Saturday, April 26, 2014

Clinical Depression - My Experience With and the Effectiveness of Client Centered Therapy

When first diagnosed with clinical depression in 1986, I did not want to talk to anyone, and I do mean anyone, about my emotional issues. That included my wife, parents, relatives, and friends After I was told that I should go to a therapist for treatment I didn't want to do that either. I figured my issues were my own business and no one else's, not even the psychologists. "Give me some pills and I'll be fine ", I said to the psychiatrist. I figured all I needed was some medicine and eventually I'd get over being depressed for good. It did not take too long to find out how wrong I was.

My doctor also insisted that if I wanted to get better, I needed psychotherapy. There are different types of psychotherapy available to help anyone who is depressed. Psychotherapy focuses on either affect (emotions), behavior (actions), or cognitions (thoughts), Some psychotherapies focus on a combination. The idea is that when either affect, behavior, or cognition get out of whack, they are all negatively effected. Through a series of psychological tests it was determined that my emotions were seriously damaged. For example, I'd cry at the drop of a hat, my self-confidence was in the toilet and I felt totally worthless. I needed emotionally focused therapy and that is what client centered therapy is all about.

I was pretty quiet for the first two or three sessions. Remember, I didn't want to say much of anything and as I reflect back I believe it was because of the stigma associated with having a "mental problem." It wasn't until the fourth session that I really started to open up and participate. As time went by I slowly began to feel better about myself and life in general without the psychotherapist "doing anything to me." I couldn't put my finger on it at first but after I did some research on client centered therapy, I understood why I felt better.

Client centered therapy, developed by Carl Rogers, is a non structured, non directive process between the psychotherapist and the patient. It is the process itself, not something that the psychotherapist does to the patient, that ultimately enables the patient to feel better by relieving the symptoms of depression. Client centered therapy is based on the humanistic philosophy that we all have the ability to strive to be the best that we can be in this life and we can find meaning for ourselves without constant direction from others. It was within this framework that Roger's focus in psychotherapy was less on what the therapist did and more on the client's verbal and nonverbal communication.

In order for client centered therapy to be effective the therapeutic process must contain the following 3 conditions:

1. Genuineness - Just as I was able to (eventually) share many of my thoughts and feelings with the therapist, so too was he able to share his own thoughts and feelings, both positive and negative, with me. Over several sessions I came to trust him and honestly believe that he was the real deal not hiding behind a facade or a mask of professionalism.

2. Unconditional positive regard - The second condition established by my therapist was that he accepted me with all my positive and negative qualities, just the way I was without any ridicule or rejection. I became so comfortable with our sessions that I could yell or scream at the guy without feeling guilty or unaccepted for doing so. This made me feel that how I communicated was just as important as what I communicated.

3. Empathy (reflective listening) - My therapist was able to understand and share my emotions and feelings. He did this by not only listening to what I had to say but actually summarizing and restating what I had to say in his own words. So when he made statements like," I can understand why you felt like you were between a rock and a hard place" or " perhaps you feel that you're unlovable", I came to believe that he actually knew what it felt like to "walk in my shoes" without making my issues his own. This enabled me to take charge of my feelings and work through them.

To be totally honest, I really did not need a battery of psychological tests to determine that my emotions were damaged. I knew that was my problem. However testing was part of the entire process that I needed to got through since I had voluntarily committed myself to treatment. I could have been taught a whole slew of different ways to change my thinking or behavior but I knew that was not going to change how lousy I felt. Keep in mind that client centered therapy takes time. As I made progress, my sessions were eventually cut back to the point that after three years, I no longer needed them.

If you've being diagnosed with depression and it's your emotions that are getting the best of you by negatively impacting the way you feel about yourself, talk to your doctor about client centered therapy. It worked for me, it could work for you as well.

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