As a clinical social worker with a PhD in health education, I have been treating many types of depression since 1976 in many different settings – inpatient hospitals, day treatment centers, pain treatment centers, and in private practice. I have treated depression in children, adolescents, and adults, both individually and in the context of couple, employment, and family relationships. The three most common varieties, and those with which I have the most experience, are reactive, endogenous, and exogenous depression. Reactive depressions are due to crises, separations, divorces, deaths, and other unexpected waking nightmares, like disease. Endogenous depressions are physiological and often genetic. Exogenous depressions include reactive varieties, but also include long-term stressors: unhappiness with work, a spouse, a long-term debilitating health condition, or with life itself. Depressive types are loosely associated with different developmental issues, including physical (endogenous), over-identification with emotions (“neurotic”), and “existential,” in which basic assumptions about the value of life and living have been undercut. Depression may or may not have a large component of anxiety. What works for one type of depression may well not work for another. There is generally an adaptive component or “secondary gain” to both depression and anxiety. This means that feelings of helplessness, hopelessness, and powerlessness work to validate a scripted life position and keep a person from either discomfort or failure. How big this component is varies from person to person, but it needs to be considered, because to the extent that it exists, it will sabotage treatment.
My work with depression is informed by a conviction, since my early adolescence, that the best “physician” exists within the individual. This innate source of healing is called your “inner compass.” This does not mean that external sources, such as allopathic physicians, psychiatrists, and trained psychotherapists should not be consulted, but only that their diagnoses and treatment recommendations need to be compared with internal sources of objectivity. Until 1980 the only such sources I knew of and used were prayer, meditation, faith, intuition, and “positive thinking.” I have since come to recognize that these are of limited applicability for the treatment of depression and anxiety, for a number of very good reasons. I am not saying they are of no use, only that they generally fail due to issues of efficacy or compliance.
Beginning in the early 1980’s I started interviewing internal sources of objectivity, first in the form of dream characters, and then later, the personification of life issues, such as fear of failure, fear of aging and death, depression regarding the value of life (in near death experiencers, among others), feelings of hopelessness and helplessness, financial concerns, and many other life issues. Regardless of the form these issues took I found that they provided perspectives that were relatively objective and which generally produced recommendations which could be used to both test the method and the value of the recommendations themselves. This method was first called “Dream Yoga,” because it involved looking at life as a self-generated dream from which we are in a process of awakening. This process of awakening is speeded up when it is approached as a “yoga” or “life discipline” of consultation with both interior and exterior sources of objectivity and comparing the results using one’s own common sense. What I liked most about this method, which evolved into “Integral Deep Listening,” was that it was not dependent on me as a professional diagnostician and provider of treatments. Instead, it encouraged patients to use me in two ways, as one source of exterior objectivity, and as a teacher of the method, so that they would be self-supporting and autonomous, with the ability to use the process not only with whatever life issue, dream, or nightmare that might arise, but to help family members, friends, and those they chose to coach.
Integral Deep Listening views depression as a collapse of identity into a state of fusion with negative emotional states that include feelings of helplessness, powerlessness, and hopelessness. IDL works to reduce and eliminate depression by providing repeated experiences of perspectives that are not fused with such negative emotions but which instead witness them objectively in ways that are authentic and unique to each particular individual. Because such perspectives transcend and include both the depression and the perspective of the depressed individual, they are called “emerging potentials.” They are “emerging” because they are not yet the ongoing reality; the depression-related perspective is the ongoing, daily, waking reality. These interviewed perspectives are “potentials” because they are not yet stable, trusted perspectives in which the person with depression has confidence. However, the fact that they show up at all indicates that they are genuine possibilities or potentials, and that the depressed person is either waking up to them or that these healthier perspectives are in fact in the process of being born within the consciousness of the individual.
