Therapy for Depression: Bill’s Perspective

There are many kinds of depression. When the symptoms come “out of the blue” the depression is likely to be biological in origin. However, the origin of most people’s depression is abstract rather than medical.

There are good and talented people who perceive things in ways that depress them, and, consequently, the quality of their performance. They criticize themselves for being depressed and not performing better, which depresses them. Being depressed about being depressed is an example of a recursive trap.

Self-Confirmatory Bias
Self-confirmatory bias is a component of many recursive traps associated with depression. Of all the negative beliefs that one might accept, some are special in that they motivate the person to act in ways that confirm the original belief.

Barry is a 31 year-old engineer who views himself as socially awkward. Given this knowledge about Barry, what is your prediction when at an office party a co-worker makes a joke at his expense. Will he respond with a clever comeback, or feel frozen and be inarticulate?

From the clinician’s perspective, the pain that Barry feels when he ruminates on past social failures is just the insult; the real injury is that the self-consciousness and demoralizing expectations that this kind of thinking promotes, impairs his social performance. Barry’s trap: His pathogenic beliefs about his self-worth or social desirability elicit motivational states that impair his social performance, and thereby confirms the pathogenic belief.

When he is in the right state of mind Barry can be very funny and quick witted. Whether or not he can use this talent depends, to a large extent, on his subjective reality at that moment. His retort is more likely to be clever if he sees himself as a quick wit, than if he is in his “I’m a loser” trance.

Cognitive events such as the appraisal, “I’m a loser,” or the expectation, “I will respond with a clever retort” exist only in Barry’s mind not in the objective world! However, the subjective reality that Barry experiences has a considerable influence on how he performs in the objective world.

It looks different than it feels. From our dispassionate perspective, we can appreciate Barry’s trap in a way that Barry cannot (a big advantage in working with a therapist). The details of your trap may be quite different than Barry’s, but it is likely to share this recursive structure.