TMI (too much information)

I recently saw a young man, 21, who had these complaints: He has “no energy, no motivation” to do anything. Nothing interests him, including activities he used to enjoy. At college, he pursued a major in Oceanography, but found everything about the curriculum painfully unpleasant and failed every course. He left school but recently returned with the mildly desperate purpose of having “fun.” He’s into the Art Education major. When others tell him his projects are good, he doesn’t believe them. Several days a week he goes to a camping-related job that should be, almost by definition, pleasurable. It’s just work to him.

It was very clear from my client’s tone and from his missing words that he had no idea he was depressed. Therapists know that a Dysthymic person may not be aware he has depression. But the young man was naming textbook features of an acute disorder. Yet he identified himself without it.

I gave him the name of his problem. That seemed not terrible to him, though he had an expression of “dull stun” rather than one of acknowledgment or acceptance.

But when I explained where depression comes from, from depth theory, it seemed to be terrible for him. As the session came to an end, he looked like a changed person, as if everything looked different to him now. He had said that his family was problem-free, though he and his slightly-older brother had never gotten along and had recently reached a cold détente about it.

I let him know that depression is in the ignorance of the family, of mother and father. They don’t see you, who you are. They are riding along on their own life, and you think that’s normal.

– Mommy, mommy . . . the teacher was unfair to me today.

– Now dear, the teacher was only trying to do his best.*

I told him that lack of empathy in a normal home creates a different child because he never gets to be himself unless there is a listener. He never gets to feel loved without someone’s eyes and words and smiles drawing him out. The home may be lively and busy, with kaleidoscopes of conversations, laughs and activities and purposes, but without empathy, without being drawn out, it is a place to lose your life.

I don’t recall going far beyond that, but it was enough to cause him to land on planet Earth, no longer float along. He looked back to sense his origins. He could no longer assume that life is necessarily good but for some surface flaw that you call “depression.”

It’s not unusual for first sessions to feel good, warm, like an unexpected odyssey. The client’s eyes are wide, deeper. She feels this was very different, even very important. Almost always she returns. This young man – I wonder not only if he will not return, but if he may wander off to some underground continent where one’s eyes never close to the darker and emptier self.

Questions I ask myself now: Should I avoid telling very surface-living clients, such as this young person, about their problem? If no, and as the facts are not mitigable, is there a way to have depth therapy without falling and drowning in the deep end? If yes – we should avoid knowledge – what can really help this problem, depression, that turns every cell in the body and mind into a clock whose hands read “the past”?

I’ve learned the history of psychotherapy and have read the old “legends” – case histories that all seem so drastic and moving – so feces and incest, dreams and libido-twisted – but more as intellectual mind-fucks in the musty pages, less so in the impeccably dressed supine patient on the couch. Real change may have only nipped the surface in our modern, feel-all culture with Esalen and Whitfield and their inner child, Bass and Davis and their women sexually abused as children, “codependent no more” and est and Perls and Oprah. And still, I’ve seen almost no approach, other than Janov’s primal therapy, that brings our buried roots into the room to be healed, or at least worked with. And even that system of radical insight can only help those who are already partially better: men and women who’ve read the books and know of their killed childhood, who accept that there’s an ocean of blood waiting to be screamed out. Most people, most clients who come to therapy are on an adamantine plane of unreality. They cling to the parents who have ruined them. They choose only the present and ignore their history. They are uncomfortable with silence, and lying on a couch.

If I could redo my session with the ignorantly depressed young man, I might say: Do you want to know what has tired out your interests and energy? Do you want to know where your depression comes from?

Really?

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* From Paul Vereshack’s online book, Help Me – I’m Tired of Feeling Bad -- http://www.paulvereshack.com/.