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Depression: Exploring The
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Depression:
Exploring
the Whole-Person Approach
Through the Application of Psychopharmacology and
Psychotherapy
A paper invited for presentation at the World Psychiatric Association Thematic Conference on The Synthesis Between Psychopharmacology and Psychotherapy, Jerusalem, November 16-21, 1997 (revised 10/18/1999).
Depression is an illness that can change the very core of our being. The way we relate to the world and even our perception of who we are may be affected because of the pervasiveness of depression. One may enter a personal world where perspective disappears, emotions are drained and there is no guide for making decisions. It is a colorless life without meaning and motivation.
One of the most upsetting factors of depression is the desperate feeling you have that there is nothing, or no one, to stop your downward fall. You don't know where you can turn for a net to catch you. Keeping busy, taking medication and finding people who care can be very helpful, but these actions might not be enough to make you feel secure. There is no one solution to human needs. We must look for what is best for each individual, the whole person, not a human being with a series of parts.
In order to treat the pervasiveness of depression, I recommend a whole-person approach. By using the Bekoff method of Intra-Persona Therapy, which explores the social, emotional, physical and spiritual needs that are not being fulfilled, my clients have achieved new levels of personal awareness, serenity and peace of mind.
Exploring Social Needs
When I refer to social needs, I am not referring to going to parties or social events. Rather, the needs are ones that reach into the core of your being. The unconditional love that can be provided by family relationships is very important. When you can relate with ease and assurance of acceptance in family relationships, it lets you know that someone finds you worthy.
Another answer to your social needs is friendship. A friend is someone who understands and accepts you. By having at least one good, mature friend, you have fulfilled a basic need. A friend is one who enjoys you, and does not try to use you for his or her own gain.
One can satisfy social needs through a marriage relationship. Each partner has promised, in vows of marriage, to enter into a friendship that carries a pledge of mutual support.
Your social commitment to others on a personal level and on a community level is another way to satisfy your social needs. On the community level one should be open to the needs of others, but not to the detriment of one's personal needs.
Exploring Emotional Needs
Everyone needs to be able to express their emotions. However, emotions require some directive force that will keep them within healthy and constructive boundaries. How do you express anger, fear and other negative emotions? As you take control of your negative emotions, you will find that you will be less aggressive and more assertive. As a result of being assertive, you will become aware that your well-being and self worth do not depend on impressing others. In stages, your depression will leave you.
Exploring Physical Needs
Physical needs encompass all of the basic things your body requires to maintain itself in normal health. These include an adequate supply of oxygen, food, and drink, as well as sufficient sleep, exercise and recreation. If you are deprived of these needs, you can endanger your health and even your life.
What can cause us to abandon our basic needs? Unfortunately, a conflict arises in the lives of many over the goals they set for themselves concerning the accumulation of material goods, and the time it takes to take care of themselves. The pursuit of present and future financial security can cause more distress than the human body can take. Such a pressured person is left prematurely old and worn out.
Exploring Spiritual Needs
Your spirit seeks to find out what or who is responsible for the truth and goodness that we have in the world. As we play detective and investigate, we may come to the conclusion that it must be some being with intelligence and compassion who has been at work in us and the world. I propose that we give this being a name, "Universal Principle." Now that this being has an identity, many may feel more comfortable addressing their problems on a spiritual level.
A Case Study
The purpose of this case example is to illustrate the results of medication as the primary factor in the treatment of depression and the follow-up after a relapse using the Whole Person Approach.
In 1990, my client, who I will call Zeke, was referred to me for an evaluation. As we spoke to each other, I was aware that Zeke was tense and showed signs of distress. I knew that I could never reach him. In order to help him, I suggested that he set up an appointment with his primary physician. I contacted his physician and recommended that he refer Zeke to a psychiatrist. In the follow-up, I was made aware that Zeke had seen a psychiatrist and was admitted to the psychiatric ward of a local hospital.
About two years had gone by when I received a message that Zeke would like to see me. I set up an appointment. When we met, I suggested that he bring me up to date as to his treatment and how he was getting along. He related to me that he had experienced a traumatic incident that precipitated his previous illness. He stated that he spent twenty-eight days in the hospital. The psychiatrist prescribed medication for his condition. About a week later he said he felt a little better. Besides taking the medication, a counselor was assigned to him. The counselor would see him privately for about fifteen or twenty minutes about three or four times a week.
During the day he would attend group sessions and there would be discussions relating to tools that the patients could use to help themselves in their recovery. After two weeks had gone by he was issued a four-hour pass giving him permission to leave the hospital. When his wife picked him up he felt tense and had trepidations about leaving. He decided to go home and spend the time there. He was experiencing anxiety knots and decided to go back to the hospital three hours later.
When he was offered another four-hour pass a week later, he decided not to take it. A week later he was feeling much better and was dismissed. He was concerned since he had witnessed patients leaving and returning a week or two later. In speaking with them, they stated that they were feeling good when they left, but when they returned home they were in the same situation that had caused them to be admitted originally.
He was told that if he took his medication as prescribed, he would feel much more comfortable and would be able to cope with his situation. He said that when he left they gave him an appointment to see the psychiatrist and was told that if he needed to see the psychiatrist before they would arrange for him to come in. For the next two months, his wife took him to the mall to walk, be among people and get back to his regular routine. Things went along fine. He started to play tennis, golf, and other activities and was his old self again.
His visit was a visit of precaution. He was feeling the same anxiety as he had experienced when he first came to me. He told me that he felt comfortable with me and was seeking advice. I asked him if he was taking his medication, and about his daily routine. I told him that I would like to speak with his psychiatrist. When the psychiatrist called me, I suggested that Zeke be admitted to the psychiatric pavilion. I told him that I would see Zeke daily. This was agreeable.
Zeke was admitted and, as agreed, I saw him on a daily basis. After my visit, I would call his wife and keep her up to date about Zeke's progress. After two weeks, he was ready to go home. It is over four years since his last discharge, and Zeke still calls me to let me know how he is doing. He says that he never felt as comfortable and self-assured as he has been in the last four years.
In this case, medication provided relief from depression so that Zeke could be responsive to learning new and more direct methods of coping with his problems.
There is a danger of looking for the answers to depression using just one method. This single-minded approach to depression may point out particular needs that require attention. There is nothing wrong with that. However, there is something wrong when that one area is the only one heeded. Your depression will not go away until you begin to handle life as a whole person.
