A Relational Approach to Depression
Is it the result of ’faulty thinking’? Is it a genetic pre-disposition? Maybe it’s a spiritual malaise? There are many ways to explain and understand a condition that afflicts a large percentage of the population of the UK. In my work at a reputable private hospital, I help a lot of people suffering from depression. It is usually accompanied by anxiety and the two go together to create low mood, lack of sleep and appetite and a general loss of interest in the world.
Given the medical setting I work in, most are under the impression that they are suffering from some a chemical imbalance in their brain that medication and CBT will put right. Not to suggest that these things aren’t helpful, but on further exploration it becomes clear that depression has a very clear ‘relational’ component. That is to say that most people suffering from depression are experiencing some form of breakdown or tension in their relationships with others.
This is why a relational approach to depression is necessary, in order to uncover the fixed patterns of relating to others that have created the lack of connection and intimacy that are the precursor to depression. Most say they are burnt out from work and need to reevaluate their work life balance. Unrelenting high standards transmitted via powerful messages from family and social groups, mean that the depressed are often driven by unconscious forces to work hard and perform, often to the detriment of their relationships and subsequently their psychological wellbeing.
Addressing these belief systems, challenging and testing them out can be an important part of gaining the insight necessary to free themselves from the inner critic who pushes and prods them into working until they can work no more, usually in an effort to please some pushy parent or authority figure.
I usually find there are other unresolved inter-personal conflicts that create psychic tension and depression. Sometimes there has been a key event, divorce, illness, relationship breakdown, bereavement, all of which necessitate a period of reflection. Sometimes the cause is deeper still, with roots in childhood, whether through obvious trauma, like abandonment or abuse, or through neglect, which can have as great an impact on psychological wellbeing as anything else.
It is through attending to these early conflicts and resolving them emotionally that the depression lifts and the patient is able to establish healthier relationships, first with herself through better inner-parenting, them through the therapist in a more interpersonal way and then with the outside world.
This relational approach to depression means that an integrated approach of psycho dynamic thinking, humanistic relating and behavioral experimentation is the most appropriate and successful.
I have seen many people recover in as relatively short period of time from the crippling effects of depression through this approach which I now offer to patients in private practice.
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About David Polak
David Polak (MA) is a UKCP and BACP accredited psychotherapist. He works in private practice in Central and North London, with individuals, couples and supervisees. He also works in a private hospital where he specialises in treating depression and anxiety in one to one and group settings.