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Depression Therapy

A cognitive therapy session for depression - a short interview with Dr. Judy Beck

The Selfish Path to Romance. Download chapter one for free at DoctorKenner.com

I haven’t been sleeping. I haven’t been clear in my head or felt like myself, sick, nauseous, sleepy. Everything looks distorted, and inside, it just kind of aches, and you can barely find the will to complain.

Let’s say that I’m somebody who’s seriously depressed. I get up in the morning, and there’s nothing to look forward to. My kids don’t care for me anymore. I’ve just given up on life. I’m not quite suicidal, but I’ve got no energy to move, no energy to go on. Then I go to a cognitive therapist, such as Dr. Judy Beck. Today, I have the pleasure of introducing Dr. Judy Beck, who is the director of the Beck Institute for Cognitive Therapy and Research, and she’s a clinical associate professor of psychology and psychiatry at the University of Pennsylvania. She’s written a few books, her recent book being Cognitive Therapy: Basics and Beyond by Judith S. Beck. Her dad is the father of cognitive therapy. Judy, welcome to the show.

Thank you. It’s wonderful to have you on. If I’m that depressed person, really down in the dumps, help me out. What would you be asking me? What would you be looking for in terms of my thinking processes? Because that’s what cognitive therapy looks at.

Yes, that’s right. Actually, there are two things that we want to do simultaneously. One is, I need to get a lot more information about what your day looks like. So I would ask you to describe a typical day for me.

I get up in the morning. I wake up, I watch the news. The news is so depressing. Then sometimes I take a nap because, honestly, what’s there to live for? I mean, I just, I try to go to work a little, putter around the house, but I just don’t have it in me anymore.

The next thing I would ask is, what did you used to like to do before you got depressed? How was your day different?

Oh, boy. That’s a tough question, and I’m breaking out of role-play now. But that was tough because you’re shifting gears. Here I am, so depressed, and suddenly I’m supposed to focus on things I love in life. You know, I used to be so active. If you had met me even 10 years ago, I was up first thing in the morning. I was playing tennis, then out and off to work. Every day, I would call my kids. I wouldn’t sit and wait for them to call me. I loved my life.

And it sounds like things are pretty different now.

Yeah, they’re very different. So if it’s all right with you, I’d like to talk about how you might make this coming week different. How you might try to do some of the things you used to do.

I can’t play tennis anymore.

In that case, we’ll have to substitute some other activities. Let me tell you also, there’s something else I want to do. It may be that we come up with activities for you, but you might have thoughts that get in the way. For example, you might think, "I’d be too tired," or "It wouldn’t help," or "I wouldn’t enjoy it."

Yeah. Well, I do think that nobody wants to be around me because I’m so depressed, right? And I always tell them what I heard on the news.

I see. Well, Ellen, let me give you a choice. Would you like to first talk about activities you could do differently this week? Or would it be more important to discuss the thought, "No one wants to be with me"?

Maybe… nobody wants to be with me.

Okay, Ellen, when you have that thought, how does it make you feel emotionally?

Oh, depressed. Really depressed.

And when you think, "No one wants to be with me," how much do you believe that?

100%. 100%.

Ellen, can you tell me what evidence you have that the thought is true? Who specifically doesn’t want to be with you?

I was talking with my son the other day, and he just got off the phone quickly. He said he had to go.

Right. But has he ever said, "Mom, I don’t want to talk to you"?

Oh, no, he’s in school, taking exams right now.

I see. So, Ellen, might there be another reason he got off the phone quickly besides not wanting to talk?

Oh, yeah. I think it’s his girlfriend. He was probably getting ready to be with her.

I see. So, is it possible that when he’s not with his girlfriend, he might actually want to talk to you?

Yeah, we don’t have a bad relationship. It’s just… I don’t call him anymore.

I see. And what do you think would happen if you called him at a convenient time?

Hey, I’ve got to interrupt because we have to pay some bills. Thirty seconds—that’s it. A quick ad, then Ellen will be back.

I wish I knew more about what girls want from a relationship. Well, I wish I knew more about what I want. Where’s that ad I saw? Here it is—The Selfish Path to Romance, a serious romance guidebook. Download chapter one for free at SelfishRomance.com and buy it at Amazon.com. Huh? The Selfish Path to Romance—that’s interesting.

And what do you think would happen? What’s your prediction if you called him at a convenient time?

It’d probably be better if I emailed him. He always responds when I email. If I tell him something depressing, he tries to pick me up. If I share something positive, I get a longer reply.

That’s wonderful. So, you’ve already figured this out. How would you feel about a special "homework assignment" this week? Not like high school homework, but maybe "depression homework"—or anti-depression homework, I should say. Would you be willing to email your son a couple of times?

Yeah, I could do that. I have plenty of time now.

You could email him depressing things, or you could send uplifting messages. Which do you think would help your mood better?

Oh, obviously the uplifting ones.

Can you tell me a few things you might email him about?

I love ice skating, and I watched it on TV recently. He loves it too. I could share that with him, and I could ask about his day instead of focusing on myself, sharing in some of his joys.

Ellen, that’s terrific. So, this idea that "No one wants to be with me" is starting to sound less true if your son does want to connect with you.

Right. It can’t be 100% true because I know he loves me.

Is there anyone else who might want to be with you?

I have a neighbor. She was on vacation, but we usually walk together and sometimes go to the movies.

What’s her name?

Sandra.

Sandra. Do you have any evidence she doesn’t want to be with you?

Only when she’s busy.

Do you think she might want to go out for a 10-minute walk?

I think she’d probably enjoy that. Maybe I could give her a break by calling her in the morning.

That’s a good plan. Would you like me to write these down, or would you?

One: you’ll email your son, share uplifting topics, and ask him questions. Two: you’ll call Sandra and ask her to walk. You might even share positive topics with her too.

I could do that. You know, I’m feeling better already.

I bet! So, the old thought was, "No one wants to be with me." What’s the new thought?

People want to be with me. They just have busy lives, and I need to make an effort to reach out.

That’s excellent. Old thought: "No one wants to be with me." New thought: "People have busy lives, and if I reach out, they’ll respond."

I’m talking with Dr. Judy Beck, who’s showing us what a cognitive therapy session might look like for a depressed person. I’ve been role-playing as the depressed person. I wish we had more time to cover how you identified my problem, challenged my thinking, wrote a coping card, and gave me homework. That’s all part of cognitive therapy. How can people reach you?

A good way is through two websites. One is academyofct.org, and the other is BeckInstitute.org. The second site has a brochure, Questions and Answers about Cognitive Therapy, for more information.

Thank you so much, Dr. Judy Beck, for joining us today.

My pleasure.

For more Dr. Kenner podcasts, go to DrKenner.com.

Here’s an excerpt from The Selfish Path to Romance, the serious romance guidebook by Dr. Ellen Kenner and co-author Dr. Edwin Locke:

To discover a potential partner’s actual values, don’t just listen to what they say. Look at their choices, actions, and responses over time. Observe what a potential romantic partner responds to emotionally and why. Notice their passions, indifferences, and dislikes. Observe how they make difficult choices, whether by careful thinking or solely by emotion.

You can download chapter one for free by visiting DrKenner.com and buy The Selfish Path to Romance at Amazon.com.