It’s not a secret that most people presenting for therapy come with symptoms of depression or anxiety and in many cases both – more about that later.
And it is also not uncommon for people unfamiliar with psychotherapy to simply want to be ‘happier’. After all, don’t we all on some level wish to be happier?
What is depression?
Depression is a word that has become part of daily vernacular. People often will use it to describe feelings of prolonged sadness as in ‘I have felt really depressed lately’; people will use it to describe feelings that are actually grief and it also it is also a medical diagnosis for which medication is prescribed.
In my view as an analytically informed psychotherapist, depression is a state of inner ‘deadness’. It is heavy and dulls down life so that very little seems to have any meaning at all. In this sense it therefore would seem to be the opposite state of happiness, however, this is too shallow and reductionist an interpretation and limits further thinking around questions of meaning and purpose.
Is psychotherapy about making me happy?
Happiness is an enjoyable feeling but it is just that – a feeling – and feelings are fleeting in that they come and go. The key to this sentence is that feelings ‘come and go’, or at least, they should.
Psychotherapy is about many things but not least about learning to listen to our feelings and then to think about those feelings. Neither thinking nor feeling can, on their own, guide us through life.
If we rely solely on our feelings as our navigation system, then we are prone to be reactive and can confuse feeling states that belong in the past, with events occurring in the present.
Conversely, to rely solely on thinking renders us unable to access our inner world and unable to understand the inner worlds, and thus the experience, of others; we become in essence like a version of Star Trek’s Dr. Spock.
Psychotherapy is not about making people happy – in fact, the process of going through open-ended therapy is one that can be immensely difficult and at times painful. So why do it? Because it is only through grieving what we have either lost or never had, and then learning to navigate by listening to our emotional world – our deepest desires and wants – that we can start to lead a fulfilling life. Fulfilled lives should include moments of happiness (I hope many) but most importantly they bring meaning and purpose, which is far more valuable than some fantasy notion of perpetual happiness.
Why depression and anxiety are two sides of the same coin
I stated earlier that many patients/clients present for therapy with symptoms of anxiety and or depression – why is this? On the face of it depression – a state of deadness, and anxiety – a state of agitation, seem very far removed from each other. However, both originate from the same cause: the inability of feel alive in the world.
Feeling alive in the world is arguably what a successful outcome of psychotherapy should be – again, not to be confused with being happy. Feeling alive is being able to feel and to navigate those feelings and make sense of them as signals telling us something important. Navigating ‘in the world’ is the next step, which is taking those signals, understanding them and converting them into action in the world as it is presented to us.
People who cannot really feel and are too fearful or limited to bring their desires into the world and into their relationships, become stuck and will likely oscillate between depression and anxiety.
Is there an opposite to depression?
I hope that it is now clear that the opposite of depression is aliveness and that aliveness is defined by being in touch with both our inner world, the world of feeling and emotion, and our outer world, finding a sense of purpose and meaning in our community based on what we desire.
‘In our dreams we can have our eggs cooked exactly how we want them.’
Anna Freud, Sigmund Freud’s daughter, and an enormously influential psychoanalyst in her own right, used the above expression to talk about the maturity and courage it takes to take a desire or fantasy (the idea of a plate of eggs) and risk turning that into reality. Anna’s point was that once we turn a desire into reality it will not be as we expected and so we must tolerate that – ie. once we cook we eggs we have imagined, they will always turn out slightly differently to how we imagined. They may exceed expectations, they may disappoint, but however they turn out, they will differ to our idea of them. And so it is with all of our desires: we bring them into the world and we learn to accept that once we set them free in reality we will, to some extent, lose control of them. However, coming back to Anna Freud, she would argue that a plate a of real eggs is always superior to a fantasy as at least we can actually eat them!
Being in the world, and thus feeling alive, is about breaking eggs and finding satisfaction in the outcome even if it differs from what we expected. This is the opposite of depression.
Mark Vahrmeyer, UKCP Registered, BHP Co-founder is an integrative psychotherapist with a wide range of clinical experience from both the public and private sectors. He currently sees both individuals and couples, primarily for ongoing psychotherapy. Mark is available at the Lewes and Brighton & Hove Practices.
Further reading by Mark Vahrmeyer
Are People with Mental Health Problems Violent?
The limitations of online therapy
Pornography and the Online Safety Bill
Does the sex of my counsellor or psychotherapist matter?
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