Depression; Problem rating; and the concept of ‘awfulizing’

Blog Post No. 142

By Dr Jim Byrne

15th February 2016

Dr Jim’s Counselling Blog: Understanding depression; how to accurately rate your problems; and the myth of ‘awfulizing’…

Copyright (c) Jim Byrne, 2016

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Introduction

DrJimByrne2.JPGA few days ago, I finishing Appendix F of my new book on E-CENT Counselling.  Appendix F is about how to define, understand and reduce depression.  I thought you might like to see a quick preview of the first couple of pages; so I have appended them below.

The next thing I did was to write Appendix G, which looks at how to evaluate the degree of badness of your problematical situations in life. This is important because an exaggerated evaluation of the degree of badness of a problem in your life will result in a more painful emotional state than a more accurate evaluation.

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But first, here’s how the book’s Summary begins:

Summary

New-counselling-book.JPGChapter 1 begins with a basic description of Emotive-Cognitive Embodied-Narrative Therapy (E-CENT).  This if followed by a brief outline of the basic theory of E-CENT.

The chapter then goes on to explore some of the models (of the social individual) that were integrated to produce Emotive-Cognitive Embodied-Narrative Therapy (E-CENT), plus those that have been added since 2010. But the main presentation of the core models of E-CENT theory can be found in Chapter 6.

E-CENT counselling theory sees humans as essentially socialized-physical-cultural-emotional-story-tellers. We tell stories to ourselves and others, and we live in a world of narratives and scripts, which include reasonable and unreason-able elements, logical and illogical elements, and more defensible and less defensible elements. We tend to delete elements of our storied experiences; to distort some other elements; and to generalize from particular experiences. And we also have lots of early experiences which are non-narrativized, but still operational in the basement of our emotional lives.

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Childhood-experiences.JPGHumans often tend to push away (or repress) unpleasant experiences; to fail to process them; and to then become the (unconscious) victims of those repressed, and/or undigested experiences.  E-CENT theory also sees adult relationships as being the non-conscious acting out of childhood experiences (which occurred with parents and siblings), because some part of those earlier relationships have not been properly digested and completed.

Furthermore, there are significant disruptions that can occur at various stages in the early childhood experience of the individual which can produce specific forms of relationship dysfunction in later life.

In a broader sense than that outlined above, E-CENT was developed by this author over many years of study and application, in private practice with more than 800 clients.

Here are just two of the key principles of E-CENT:

# Firstly, it takes into account that we are bodies as well as minds, and so diet, exercise, sleep, relaxation/meditation, drugs and other physical inputs and stimuli are seen as important factors in determining the emotional state of the individual client.

# Secondly, it starts from the assumption that we are primarily social animals, and not solitary individuals. We are social to our very roots, especially from the moment of parturition, when we are handed into the arms of our mothers. Everything that happens from that point onwards – and also including the original birth trauma – is significant for the development of the so-called ‘individual’ (who is really an amalgam of significant other ‘individuals’ with whom we are related from birth onwards, and who we ‘internalize’ as ‘models’).

Chapter 2 outlines twenty such core beliefs of E-CENT philosophy.

Chapter 3 explores the structure and application of the Six Windows Model.

The.6.windows.model002.jpg

According to E-CENT theory, we do not see with our eyes so much as with our brains.  Eyes are part of the machinery of perception, but the decisions about ‘what it is’ that we see are not made by our eyes.  Those decisions are made by our ‘stored experiences’ driving our ‘judgements’.  We do not see ‘external events’ so much with our eyes then as we see them through ‘frames of reference and interpretation’ which were created in the past, and which we now implement as habit-based stimulus-response pairings.  Or we could call these responses ‘pattern matching’ processes.  If this pattern matching process was conscious and linguistic (which it is not!) then this is the sense it would make of an incoming stimulus: “I’ve seen this stimulus (or ‘external event’) before.  This (particular interpretation) is the sense I made of it last time.  So that is how I will relate to it this time”.

…End of extract.

