Bob Rich’s Self-Therapy Guide: Depression in the Family

In this series, Dr. Bob Rich teaches you how to leave behind depression, anxiety, and other forms of suffering all too common in our crazy world. Recovering the Self published three sections of Bob Rich’s book From Depression to Contentment: A self-therapy guide in a series of posts – the first section ending with the quest for meaning and the second section concluding with The Development of Resilience.

The third section of Bob’s work was marked by special attention to various techniques and practices that are helpful in controlling depression. It concluded with a discussion on values and their implication in therapy. Bob now shares the final section of his self-therapy guide that delves deeper into the practical side of his therapy work illustrating with examples from individual cases of his own patients.

In the previous part, Bob discussed equanimity through acceptance. Here, he shares some important guidelines on how to address the issue of depression in a family member.

Depression in the Family

When I have finished a book, I seek feedback from “beta readers.” Fellow inspirational writer Jennifer Bonn suggested, “I wonder if you would consider a section with maybe how to have a conversation about depression with the family… how the family can help.”

So, here it is. And this chapter is well worth reading even if you are not in this situation.

Suppose you’re OK, but someone you love is tortured by depression. What can you do to help?

Healing can only come from inside. However frustrating it may be, you cannot “fix” someone else. Part of depression is feeling hopeless. “The world is a terrible place, and is guaranteed to continue that way forever. What’s the point of doing anything anyway?” No amount of argument, encouragement or guidance will shift this view, because it isn’t based on reason. People cannot just “snap out of it.”

All “mental disorders” have this kind of irrationality. The starkest example is when an anorexic, skeletal person looks in a mirror and sees fat.

You may have noted how this applies to depression in the many case studies I’ve described. However, these people came to me as clients: seeking help from a stranger. I could work with them precisely because I was a stranger. When members of my family suffered from some devastating event, all I could do was to give them a loving hug, be there for them, let them tell me anything without judgment or advice, let them say nothing if that was what they needed to do at the time.

Not only could I not do therapy with relatives or even friends, it actually would have been unethical for me to do so. That is termed a “dual relationship,” and is a no-no for a reason. You’re sure to share the emotions of people you care for. You cannot lead someone out of an emotion by joining in.

Here are two examples of how I achieved “professional distance” when needed.

I once had a “victim of crime” client: a blind old gentleman whom a bunch of teenagers bashed up. They also hurt his old seeing-eye dog. I visited him at home. When I left, I worried that I wouldn’t be able to work with him, because my sense of outrage got in the way of the professional relationship. So, that evening I started what I thought would become a short story in which a far worse criminal teenager would get just retribution. This is the standard technique of “displacing emotion.” I invented two people: a fourteen-year-old boy who murdered six little kids and a woman, and an old lady, Sylvia, who was the witness. Only, Sylvia then took charge, and the story became one of the power of compassion. It grew into a novel, Hit and Run, which many of my fans have considered as my best.

Twenty years earlier, my daughter fell from a horse, and suffered multiple fractures of her right arm. I splinted the injury to reduce her pain and make the ride to hospital bearable. I achieved professional distance by repeatedly saying inside, “It’s only a broken thing I need to fix.” I collapsed a second after handing her over to the professionals.

Normally, however, you don’t want emotional distance from your family; rather, the opposite. Nevertheless, there are things you can do when there is depression in the family (or somewhat further away, like a friend).

Caring for the carer

You must first look after your own welfare. The first lesson of nursing is, “You can’t care for others until you care for the carer first.” The second lesson is, “It’s not your pain; you’re not there to share it but to relieve it.” In a therapeutic relationship, “professional distance” is one step further: you are not even there to relieve the pain, but to guide the sufferer to do so.

How do you ensure that your loved one’s misery doesn’t drag you down?

Um… read the book again:

• Put the seven recommendations of my first aid chapter in place: healthy eating, adequate sleep, regular vigorous exercise, regular fun, creativity, social connectedness, and meaning.
• Learn to relax your body, and do so whenever unwanted muscular tension intrudes on your awareness.
• Meditate daily, and in odd moments when you have the chance. This should include both mindfulness and guided imagery meditation (not at the same time, unless you’re a lot better at it than I am).
• The strongest, most powerful tool is equanimity/acceptance. That applies to any problem. Read that chapter again.
• You may feel some guilt, especially if the person struggling with depression is your child. By all means, examine if any past or current action of yours may have contributed to the problem, but responsibility is one thing; guilt another.

Dealing with guilt

Suppose you’ve identified some way you have contributed to the fact that your child is now depressed.

I’m sure you did the best you could at the time, and no one can do better than that. Here is a card about this:

Homework

You may never have been depressed. All the same, reading the preceding chapters will improve your life. You might even enjoy the journey! If you have already done so, continue using the tools that lead to contentment, because they help you to rise far above “normal.”

– Dr. Bob Rich

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