenberg:

Let’s start with somebody with low energy. Almost everybody who is depressed is doing something even while they are depressed. Playing a game on their phone, watching T.V. or watching Netflix.  They are doing something. Unless, they are sleeping, of course.  But I want to use what you’re already doing to help motivate you to do something you think you should do. So, for example, I often see people with depression that aren’t doing good health care, they’re not doing good care of their environment, they are not doing dishes, they are not doing laundry, stuff like that. So if you just think about household stuff for a second, what I want my clients to do is to break down the task into its parts.

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If you’re going to do laundry, the first thing you have to do is pick it up off the floor. So, I don’t want you to think, “Oh, I’ve got to get all the laundry done.”  If you’re depressed, that won’t work. What I want you to do is think is, “All I have to do is pick up the dirty clothes in the family room and then I’m going to sit down for 15 minutes and do what I’m willing to do anyway – play a game on the phone, turn on Netflix. Set a timer for 15 minutes of enjoyment of your show and then when the timer goes off, you just get up and pick up the clothes off the floor of your bedroom. Little pieces, okay.

What we know about depression is those small accomplishments are perceived in the brain as positive and encouraging, and you start to feel, “Oh, I can do something for myself.” You begin to have just a little rise in your overall energy. If you can do that consistently, then pretty soon, you get the task of doing the laundry over with. It may take a few days, but it’s done. Then you have a positive self-appraisal. That’s what I’m going for, for example, with a very simple way to think about raising your energy through small increments.

Dan:

So the small steps and small behaviors affect neurochemistry?

Dr. Wehrenberg:

They do, indeed. Because when you take action and it has a positive outcome, you have just changed the level of the neurochemical called dopamine, which I call the “James Brown” of the brain.  It’s the “I feel good,” when dopamine is released in your brain you feel better. We know that people who decide, “I am going to do this,” and do it, they get a rise in dopamine and change your neurochemistry.

Dan:

I want to discuss your second book, “Anxiety + Depression: Effective Treatment of the Two Co-Occurring Disorders.” I struggle with both anxiety and depression with depression being the primary diagnosis. Many people I meet struggle with both.  Why do the two co-occur together and sometimes not?

Dr. Wehrenberg:

Very often, if you are looking at brain function and structure, what you see in people who have both anxiety and depression, which, by the way, is about fifty-percent of the time, is that people who have one, have the other. Often, the anxiety comes first, and it’s not treated well. There’s a neurochemical called serotonin which is related to something called rumination or you might think of it as “brooding.” When people brood, when they go over and over a failure or fear, they get stuck mentally. It raises anxiety because it’s hard to solve a problem that you’re just brooding about and it raises depression because you don’t feel like you’re moving very much in your behavior or your thinking. That’s a pretty simplistic statement. And people will say, yes, but there are far more theories about the underlying neurochemistry.  That’s true, but the chemistry that relates to brooding is related to both anxiety and depression, the repetitive, negative thinking.

Dan:

Regarding your history as a therapist treating people with anxiety and depression, are there some techniques that work better with anxiety versus depression? Or, do all these techniques work equally well with both conditions?

 Dr. Wehrenberg:

I think you have to look at the energy level. Some people with anxiety and also depression have a fair amount of energy to cope with the depressive quality of repetitive, negative thinking. And you use the energy of that anxious person to be more assertive with yourself to say, “I’m going to take charge of this.”

But what I also find that works very well with anxiety and depression together is to work on mindful awareness, to try to stay in the moment, not to try to predict a negative outcome, but rather to pull yourself into the moment. And mindfulness, which can be done by meditating to stay in the present moment, but you can also just keep pulling yourself back to this moment by saying to yourself, “What’s happening now?” This pulls you back from predicting negative outcomes and then getting upset about what might happen. If you stay in the now, you can say I can do this activity now, this action now, and all I have to worry about is now. And then you tend to get better outcomes. So, that’s good for both for anxiety and depression.

