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How to use the law of opposites to relieve distress associated with depression

How to use the law of opposites (C) (from Session 17 "Think about your thinking to stop depression: A fast simple system to relieve distress" 2009 Dr Nicola Ridgeway and Dr James Manning, Foulsham Publishers.) Available now from the West Suffolk CBT Service.

A useful rule of thumb when dealing with depressed mood is to think: What could I do to make myself feel worse? Make a list, and make your list as exhaustive as possible. When your list is complete, take each point on the list and write down exactly what you would need to do to make it happen. Then do the opposite!

Client: I’m slightly frightened of doing this. I feel as though I’ve come a long way and if I start thinking about what might make me feel worse, I’ll get depressed again.

Therapist: Well, I can understand why you’d think that. However, in order to truly reduce the risk of relapsing into old ways of being, we need to be aware of the risk factors. When you’re able to do this you’ll feel as though you’re much more in charge of your life. Now, what things could you think or do to make yourself feel worse?

Client: I guess I could isolate myself, stop spending time with others, think that there’s something wrong with me, continually ask myself why I’m feeling the way that I do. I could ruminate, dwell on negative issues, think about the worst case scenario or tell myself off. I could think in alls, nothings and everythings – and do all of those things automatically without bringing any of it into my awareness.

Therapist: That’s an impressive list. Now what I’d like us to do is simply think about one of the factors and then, when we’ve worked on that, I’d like you to try the same process on the rest of the list by yourself.

Client: OK, I’ll pick the first – isolating myself.

Therapist: Right, OK, so what would you need to do to make that happen?

Client: I suppose I’d need to stop contacting my friends and acquaintances, when people phone make excuses about why I can’t go out, don’t phone people back, spend more time on my own or spend a lot of time sleeping.

Therapist: And what would you need to do to make that happen, for example, how would you need to think?

Client: I guess I’d need to convince myself that people would have a better time without me – tell myself that I’m too tired, tell myself that they don’t really want me there.

Therapist: OK. Now if you were to do those things what would happen?

Client: I suppose I’d become more withdrawn, people would contact me less, then I could somehow turn it around to being about me – I could tell myself that this always happens to me.

Therapist: How would you feel then?

Client: Lonely and isolated.

Therapist: So I guess the strategy would work then?

Client: It seems so obvious when I talk about it.

Therapist: So we know what the problem will be if you isolate yourself using the strategies that you’ve just described. ... So what’s your solution?

Client: Go out more.

Therapist: And what would you need to make that happen?
Client: Contact people. Look in the local papers to find out what is happening. Believe that people do enjoy my company. Generally spend more time being with others.

Therapist: And, when you do those things, what will be the outcome?

Client: I’d probably have less time to worry about feeling low. I’d just feel a lot better.

Therapist: Now the important thing to do is to work through the rest of your list using the same procedure – and I predict that what you’ll discover is that it boils down to a simple choice. Engage in old types of thinking and behaviour and you’ll have predictable and recognisable negative results. Engage in alternative types of thinking and behaviour and you’ll get different, more positive results. The new results will be highly preferable not only because you’ll be living a life you value, but also because you’ll be feeling well.

Remember, remember, remember – the law of opposites.

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