Even though it appears that my BDI-II score lingered in the same area since March, there has been a great shift when looking at the individual topics of the assessment. The points used to be evenly spread over a lot of categories, but out of the 11 points I scored on Monday, 7 resulted from somatic reactions to stress: fatigue, lack of energy, hypersomnia, inflamed eyes and muscle pain. They will go away or at least get better if I manage to reduce the stress and relax, but are not related to negative thought patterns.
That means only 4 points are left where we need to work on the way I perceive myself and the world around me: the most persistent over all those months has been the self-dislike category, where it took the longest until any change occurred at all, and where I have never been down to a score of zero. Currently, I rate myself as 1 – “I have lost confidence in myself”. Which is pretty good in my book already, but my therapist thinks it could be even better… He knows that I have strong tendencies towards ruminating over the past and constantly reminds me of staying in the present, “I did not notice anything in the last months that you should blame yourself for.”
A lot of things that used to be very difficult or intimidating have become a lot easier: I am not constantly obsessing over the camera which records our sessions (for documentation and supervision purposes) anymore – though I hardly ever forget that it’s there for longer than a few minutes. I also write the situational analysis on the flip chart myself now, which I always avoided, and even the dreaded role-playing exercises are not quite that bad anymore. For months, my therapist would ask, “Would you like to write on the flip chart?” And I would reply, “I’d rather not.” But now he’s changed to, “Why don’t you write on the flip chart?” And so I did, and it was ok.
I told him about the nice feedback I had received from a former colleague last week, and he emphasized that it was me who had put the new batteries into me, nobody else. According to the theory that depression is “learned helplessness”, people get depressed when they feel that it doesn’t matter what they do, they’ll fail or suffer afterwards anyway – one of the main focuses of CBASP is making you realize that your behaviour does make a difference.
He’s right in so far as nothing we did in therapy would be worthwhile if I didn’t apply it to my everyday life. I have worked hard on myself, and I worked for therapy too: doing my homework, being prepared, being very willing to work with my therapist and not against him.
I agree that the progress has been my doing, but I couldn’t have done it without professional help. After almost a year of most severe depression, I was so depleted that I couldn’t have helped myself even if I’d known what to do, and I also think without guidance, I might have given up trying soon. It was necessary to hand over the planning to someone else and trust that they’d know what to do. For the first three months, I just followed the lead until I was well enough again to even start thinking about how to take my life into my own hands.