Read Feeling Good: The New Mood Therapy Online
Authors: David D. Burns
(At this point I thought I had really made a mark. But again, in her adolescent insistence that things were no good, she continued to outmaneuver me and contradict everything I said. Her contrariness made my work with her challenging and more than a bit frustrating at times.)
H | But you see, there are so |
D | How do you feel when you’re feeling good? Do you feel that it doesn’t weigh out then, or do you just feel this way when you’re feeling bad? |
H | It all depends on what I want to focus on, right? The only way I get myself not to be depressed is if I don’t think about all the lousy things in this universe that make me depressed. Right? So when I am feeling good, that means I’m focusing on the good things. But all the bad things are still there. Since there is so much more bad than good, it is dishonest and phony to look only at the good and feel good or feel happy, and that’s why suicide is the best thing to do. |
D | Well, there are two kinds of bad things in this universe. One is the pseudo-bad. This is the unreal bad that we create as a figment of our imagination by the way we think about things. |
H | (interrupting): Well, when I read the newspapers, I see rapes and murders. That seems to me to be the |
D | Right. That’s what I call the real bad. But let’s look at the pseudo-bad first. |
H | Like what? What do you mean by pseudo-bad? |
D | Well, take your statement that life is no good. That statement is an inaccurate exaggeration. As you pointed out, life has its good elements, its bad elements, and its neutral elements. So the statement that life is no good or that everything is hopeless is just exaggerated and unrealistic. This is what I mean by the pseudo-bad. On the other hand, there are the real problems in life. It’s true that people do get murdered and that people do get cancer, but in my experience these unpleasant things can be coped with. In fact, in your life you will probably make the decision to commit yourself to some aspect of the world’s problems where you think you can make a contribution to a solution. But even there, the meaningful approach involves interaction with the |
H | Well, see, that’s what I do. I just get immediately overwhelmed with the bad things I encounter, and then I feel like I ought to kill myself. |
D | Right. Well, it might be nice if there were a universe where there were no problems and no suffering, but then there would be no opportunity for people to grow or solve these problems either. One of these days you’ll probably take one of the problems in the world, and contributing to its solution will become a source of satisfaction to you. |
H | Well, that’s not fair to use problems in that way. |
D | Why don’t you test it out? I wouldn’t want you to believe anything that I say unless you test it out for yourself and find out if it’s true. The way to test it out is to begin getting involved in things, to go to classes, do your work, and establish relationships with people. |
H | That’s what I am beginning to do. |
D | Well, you can see how it works out over a period of time, and you may find that going to summer school and making a contribution to this world, and meeting with friends and getting involved with activities, and doing your work and getting adequate grades, and experiencing a sense of achievement and pleasure in doing what you can—all of this might not be satisfying to you, and you might conclude, “Hey, depression was better than this.” And “I don’t like being happy.” You might say, “Hey, I don’t like being involved in life.” If that’s true, you can always go back to being depressed and hopeless. I’m not going to take anything away from you. But don’t knock happiness until you’ve tried it. |
Holly again experienced a substantial emotional relief as she realized, at least in part, that her intense conviction that the world was no good and life was not worth living was simply the result of her illogical way of looking at things. She was making the mistake of focusing only on negatives (the mental filter) and arbitrarily insisting that the positive things in the world didn’t count (disqualifying the positive). Consequently, she got the impression that everything was negative and that life was not worth living. As she learned to correct this error in her thinking, she began to experience some improvement. Although she continued to have a number of ups and downs, the frequency and severity of her mood swings diminished with time. She was so successful in her summer-school work that she was accepted in the fall as a full-time student at a top Ivy League college. Although she made many pessimistic predictions that she would flunk out because she didn’t have the brains to make it in academics, to her great surprise she did outstandingly well in her classes. As she learned to transform her intense negativity into productive activity, she became a top-notch student.
Holly and I had a parting of the ways after less than a year of weekly sessions. In the middle of an argument, she fled from the office, slammed the door, and vowed never to return. Maybe she didn’t know any other way to say goodbye I believe she felt she was ready to try and make it on her own. Perhaps she finally got tired of trying to batter me down; after all, I was just as stubborn as she was! She called me recently to let me know how things turned out. Although she still struggles with her moods at times, she is now a senior and at the top of her class. Her dream of going to graduate school to pursue a professional career appears to be a certainty. God bless you. Holly!