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Depressed-woman2.jpgAppendix F: How to control your depressive tendencies

by Dr Jim Byrne

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Copyright (c) Jim Byrne, 2016

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Introduction

This appendix to Chapter 5 will focus on the emotion of depression, as it is found in counselling and therapy sessions.  And we will address the questions of:

(1) how to understand depression; (and some of the differences between ‘depression’ and ‘grief’); and:

(2) how to control or reduce depressive tendencies.

This appendix is written in the form of a self-help manual, but it can be used by counsellors and therapists to learn how to apply the E-CENT approach to depression in counselling sessions.

One of the systems from which E-CENT theory was derived is Rational Emotive Behaviour Therapy (REBT).

REBT theory has a straightforward binary distinction between:

(1) ‘sadness’ – (which is a less intense level of negative mood than depression; and is also said to be ‘appropriate’) – and

(2) ‘depression’ (which is a high level of negative feeling, which is both distressing and ‘inappropriate’).

In E-CENT theory, we do not consider all depression to be inappropriate.

Just as we see anger and anxiety as innate aspects of our biological survival equipment, so also do we begin with depression (or rather grief) as an innate element of our emotional repertoire which has served, and to some extent still serves, to enhance our survival goals and capabilities – especially in relation to our attachment systems.

Understanding grief and depression

As usual, if we begin our attempt to understand an emotion by examining a modern adult in a counselling room, we are going to miss many important, concealed elements of that emotion.

Babt-as-model.JPGBut if we think of a baby on the plains of the Serengeti, about one hundred thousand years ago, we can well imagine that it was the infants who screamed and wailed with grief whenever they were parted from their mothers (even for a short time), who had the best chance of survival, and passing on their genes to their descendants; and that those babies who lay quietly while mother ignored and abandoned them, would have been quickly found and devoured by hungry predators.

John Bowlby has described the grief process in four stages: the first of which was shock; secondly, anger and wailing; then resignation; and finally detachment from the lost attachment figure (which would facilitate re-attachment to a new care-giver in the case of a lost or abandoned child – or a ‘divorced’ adult).

The anger and wailing stage is helpful because it draws attention to the plight of the grieving one, and calls for sympathy and rescue.

It was in the context of this kind of evolutionary perspective on the value of grief that I originally wrote this statement:

“Grief is appropriate depression about a significant loss or failure; while depression is inappropriate grief about some apparently significant loss or failure.  And theinappropriate quality comes out of our unrealistic demands about life and experience, and our tendency to catastrophize”.  Dr Jim Byrne

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Focusing on depression

Let us assume that you are a counselling client who is currently feeling strong feelings of depression (though you could, of course be a counsellor or a self-help enthusiast, looking for ways to help others rather than yourself!)

Your symptoms might be as follows:

Common symptoms of depression: Feeling extremely sad and lethargic; Mentally pained and miserable; Crying a lot; Sleep disturbance; Reduced sex urge; Feeling helpless; Pessimism about the future; Primarily negative memories of the past; Perhaps feeling suicidal, or seeing little value in living.

Depression-solution.JPGMy job here is to present you with a useful model of grief/depression; and also a brief, effective solution to the problem of depression, in terms of how to manage it and reduce it. (But my overall aim is to illustrate the E-CENT theory of depression, and how we set about helping clients to reduce their feelings of depression).

The first thing we need to do is to check how depressed you are at the moment, so you can monitor your progress as you learn how to eliminate your negative feelings.

…end of extract.

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Let us now take a look at a brief extract from Appendix G:

Appendix G: Just how bad is your problem? Or how to emote appropriately

Copyright © Dr Jim Byrne, February 2016

Introduction

Human disturbance is not too difficult to understand.  There is one key distinction that you must be able to make, if you are going to optimize the management of your emotions.  This is it:

  1. Sometimes you have a really big problem in your life; and:
  2. Sometimes you have a small problem, but, because of your tendency to exaggerate, it feels like a huge problem.