Anxiety is “I worry about the future; I fret about the past.” And depression includes, “I think the future will be grim.” So if you stay in the moment, you’re addressing both of them.

Dan:

As a psychologist and therapist who’s worked with people with anxiety and depression for decades, tell us a little bit why a person struggling with depression and anxiety should see a psychologist, a therapist? What benefit could be obtained from seeing someone such as yourself and how does that work?

Dr. Wehrenberg:

We know that medication, which is often people’s first choice, can be extremely helpful. But what I say to my clients is that medication can help you feel somewhat better, but it doesn’t teach you anything about managing your life. Psychotherapy, when it’s practical, when I’m looking at it through the “The Ten Best-Ever Depression Management Techniques,” what it’s teaching you is how to handle your negative mood, what to do when you don’t have energy. It’s teaching you behavior that will rewire your brain. It talks about how and why exercise and nutrition are important.

But also why taking even a small action on your behalf changes your neurochemistry.  So, psychotherapy immediately affects brain function. But, you usually need a psychotherapist to give you ideas, help you find ideas of how you stop yourself, how you block yourself, and to help you find the most effective tools for you in your specific situation. A psychotherapist can be very helpful in teaching you how to get rid of these negative symptoms and feel better for life.

Dan:

Dr. Wehrenberg, what’s the best way for our listeners and readers to get in contact with you?

Dr. Wehrenberg:

Well, if you’re able to spell my name, you can look me up on Margaretwehrenberg.com.  I work in Naperville, Illinois. But my website has my telephone contact and a link. And if you went to the Psychology Today magazine website, you can look at my blog on depression, and you would be able to contact me through there as well. I have a really good “Contact me” on my website.

Dan:

On behalf of your listeners at Lawyerswithdepression.com., I want to take the time to thank you for this insightful interview. I think it’s going to help many people.

Dr. Wehrenberg:

Thank you for having me. I appreciate it.

 

 

Volunteer When Depressed? The Life You Save May Be Your Own

Dr. Susan Noonan blogs, “The first thing to know is that when you volunteer  you commit to make yourself available to a person or an organization for a period of time, say 2 or 4 hours per week, on a regular, ongoing basis.  You do it in small steps, not all at once.  You become accountable to others for showing up, on time and ready to function at some moderate level.  They will depend on you for that.  It’s a big step.  This was good for my depression, and I’ll bet yours as well.”  Read the Blog

Down is the Way to Well-being: The Dangers of Living at Altitude

Parker Palmer, Ph.D., writes, “When you’re depressed, it seems insulting, even insane for someone to suggest that the soul-sucking spawn of Satan that has sunk its claws into you is your BFF. And yet, as time went by, the image of depression as a befriending force began to work on me, slowly reframing my misery and helping me find a way through. Something in me knew what my therapist knew: down is the way to well-being.” Read the Blog

What’s Up? Gratitude and Depression

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When first squashed by clinical depression years ago, some told me to think of all the things I had to be thankful for – as if this would cure my “blues.”

But I didn’t have the blues. I didn’t just feel “sad.”  I had an illness.  I had entered a long, dark tunnel.  I didn’t see a glimmer of light at the end of it.  I wandered in it for years before things got better.  At some point, I saw an end, of sorts, in sight.  I exited that tunnel and felt the warming sun of life reinvigorating my body. I knew I was going to be okay.

It was only after having exiting the tunnel that I was capable of even thinking about gratitude.  But now it’s an important part of my “Depression Toolkit”: things I do to keep what sufferer Winston Churchill called “the black dog” at bay.

Listen to the podcast of my interview with Rabbi Mark Gellman

Depression and Faith: An Interview with Rabbi Mark Gellman

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Today’s guest on our show is Rabbi Mark Gellman.

Rabbi Gellman is the Rabbi Emeritus at Temple Beth Torah in Melville, New York where he has served since 1981.  He earned his Ph.D. in Philosophy from Northwestern University in 1981 where he also completed doctoral work in the History and Literature of Religions specializing in Buddhism and Judaism. He is the recipient of many honorary degrees.

