At first, you may not notice that the wrong person is talking. When
you do notice, shift the attention back immediately; say: “This is about you,
not me.”
If you look back at Chapter 1 and the approach I described for deal-
ing with Rachel’s explosion into sadness when criticized at work by her
manager, you’ll notice that most of it is the opposite of what I’m suggesting
for bereaved people like Carol. The discrepancy represents what I consider
to be the biggest problem with people’s conception of what psychotherapy
is and how to do it.
For almost 100 years our ideas about the talking cure have been based
on the rather simple hydraulic model that works well for treating grief but
little else. To help people who are grieving, all you have to do is sit quietly
and listen while they express what they feel. This relieves internal pres-
sure, and eventually people get better on their own. This technique works
so well for grief, and is so easy—all you have to do is keep enough distance
to avoid being swept away—that it’s become most people’s unconscious
model for how psychotherapy is supposed to work.
But though this approach helps people who are grieving, for most other
disorders, particularly the emotionally explosive kind, sitting passively
while people talk about how badly they feel makes them worse. People
work themselves up to emotional explosions by ruminating, repeating their
fears, sadnesses, and angers over and over inside their heads, making them
larger with each retelling. There is no evidence that duplicating this process
in a doctor’s office or in a support group does anything to make explosions
less likely. Still, almost everybody who isn’t a therapist—and far too many
people who are or would like to be—believe that the purpose of psy-
chotherapy is to get your feelings out.
If you want to help the people in your life who explode into the
sadness, emptiness, or whatever that is classified as depression, you have
to look beyond the diagnosis and the popular misconceptions about the
nature of therapy, and see not so much the source of people’s pain but
what they’re doing about it. Are they facing it or running away? If they’re
facing their pain, by all means listen and validate their struggle. If
they’re running away, you need to gently turn them around so they’re point-
ing in the right direction, or, at the very least, avoid encouraging them.
Unfortunately, recognizing whether a depressed person is facing or
running away from pain is difficult, because the only thing they have to
The Psychology of Depression ❧ 179