Let’s take a closer look at that this distinction:

  1. Sometimes you have a big problem in your life, and that is why you are (predictably and necessarily) upset.  (An example would be the time when Albert Ellis – the founding father of Rational Emotive Behaviour Therapy [REBT] was unfairly {in his judgement} removed from his professional duties, and removed from the board of his own institute – after more than fifty years of successful practice.  He was extremely upset, as was shown by the fact that he wanted his main adversary “dead, dead, dead”.  And also by the fact that he sued his opponents for ‘unfair dismissal’ – even though he had spent a lifetime denying his clients the right to raise ‘unfairness issues’ with him!  [This is an example of the disparity between the thoughts and actions of an extreme Stoic.  They talk a great story of indifference to harm, but if you harm them, they will squeal!])

So if you have a real, actual, major problem, don’t let any CBTers or REBTers talk you out of your right to be realistically and reasonably upset about it!

Exaggerated-problem.JPGHowever:

  1. Sometimes you think you have a bigger problem than you actually have, and that is why you are (unnecessarily) upset – or much more upset than you should (realistically) be. I will give you an example of such a situation later, below (involving a traffic jam while driving); and also show you how to produce a more realistic assessment of the degree of badness of any situation.

Really big problems, and apparently big problems

Here are two examples of the first kind of situation, where the problem is realistically appraised by you as being a major problem:

(a) You are predictably (and appropriately – and unavoidably) upset whenever things orevents or people in your environment exert more pressure upon you than you can handle at that time.  The solution in those situations is to try to reduce the pressures (to the degree that any of them can be controlled), while building up your coping capacities – (through improved diet; getting plenty of sleep; doing some physical exercise; setting social support (or professional help and advice); seeing a counsellor or therapist who can help with your thinking/feeling/behaviour; self-managing your thinking about your problems [for example, with the Six Windows Model, from Chapter 3]; and so on).

(b) You’re predictably (and appropriately – and unavoidably) upset when early childhood experiences are re-stimulated in the present moment. The solution in these kinds of situations is to work at resolving your childhood traumas, with a suitable counsellor or therapist; and/or through writing your autobiography of the traumatic period, in order to re-frame and process the trauma.

So much for the real, major problems.

As suggested above, you can also create problems for yourself by exaggerating the degree of badness of a challenging or frustrating or insulting experience.

Exaggerating the extent of your problems

When something relatively minor happens in your life – something that you would like to have avoided – you may have a knee-jerk reaction of trying to push that event or experience away.  But if it cannot be eliminated, and you are rating it (consciously or non-consciously) as very, very bad, then you will feel a really uncomfortable emotion – like anger, anxiety or depression, hurt, etc. – as a result of the exaggerated intensity of the badness of the problem.

An example of this kind of problem would be the driver who gets out on the motorway, (or highway, autobahn, etc.) with the expectation that it will take a certain amount of time to get to work, only to find a huge traffic jam which will make him or her very late for work.  If this individual makes the mistake of ‘perfinking’ (or perceiving/feeling/thinking [consciously or non-consciously]) that this is the worst imaginable situation to be in – or that this is totally bad – then they will feel intense frustration, leading to angry and/or anxious feelings, and high blood pressure, at the very least.

But this situation has a history, which has to be understood.  It is not a pure product of the present moment!

The historical aspects

If this person had previously been to see me, I would have advised him or her to always ‘pad’ (or overestimate) his or her travel time requirement, and to use any surplus time they ‘inherit’ (by arriving too early for work) to meditate or do some physical exercise (or to write some Daily Pages,[1]) somewhere quiet in their work premises. And I would also have trained him or her to spot when they are exaggerating the degree of badness of mildly badproblems.

But this person, stuck in a traffic jam on the motorway, has not been to see me.  And they are panicking about being late for work, because they did not allow time for such a (fairly predictable) traffic jam.  And they are feeling so frustrated and angry, about this delay, that we can infer that their perfinking (perceiving/ feeling/ thinking [probably mainly non-consciously]) could be translated as something like this: “This is a totally bad situation, which I refuse to accept.  It’s not fair that I’m going to be late for work, which will count against me with my boss.  I can’t stand this kind of situation.  And the world’s a rotten place for doing this to me!”

I am not saying “this is what they are thinking”, which some CBT or REBT therapists would say.  I am saying, their (conscious and non-conscious) thinking/feeling/perceiving (which I call their perfinking) could be interpreted as being very roughly equivalent to the statements presented above.