Rabbi Gellman writes a weekly column, “The Spiritual State,” for Newsweek magazine and the syndicated column,“The God Squad,” read by readers around the world.

Welcome to our show Rabbi Gellman.

Dan: 

Rabbi, during your time that you’ve been a Rabbi, and I understand that’s been decades now, have you counseled people with depression?

Rabbi Gellman:

Yes, I have.  Although my general orientation, and I hope it’s the orientation of most clergy, is to refer people to professional psychiatrist or psychologists who specialize in this. It’s not something that clergy should enter, in general, because they’re not trained for it.

Dan:    

Once you’ve referred those people and they are treating with a psychologist, psychiatrist, or both, do the clergy have some role in comforting the people with spiritual support with this kind of condition?

Rabbi Gellman:

Yes, I think we serve two roles.

One is what I would call “psychiatric first responders.”

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We’re the ones who first alert people to the fact that they are depressed and that they need some kind of professional treatment in order to get back to some level of functioning life. The second purpose which we serve as clergy, if we are doing our jobs well, and our calling well is to provide to the community a message of hope. The antidote to depression, of course, is hope. And in a communal sense, Rabbis can provide that hope. In fact, it is my view that the search for hope that is the primary motivator for people to affiliate with religious denominations and to seek personally their own way to God.  It is the search for hope, ultimately.

Dan:    

Many people who I speak to around the country, and myself included, I am a practicing Catholic, and so often in the throes of depression, or maybe even at the beginning, I would often ask God, “Why me?” I think that so many people, and maybe it’s true for any kind of suffering that afflicts people, ask that seminal question.  In your faith, and in your experiences, how do you respond to that?

Rabbi Gellman:

Well, I have a rather unconventional view of many things. And I have an unconventional view of that question. First of all, I don’t think it’s a common question. People say it is, but I don’t believe it. I’ve never heard it. Most people are not really consumed by the question of why this has happened to them.

There’s two reasons for that. First, they can think of a lot of reasons it’s happened to them. So, they know the reasons it’s happened to them. Second, the question, “why me,” presumes a kind of spiritual and ethical arrogance that most people are mature enough not to have.  By that, I mean the question, “Why me?” if you sort of unpack it a little, means, “I am so righteous, I am so good, I’ve done so much for the world, and for my family, and for my community, that my virtue is so enormous, that it should protect me against all evil.

Now, no one really believes that.

No one believes, in their right mind, in the list of the greatest human beings that have ever lived, Gandhi and Mother Teresa, that they should be No. 3.  I honestly don’t think people ask the question, “Why me?”

My approach has always been on two levels. One on a level of personal counseling to try to get people to find some resources to find some reasons to hope and I have some techniques that are very effective in that way.

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Second, in my teaching, to explain to people that there are two reasons why bad things happen to them.  The first is that they caused them to happen. People who have lung cancer after a lifetime of smoking really have no right to say, “Why me?” They did it to themselves. People who have neglected their physical fitness and have developed different pathologies that come from obesity or inactivity have done it to themselves.  So, much of what happens to us, that is evil, is self-produced.

The second reason why bad things happen is because of what Aristotle called, “natural evil”. That is just the way the world works. A Rabbi said a phrase, “Olam K’minhago nohgge,” which means the world goes according to its own order. It means if you’re walking along the street and a brick falls from a scaffolding and you’re underneath, it’s bad luck on you. But, that’s just the way the world works. If you happen to be in a place where a tornado hits, or a hurricane hits, it’s the way the world works and this natural order of the world is not evil.  It’s just the natural working of the laws of the world. A Tsunami is not evil. If a wave crashes over an uninhabited island it’s not evil. It’s only if people are there. Well, people choose to be there.  The point is there are things we do to ourselves and there are things that happen to us because the world is the way it is.