If a depressed person experiences enough perspectives that transcend, yet include their own, non-depressed perspectives in time become internalized as their normative, ongoing waking orientation, attitude, and affective state. The feelings associated with depression either lessen or disappear, on the one hand, or are objectified to a degree that they become less and less problematic.
IDL is not a cure-all; endogenous or purely physiological depressions do not respond well. But most depressions are not “purely” anything. Most endogenous depressions contain exogenous elements and are supported by co-morbid factors. In my experience, most depressions are mis-diagnosed. People who have been labeled “depressed” or think of themselves as having a “depression” may be approaching their unhappiness in an unhelpful way. Why? For one, this diagnosis usually leads to medication. Medications for depression have a hard time demonstrating value beyond placebo. That means if you take one or more, you have about a 33% chance of feeling better, a 33% chance of experiencing no change, and a 33% chance of feeling worse. When you throw in side effects and the issue of polypharmacy (drug interactions) you reduce total benefit below that of placebo. That means your doctor might as well prescribe you colored water. This is not to say that there are not real and demonstrable benefits for some people from some SSRI’s, SNRI’s, or tricyclics, only that there is good reason to distrust pharmaceutical claims of their benefit.
That being said, I have used Integral Deep Listening successfully for the treatment of depression for individuals who were not taking anti-depressants and those who were. There have been situations when I have required patients to be on one before I would work with them. That is because I do not claim to have all the answers, and I have wanted some individuals, particularly those seriously suicidal, to have maximal physiological support before I would work with them. Still, anti-depressants, along with pain-killers, are the most over-prescribed, dangerous and unnecessary medications on the market, with anti-anxiety medications running a close second. A good rule of thumb for these is that if you are not well enough to be off of one of these medications in six months it probably is not doing you any good. Your chances of receiving benefit from a trial on a second one are diminished. If you are receiving no benefit, you are being maintained in a miserable state while known and unknown side-effects are damaging your health and breaking down your resistance to stressors of various sorts. If you can’t bring yourself to stop a medication after six months, consider yourself addicted. Now you need to seek treatment not only for your depression, but for your addiction. If you can’t bring yourself to stop hopping from one medication to another, or from one “cure” to another, consider yourself addicted to treatment rather than to getting well.
To have someone label you as depressed, or to think of yourself in those terms, is generally unhelpful. This is not how life itself views you; why should you so view yourself? Do not reject the label of depression out of denial or a determination to only think happy thoughts, but instead consider that it is a definition that has not helped you get well, and that therefore it is inadequate. But what definition could be more appropriate and helpful?
One young lady I worked with had been told by doctors she was depressed and put on SSRI’s. In her community, over many years, a number of people, mostly alcoholics, had hung themselves. She had persistent worries that this might happen to her, since so many people she knew had done so. Was it her destiny? This thinking is not so different from that of copy-cat suicides that often happen when a schoolmate, workmate, or a famous person kills themselves. When a person feels overwhelmed by conditions or possibilities that are beyond their control, and that they do not understand, a perfectly reasonable response is to feel helpless, powerless, and hopeless. However, was that basically what is going on with this lady? Is this woman’s basic problem depression? If it is, then maybe she needs an anti-depressant, but what if it is something else? How do we find out?
Generally, one or more Integral Deep Listening interview will clarify the situation. This lady did several that indicated that her basic problem was chronic anxiety, in this case expressed as a morbid preoccupation that she was somehow predestined to commit suicide. She was not suicidal and had never attempted it, nor did she have a plan for how she would do it. With the help of interviewed emerging potentials a differential diagnosis of chronic anxiety was made. When a problem is basically anxiety, there are plenty of doctors who will be more than happy to prescribe a benzodiazepine, SSRI, or beta-blocker. But benzodiazepines are highly addictive, and all anti-anxiety medications are subject to the usual issues of polypharmacy and side-effects. In most cases, it makes sense to try a non-interventionist approach first. The problem is, most of those that are available have not been shown to perform above placebo. These include Reiki, Touch for Health, homeopathy, Oberon and other bio-resonance, radionics technologies. Save your money, or go for temporary good feelings and a renewed sense of hope, and by all means use these with the expectation of cure, because if they have any healing benefit, it comes because they manage to arouse within you that expectation.
