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.