Holly’s thinking represents many of the mental traps that
can lead to a suicidal impulse. Nearly all suicidal patients have in common an illogical sense of hopelessness and the conviction they are facing an insoluble dilemma. Once you expose the distortions in your thinking, you will experience considerable emotional relief. This can give you a basis for hope and can help you avert a dangerous suicide attempt. In addition, the emotional relief can give you some breathing room so you can continue to make more substantive changes in your life.
You may find it difficult to identify with a turbulent adolescent like Holly, so let’s take a brief look at another more common cause for suicidal thoughts and attempts—the sense of disillusionment and despair that sometimes hits us in middle age or in our senior years. As you review the past, you may conclude that your life hasn’t really amounted to much in comparison with the starry-eyed expectations of your youth. This has been called the mid-life crisis—that stage in which you review what you have actually done with your life compared with your hopes and plans. If you cannot resolve this crisis successfully, you may experience such intense bitterness and such profound disappointment that you may attempt suicide. Once again, the problem turns out to have little, if anything, to do with reality. Instead, your turmoil is based on twisted thinking.
Louise was a married woman in her fifties who had emigrated from Europe to the United States during World War II. Her family brought her to my office one day after she had been discharged from an intensive care unit, where she had been treated for an almost successful and totally unexpected suicide attempt. The family was unaware she had been experiencing serious depression, so her sudden suicide attempt was a complete surprise. As I spoke with Louise, she told me bitterly that her life had not measured up. She had never experienced the joy and fulfillment that she dreamed of as a girl: she complained of a sense of inadequacy and was convinced she was a failure as a human
being. She told me that she had accomplished nothing worthwhile and concluded her life was not worth living.
Because I felt a rapid intervention was necessary in order to prevent a second suicide attempt, I used cognitive techniques to demonstrate to her as fast as possible the illogic of what she was saying to herself. I first asked her to give me a list of things she
had
accomplished in life as a way of testing her belief that she hadn’t succeeded at anything worthwhile.
L | Well, I helped my family escape from the Nazi terrorism and relocate in this country during World War II. In addition, I learned to speak many languages fluently—five of them—when I was growing up. When we came to the United States, I worked at an unpleasant job so that enough money would be available for my family. My husband and I raised a fine young son, who went on to college and is now a highly successful businessman. I’m a good cook; and in addition to perhaps being a good mother, my grandchildren seem to think I’m a good grandmother. These would be the things which I feel I have accomplished during my life. |
D | In light of all these accomplishments, how can you tell me you have accomplished nothing? |
L | You see, |
I realized that Louise was upsetting herself unnecessarily by saying, “It doesn’t count” with regard to anything good about herself. This common cognitive distortion, called “disqualifying the positive,” was her main enemy. Louise focused
only
on her inadequacies or errors, and insisted that her successes weren’t worth anything. If you discount your achievements in this way, you will create the mental illusion that you are a worthless zero.
In order to demonstrate her mental error in a dramatic fashion, I proposed that Louise and I do some role-playing. I told her that I would play the role of a depressed psychiatrist, and she was to be my therapist, who would try to find out why I have been feeling so depressed.
L | (as therapist): Why is it you feel depressed, Dr. Burns? |
D | (as depressed psychiatrist): Well, I realize that I’ve accomplished nothing with my life. |
L | So you feel you’ve accomplished nothing? But that doesn’t make sense. You must have accomplished something. For example, you care for many sick depressed patients, and I understand you publish articles about your research and give lectures. It sounds like you have accomplished a great deal at such a young age. |
D | No. None of those things count. You see, it is every doctor’s obligation to care for his patients. So that doesn’t count. I’m just doing what I’m supposed to do. Furthermore, it is my duty at the’ university to do research and publish the results. So these are not |
L | (laughing at herself—no longer being the therapist): I can see that I have been criticizing myself like that for the past ten years. |
D | (as therapist again): Now, how does it feel when you continually say to yourself, “It doesn’t count” whenever you think about the things you have accomplished? |
L | I feel depressed when I say this to myself. |
D | And how much sense does it make to think of the things that you haven’t done that you might have liked to do, and to overlook the things that you have done which turned out well and were the result of substantial effort and determination? |
L | It doesn’t make any sense at all. |