This young woman mostly needed two things. First was some validation that she was not chronically depressed and scripted to emotional misery and suicide just because she happened to be surrounded by those who were so brainwashed. She also needed to be reminded that she was not an alcoholic and that her own assessment of the realism of such a possibility was 1%, since she never drank more than a glass of wine. She also needed to be told that her basic problem was fear, not depression, based on the perspectives of her own interviewed emerging potentials, and that feelings of depression arose because she kept scaring herself by ruminations about powerlessness and suicide. She was scaring herself. Consequently, what she needed were some practical tools for interrupting those anxiety-generating ruminations. These included scoring herself daily both on how often she felt anxious and to what extent, on a zero to ten scale. The purpose of this was to create separation or objectivity in relationship to her feeling state. As long as she stayed fused, or subjectively immersed, in her feelings, they are her self-definition; they control her; they define her; her potential for happiness is determined by her feelings. To the extent that you are able to look at your feelings, to objectify yourself from them, to observe them, they no longer control or define who you are. The other instruction she was given was to learn to catch herself whenever she found herself thinking morbid thoughts and to recognize she was at a choice point. She could continue to scare herself, or she could do something else. One possibility would be to become one of the non-scared, non-depressed perspectives that she accessed during her Integral Deep Listening interviews.
What is good about this approach is that the diagnosis was not mine; it came from her own interviewed emerging potentials. Therefore, clients are not disempowered by making me the healer. Instead, they are empowered by learning to listen to and trust their own sources of internal objectivity. IDL is also operational. That means that the recommendations from interviews are defined in ways what are testable. If people follow the recommendations, they either get better, while proving the efficacy of the method, or they do not. Follow-up interviews both trouble-shoot the process and provide more recommendations for taking healing, balancing, and transformation to the next level.
States of depression and fear involve a compression or regression of the self. Who you are becomes fixated at an earlier or ineffective stage of development. Your sense of self gets trapped in a box of its own creation. While these things will definitely make your misery more comfortable, this “trapping” is not going to go away by thinking happy thoughts, taking magic pills, vacations to sunny lands, landing a trophy partner, trying one miracle cure after another, or by making tons of money. By accessing perspectives that are authentically your own but which both include, yet transcend your own, Integral Deep Listening slowly but surely expands your sense of self. The compression relaxes; the box first gets lighter, then larger, then transparent; regressive fixation stops, because a legitimate, workable way forward that uniquely fits for you is found.
While most anyone, including children, can be taught to interview themselves and others with Integral Deep Listening, most people need help following the recommendations they receive. Most people need accountability and support over a period of time. I have found that eliminating depression and anxiety is relatively easy in most cases if people are willing to submit to following the recommendations from their interviews and work with an Integral Deep Listening Practitioner for ongoing accountability and support. While most people stop IDL after they feel better, some want to continue to grow beyond “normalcy” and instead grow into the person they are capable of becoming. Therefore, they continue to work with the process of interviewing and following recommendations under the supervision of a source of support and accountability, like an IDL Practitioner. Others choose to study to become IDL Practitioners so that they can serve as effective coaches to their friends, family, and clients. These people understand that this is a method that they cannot outgrow, because they will always have issues; they can always be more awake; and they can always grow more not only in objectivity by accessing emerging potentials, but in the other five core qualities for health balance, and transformation that IDL builds within you: confidence, compassion, wisdom, acceptance, and inner peace.
If you know someone who has tried either medication or some other treatment for the treatment of depression or anxiety disorder and has not received the benefits they seek, forward this overview to them. Anyone can contact us at Joseph.Dillard@gmail.com for a free in-person or Skype introductory session. While it will not eliminate their problem, they will learn that IDL is easy, fun, and effective.