Dan:

With respect to “the way the world is, would that include our bodies, our brains, and our genetics? There are now studies which show that many, many people, especially with the more severe forms of depression, have a strong genetic vulnerability to depression. Or, other people grow up in neglectful homes where they are neglected or physically abused.  Those people have high rates of adult-onset depression.  Can you follow-up on this?

Rabbi Gellman:

Sure, I mean, sometimes you draw some bad cards. You draw environmental bad cards, you grow up in an abusive, deprived upbringing, and, in some cases, you draw a bad genetic card. But, I would say to both those things that there are ways that people overcome those inheritances.

For example, there are people who grow up in very, very difficult circumstances.  And for some reason, they are disciplined and hopeful, and they are able to move out into better circumstances for the rest of their life.   Other people surrender to the difficulties of their environment.  How do you distinguish between one and the other? Why is someone able to pull themselves up by their bootstraps and someone else isn’t from the same deprived neighborhood? So, something else is at work here.

As far as the genetic inheritance, it may be true, it probably, certainly is true, studies in schizophrenia certainly seem to indicate it is true, that there’s a strong genetic component to depression.  However, there’s a problem with focusing on that medical fact and the problem is that it gives people an excuse to wallow in their depression, to surrender to their depression.  Hey, look, I’ve known people who are obese, who say, “Look, I can’t lose weight because I’m genetically fat.”

You know, that’s ridiculous.

You may have a genetic predilection to obesity, you my have a genetic predilection to depression, but that doesn’t mean you can’t fight it.  And if you believe that this was your inheritance, it’s just another reason to surrender. And depression requires vigilance, and it requires very strong emotional dedication to becoming well again.

Dan:

Can you give us some insights into how the Jewish faith, the Jewish religion, views depression, and, specifically, do you give examples from the Old Testament that you believe are insightful into how people can see their depression and overcome their depression?  You minister and you preach. Can you give us a little insight on that?

Rabbi Gellman:

The first is a personal understanding. I think it comes out of scripture, but not directly.

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It’s a technique that I developed which I call, “spiritual balancing.” The history of this is that my wife and I, Betty, were living in Evanston near Northwestern University. We were remodeling an old house and the fellow that was helping us do some spakling was carrying two big containers of this spakle up the stairs and I said to him, “Why don’t you just carry one bucket up? Why carry two at once?” And he said, “Well, if I carry one it throws me off and it hurts my back.  If I carry two, it keeps me in balance and I can carry twice as much.”

For some reason, it was an epiphany for me.  It was a life-changing moment, just watching this guy carry spakle up the stairs. What I realized at that moment, and developed it as a counseling technique, and have spoken to psychiatric associations about it, is this technique of spiritual balancing.

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So it works this way. Someone comes to me and they’re depressed, they’re in grief, they’re in a bad place.  So I say, “Here’s what we’re going to do. We’re going to do five minutes of you telling me, in as much excruciating detail as you can, why your life is miserable. Five minutes.

And then, for the next five minutes, I want you to tell me why your life is wonderful. What are the wonderful things in your life. But it has to be for the same amount of time.

I do this often with people in grief.  “Give me five minutes of how sad you are, and how broken you are that you’re loved one died and how unfair it is and how awful it is, and how it’s breaking you, and then five minutes what you loved about the person.  And what was great about the person.”

What I discovered quickly, using this technique, is that in the end, people felt much better, at the end of the counseling session. The reason they felt better was not that anything had changed, but that they had balanced the miserable, depressive thinking that they had, that had imbedded itself in their brain because of their trauma, with positive, endorphin producing, hopeful thoughts that were also in their brain, but they weren’t accessing them because they weren’t thinking about it.  They were obsessed with the loss.  That’s the purpose of the Psalms, of many different passages in the Bible which is to get you at the moment you are most depressed to thing about the goodness that is still in your life and to overcome that natural tendency to focus on your burdens by turning in a conscious way to a meditation on your blessings.

Then you will discover when you do this that there is not a single day in which you wake up where your blessings do not exceed your burdens – not one single day.

 

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