…End of extract.

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Some further thoughts

My next priority is to write Appendix J, on two of Albert Ellis’s major errors: the role of ‘beliefs’ and the word ‘awful’.

While I was doing some earlier work, Al’s theory of ‘awfulizing’ – the idea that people are upset by describing their problems as awful – began to unravel in my head[2].  I remembered that Al claimed the “We’re the only people (meaning REBTers) who define the word awful accurately”.

He went on to say that “awful means more than bad; badder than bad; and badder than itshould be; and normally at least 100% bad; and sometimes more than 100% bad, which nothing can be”.

A bell rang in my head, and I found myself wondering how my dictionary defines the word “awful”.  When I checked, I was surprised to find that it describes awful as “very bad or unpleasant”.

If we use Ellis’s definition of ‘awful’, then clearly nothing is ever ‘awful’ – it’s just a gross exaggeration of the degree of badness of a situation.

But if we use the Paperback Oxford English Dictionary (Soanes, 2002), then many, many aspects of our daily lives are clearly awful!

Ellis’s damaged past

How did Al Ellis come to define the word ‘awful’ so badly – so far from the established meanings in society?  I would suggest that this habit of his stems from his childhood, when he was hospitalised for almost ten months on his own, at the age of six years, with just one or two visits from his mother, over that entire period![3]

According to John Bowlby’s theory of attachment, little Albert Ellis would have begun by becoming angry and whining; moved on to grieving; and then detached from his parents.  He might also have found his negative feelings of aloneness and isolation to be too painful to look at, and so he began to repress out of conscious awareness any negative feelings that came into his mind.  Because he would not allow himself to look at any degree of badness in the world – abandonment, loneliness, isolation, insecurity – he could not allow anybody else to draw his attention to anything that was awful about their own lives.

Then, when he was a teenager, he found a philosophy of life that helped him to respectabilise aversion to looking at anything bad. He found Stoicism, in the form of the writings of Seneca, Epictetus and Marcus Aurelius.   And what I have discovered about Epictetus and Marcus in particular is this: They have evolved both:

(1) moderate ways of helping people to detract themselves from their suffering; or to reframe it so it feels better. And:

(2) extreme ways of denying that they have been harmed!

I have presented examples of (1) and (2), in Appendix J.

Counsellors should not deny their clients the right to describe some of their experiences asawful, terrible and horrible; since many of life’s difficulties are actually awful, according to my dictionary.

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Conclusion

Some of my latest thinking in this new book moves E-CENT theory another little bit further away from its few remaining roots in REBT.

I hope to have this book out for Easter, or thereabouts.  It has proved to be a mammoth undertaking, and is using up much more of my time and energy than I had expected.

I hope you watch out for its arrival, and that you buy the paperback or Kindle versions at Amazon, and that you enjoy it as much as I am enjoying the writing of it.

That’s all for now.

Best wishes,

Jim

Dr Jim Byrne, Doctor of Counselling

jim.byrne@abc-counselling.com 

Here’s the link to review the archives of Dr Jim’s Counselling Blog.***

Footnotes

[1] Cameron, J. (1992) The Artist’s Way: a spiritual path to higher creativity.  London: Souvenir Books.

[2] In E-CENT counselling theory, we say that people are upset for all kinds of reasons, only some of which are related to their thinking.  But we disagree with the idea that the word ‘awful’ is part of what upsets them.  You can define a problem of yours as ‘awful’ and not feel particularly upset about it.  And you can focus your bare (conscious) attention upon another of your problems and feel dreadfully upset.  Much of the mentalizing that upsets us is non-conscious and habit based.  It involves our ‘perfinking’ (or perceiving, feeling and thinking).  And the real experiences that we have (in the present and in the past) are strongly implicated in our disturbances.

[3] Byrne, J. (2013) A Wounded Psychotherapist: Albert Ellis’s Childhood, and the strengths and limitations of REBT/CBT.  Hebden Bridge: the Institute for Cognitive Emotive Narrative Therapy (E-CENT) Publications.

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Here’s the link to review the archives of Dr Jim’s Counselling Blog.***

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