The healing process

Now that doctors have effective antidepressants at their disposal, they can more easily acknowledge the problem in the first place - it's much easier to recognise a problem when a simple solution is ready to hand. The medication can certainly be a great help, and can offer a much-needed breathing space: the very fact that the problem is acknowledged and treatable means it's not your fault, which in itself lifts a huge burden. Just having the problem taken seriously helps a lot, and the fact that the stuff actually works gives it a new dimension. You don't even need to take the pills to get the dawning realisation that the depression is not a matter of your moral character. (Of course, the morality you live with is a brain thing too. And so are your hunches and gut feelings. You can peel away the layers till you're blue in the face, but that's another story, to be pursued in a spirit of adventure rather than self-improvement.)

The way the vicious circle works is like this: the negative thoughts were all conscious once but now they've become automatic, like changing gear when you're driving. The self, on the other hand, is conscious here and now (take your pick whether that's a definition of self or a remark about consciousness). So when something depressing happens - perhaps an embarrassment, a disappointment, a clumsy accident, or something you didn't handle very well, you look at yourself and what you get is the BROH. The BROH draws your attention to your self-image and pulls it down; the low self-image in turn puts more poisonous thoughts into the BROH. The spiral can go on for days at a time until you let go of it out of sheer exhaustion. Next time something uncomfortable happens, the BROH spews back all the accumulated stuff from last time. As the process repeats itself, the BROH gets more and more elaborate in its condemnation. Eventually, you don't need to be aware of a trigger - it just seems to happen spontaneously, or as the expression goes, 'out of the blue', and then everything goes pear-shaped.

It's obvious now why the old approaches didn't work. Any technique that pays close attention to the BROH, even to challenge it, is going to be unproductive. The accumulated edifice of thoughts is neither true nor untrue, it's just a pattern, a pattern that has built on itself, not on the real world, over the years. Once you can see that, you can afford to leave it in the background and let it fade, organically, so to speak.

Just in passing: I discovered recently, when I started thinking about publishing the BROH trick on the Web, that the vicious circle (the feedback model) is actually a central part of the theory behind cognitive therapy. It would seem from anecdotal evidence, though, that the theory also assumes that the client isn't up to seeing what's going on. If the BROH trick does anything, it might be only to tell the cognitive therapists that to point out the feedback mechanism can do the trick much faster than challenging the BROH thoughts one by one and encouraging the client to replace them with new ones.

The BROH has lost its sting, and it's now just a matter of a little patience and being kind to yourself. You do still get the weepies for a while, and they still come out of the blue, but you start to treat them differently. You can just let the body/brain mechanism run its course. Now that the ego isn't feeding them, the weepies get fewer and farther between, and last minutes rather than days. Eventually you can see them coming and cut them out altogether. Because you've done all the thinking, you don't have to rush the process because you know now that there's no threat to what you are and how you see yourself. You can let it run its course, just the way you let a wound or a bruise heal.

Sleep starts to refresh you again. Whether you slept too much or too little before, you begin to discover the right kind of tiredness, the kind that goes with a sense of having achieved something today. Tomorrow becomes a whole new day, not just a continuation of all those 'orrible yesterdays. If a day does go pear-shaped, you mentally shrug it off as an effect of the weather, or hormones, or something equally non-threatening. It becomes rare to have two bad days in a row.

Like so many life changes of this kind, this one creeps up on you. Suddenly you realise that you're not depressed any more. When someone's less than civil to you, you think they're probably having a bad day. You can look at your mistakes and see them as learning opportunities. You don't take things personally any more. There's a new symmetry between you and other people.

You start to notice small things you can do for people that you never would have been bold enough to do before. It's not that you make new rules for yourself, such as: next time I see x, I'll remember to do y. It's rather that you notice things in the moment and respond. A tiny example: there I was one day, coming out of the supermarket with a full trolley and two screaming small boys, one clamped over my back in a fireman's lift, the other in the trolley which I had only one free hand to push. A bunch of 'young louts', figuratively if not actually swilling their lager, were standing outside watching me. Suddenly one of them came up to me and offered to help me with the trolley! It cost him nothing, and was exactly what was needed. That young lad wasn't depressed. If you're depressed, a little kindness like that can look like a mountain to climb. As it was, we both came away from it feeling that the world was a better place.

You're not constantly evaluating your character any more. You can accept compliments graciously because they're nice, they're feedback, and your life doesn't depend on the truth of them. Equally, you can start to accept the odd criticism without feeling devastated. After all, you're only human, and so is everyone else. You look back and realise the house is a little bit tidier for a little bit longer. You're more relaxed, and at the same time getting more things done, including those little jobs that have taunted you for years. You're finding more clothes in the shops that suit you. You discover new avenues for your creativity. You discover new depths in your friendships, and new friends are made, effortlessly. In short, good things start to happen in shedloads.

A quick word about medication: there's some debate among the professionals as to whether the low serotonin levels are caused by the depression or vice versa. It seems, from my experience, that this is another feedback loop. I haven't had my brain examined, but it certainly seems as though my serotonin levels are as high now as they were when I decided to stop the Prozac. Exercise is now formally acknowledged to be an important factor in the relief of depression, too, so it's worth making decisions in favour of exercise where you have the choice - take the bicycle or walk where the journey is short enough, for instance.

That's it for the BROH pages. There are three more short articles; the links are in the left panel. Meanwhile, I wish you all the best for your continuing journey.

Top of page

Copyright © 2001-4
Vivien J. H. Heppel PhD