Category: Vulnerability

Robin Williams, Suicide and Depression - Resources Updated

8/12/2014

I thought for a while about whether or not I wanted to write about this, because there are so many armchair psychologists who are ready to explain and point fingers in regard to Robin Williams' suicide. Today, however, after hearing some of my clients' reactions and after hearing some of the things said in the media about it, I feel that I have something to say that might be helpful.

Mr. Williams' struggles with depression and addiction are well-known, and it's very easy to point fingers and say, "that was what did it." I've heard variations on that theme all day, most of them said with the attitude that nothing could help it. One radio host even went as far as to say, "He was beyond help. He was too far gone."

I nearly had to pull my car off the road after hearing that, because I was so angry. I work all day with people who struggle with those feelings and with the pain and hopelessness that goes along with them. To hear a DJ blithely blame the victim was nearly too much for me. NO ONE IS "BEYOND HELP;" AND NO ONE IS "TOO FAR GONE." I can't emphasize that enough.

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When Is It Time To End Therapy?

8/6/2014

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In my work, one of the hardest things I face is letting a client know that it’s time move on. There are many reasons for ending therapy, and I’m going to explain some of them so you can see how complex the decision can be. I’ll start with a couple of reasons why clients end therapy.

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You Are Not Your Mood

7/14/2014

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Emotions are weird. They have a way of changing so fast we hardly know what hit us, and they can change our outlook on a situation, person or perception nearly as quickly. It helps to remember that as much as our emotions affect us, they do not define us. We are more than our emotions.

A few months ago, I struggled with this. I was feeling down - I was being impatient and it seemed like nothing was going right. Now, if you've been reading these blogs, you know as well as I do, that this is not the case. Red Flag #1 - feeling down about things does NOT mean that the feeling is reality. Ok, good enough - and I was still feeling lousy.

So, I thought...if I were the client, what would I be doing in therapy? (Yeah, I know... I'm a therapy geek.) Most likely, I'd be looking at the situation and testing out whether my emotions were really reflecting reality, or whether they were masking reality. How do you do this?

Marsha Linehan has a really cool tool that she uses in DBT called "chain analysis." You start with the event, behavior or situation that was the problem. In my case, I looked back to when I started feeling down, and the even had nothing to do with what seemed to be the situation. I was feeling lonely on the afternoon before, because I couldn't reach my family members to talk. That spiraled into feeling somewhat depressed. Specifically, I remember thinking, "I guess no one wants to talk to me. I might as well not exist." Red Flag #2: I was getting caught up in "Stinkin' Thinking."

In doing a chain analysis, you identify the event/situation that started the problem, describe the event, including what you were feeling and/or thinking at the time or what you did as a result of what you felt, and then describe how intensely you behaved, thought, or felt. In my case, the loneliness, sense of failure and depression were pretty strong. I ended up thinking, "I"m never going to be able to do this. I might as well just quit." Red Flag #3 - Stinkin' Thinking again. The idea here is that you want to describe all this in as much detail as you possibly can. Here's a good litmus test: Could someone recreate *exactly* what you went through? If so, then you've done it.

Next, you describe what led up to the feeling, thoughts, or behavior. In my case, not being able to talk to someone was the situation. This "precipitating event" (also called a "prompting event") is usually what we point to when we say that "such and such" caused the problem.

From here, you do a detailed description of all the things that affected the situation - Linehan calls them "vulnerability factors." In my case, I was tired from not sleeping well, I still had an annoying cough from a cold and didn't feel well, I was stressed by all the details stemming from running a new business as well as being worried about several emotionally intense client situations. I was overwhelmed, tired and not feeling good. I was also feeling emotionally exhausted by family situations and childcare issues.

Ok, here's where chain analysis gets tedious - you describle in minute, excruciatingly clear detail the chain of events - starting with the all the way at the beginning with precipitating event(s) and going all the way to the consequences. Ok - here goes: I called my mother and got her answering machine. I then called each of my sisters in turn and had the same result. I started feeling like I didn't matter. I called my husband, who was out at the park with our kids, and he didn't pick up. I started feeling depressed, and went to work on my task list for this week concerning my business and the paperwork I had to complete. Looking at the things I had to do, I felt overwhelmed and incompetent, and felt more depressed. I remember thinking, "Why bother?" and which led to a deeper negative mood. The consequences were that I was not present when my husband did come home and wanted to talk. Right then, I just wanted to be left alone to marinate in my own misery.

At that point, I recognized what was going on, and took steps to counteract the mood. The last step in the process is to describe in detail a prevention strategy and what you are going to do to repair negative consequences that resulted from your behavior or mood. In my case, my prevention strategy was stay mindful of my moods and to write. Writing in my journal, for me, is a safe place to vent and analyze what's going on. When I write, I feel better and so that's a good strategy for me to use. I can also go for a walk, and/or do something artistic. I could take a bubble bath, or have a hot cup of tea. Those are all things that help me - developing a list of what helps you will help you have something to turn to when you get feeling low. Nurturing and caring for yourself really IS important and necessary.

Luckily, the interpersonal consequences here were small. I went upstairs and apologized to my husband, and explained what was going on. I also told him that I needed some extra time to myself to write and sort out the depressed feelings.

If you're interested in more information on doing a chain analysis, you can go to a great website called DBT Self Help (www.dbtselfhelp.com) to get an idea of what this might look like in therapy or in practice. This website has an incredible array of tools, worksheets, handouts and articles.

Hope this helps - DBT helps with a lot of things - I highly recommend looking into it. Even if you don't go for it, learning about these coping tools and other tools available to you can help you get through these tough situations.

As Always:

Please Note: The content on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral.

If you are in crisis or danger, please call 911 for immediate help. Please, again, realize that seeking out help really IS a sign of strength and not a sign of weakness. You don’t have to be alone in facing these things – there are people who care and who will help. Email me at: thepowerofeachother@outlook.com

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Robin Williams, Suicide and Depression - Resources Updated

When Is It Time To End Therapy?

You Are Not Your Mood

Laura Burlingame-Lee:

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