Self-comparisons constitute the choke point for depressing thoughts. They are the final common path through which all depressing forces exert their influence. And if the person feels helpless to improve her situation, the sense of helplessness combines with the negative self-comparisons to cause sadness and depression rather than a state of mobilized activity or an angry mood; this description has been repeated many times earlier in this book because it is the core mechanism of depression. This short chapter briefly discusses the sense of helplessness, and how to get fight it.1
Negative self-comparisons (neg-comps) by themselves do not necessarily make you sad. Instead, you may get angry, or you may mobilize yourself to change your state of affairs. But a helpless, hopeless attitude along with neg-comps leads to sadness and depression. This has even been shown in well-known rat experiments2. Rats which have experienced unavoidable electric shocks later behave with less fight, and more depression, with respect to electric shocks that they can avoid than do rats that did not previously experience unavoidable shocks. The rats which experienced unavoidable shocks also show chemical changes associated with depression similar to humans. It behooves us, then, to consider how one can mitigate the helpless feeling.
People as well as rats learn general attitudes about their capacity to act effectively, which then affect their outlook on specific situations. When I was an infant, my parents put me into a large box-like structure hung outside a second-floor window, well-checked by an architect friend for safety. In accord with the theory of the times, they taught me independence by refusing to accede to my cries when I sought attention and company. Throughout my life, I have had a predisposition not to ask others for help such as advice, and support within institutions, because I assumed that help would not be forthcoming. It is entirely possible that my attitude of not expecting help from people, stems from my experiences outside the window as a child, probably accompanied by a general attitude on the part of my parents of making me go it alone. On the other hand, I have always had the feeling that I could master my physical and mental circumstances with study, hard work, and patience so as to make my living situation comfortable and convenient, and my intellectual problems superable, and to make do with my own company. In such fashion are lifelong attitudes acquired with respect to capability and helplessness.
One obvious tactic is to realize that you are not helpless and you can change your actual state of affairs so that the comparison will be less negative. Sometimes this requires gradual re-learning through a graded series of tasks which show you that you can be successful, eventually leading to success in tasks that at the beginning seemed overwhelmingly difficult to you. This is the rationale of many behavioral programs that teach people to overcome their fears of going out in public, of heights, of various social situations, and so on.
Indeed, the rats mentioned above which first learned to be helpless when given inescapable shocks afterwards were taught by experimenters to learn that they could escape the later shocks, and they thereby showed diminished chemical changes associated with depression. The underlying assumption of "learned helplessness" is that if a depressive learns to feel more capable and less helpless, she will be less prone to sadness and depression, because her neg-comps will then be accompanied by purposeful activity to change them.
It is not always clear just how capable people ought to feel. Sometimes vacationers are told that they are capable of swimming across a body of water which they are not capable of swimming, and hence they drown. Sometimes students are told they are capable of mastering programs which are too much for them, and hence they fail painfully. People's situations are not always like the situations of the laboratory rats which have been taught to act as if they are helpless when in fact they are able to escape from the shocks they receive.
External conditions may dictate that the individual is indeed helpless to improve a particular neg-comp. A 55-year old tennis player cannot realistically hope to improve his speed afoot to again beat the younger partner who has just begun to beat him.
Exhaustion and ill health also restrict a person's possibilities for improving one's situation. It is thoroughly reasonable that lack of energy and sad feelings often keep company.
Often, however, people feel helpless because they have "learned" to think that they are helpless in circumstances which another person would feel capable of changing in order to improve the neg-comp. Whereas a "normal" person might decide to change her work-habits so as to remove the cause of a boss's criticism, a depressive might think that she is helpless to alter the boss's judgment.
Sometimes you can change your state of belief about what you can do so, in order to feel less helpless. Athletic coaches often encourage players and persuade them that they can attain goals that they believe are beyond them, and thereby enable them to attain performances they otherwise would not reach. Toward the end of every marathon, there are bunches of bystanders who shout "You can do it" as flagging runners stagger toward the finish, and these shouts may help them along.
The underlying idea is that our judgments are affected by the opinions of others as well as by the experiences that we bring to the judgment; if the others' opinion is that we "can do it", we are more likely to believe that we can, and hence feel less helpless. Teachers in all fields employ to good effect the arts of encouragement and reassurance.
It is important to keep in mind that the very fact of being depressed biases our judgments of our capabilities in a negative direction, just as the other polar mood -- mania -- makes us feel capable of doing anything, including many things that we should not do.
Another way to increase your sense of mastery and decrease your sense of being helpless is by a graded series of practice exercises which demonstrate that you can indeed do more than you think you can. This is dramatically evident in the physical therapy of persons who have been injured or otherwise suffered diminished physical capacity. Taking one step, then two steps, then four steps, and so on, builds both physical capacity and belief. The same is true of learning to overcome phobias. The person who is afraid of heights can first practice on small hillocks, then hills, then low buildings, and continuing into higher places. This sort of practice is a key tactic staple of behavioral psychotherapy in fighting fears.
Taking a gradual view of improvement is important in occupational and educational matters, too. I once knew a gifted student of mathematics who had dropped out of school several times because he could not stand the pressure. Then each time he would return, vow to make up for all his past defaults, and proceed to work sixteen hours a day -- until he again cracked up, at which point he became depressed. With each crackup he felt more helpless to get back on the track and mold his life into sound order. It would have been much better if he had studied part-time for a while, first just one course while working, then two courses, then perhaps three courses on a "full time basis", and so on, to build his confidence and a record of success.
It is important to arrange the practices in such fashion that they do not arouse the very sense of helplessness that is being attacked. For example, the instruction "Bend down and touch your toes" only discourages a person who cannot now do it. But the instruction "Bend downwards as far as you comfortably can" does not set up an unattainable goal but rather an attainable one.
A counselor can go beyond simply stating an opinion about our abilities, and can engage in argument with us about our capacities. And a counselor can show us how we are biased in our negative opinions about our own capabilities. The counselor can even get us going on the process of successfully learning from experience that we can do more than we had thought we could. But much more than that another person cannot do for us, and indeed, much more than that one cannot do for oneself. This is not to diminish the importance of the process, but rather to suggest how little there is to say about the process of coming to feel less helpless.
Judging from animal experiments3, it is probably possible to reduce the sense of helplessness in humans with the use of chemicals. And this can constitute a basis for drug treatment of depression; the drugs reduce the helpless feeling, which in turn reduces the sadness, and also perhaps enables to person to learn to overcome obstacles which lead to unlearning the sense of helplessness. Assessing the usefulness of this approach is part of the overall assessment of drug therapy discussed in the Appendix to Chapter 4.
The building of trust in a therapeutic relationship may also have a beneficial effect on the numerator of the Mood Ratio. Believing that you are helpless is equivalent to believing that that nothing you do can improve your actual situation. When you distrust the reliability and goodwill of the world around you, you are more likely to feel helpless and hence depressed. So improvement of the ability to trust--to have hope that the world will respond positively toward your initiatives--can work against depression. And this can sometimes be learned in a patient- therapist relationship.
Here is the story of a woman journalist, Nancy Chevalier, who learned that she was not helpless to control her depression, and has actually done :
After my long ordeal, I came to realize that all the doctors and pills and therapies psychiatry had to offer would never be enough. Somehow, I would have to build up my own resistance to this horrible mental illness. I, myself, would have to develop some control over it.
In addition to taking the medication, I began to walk an hour every day, to do every volunteer job I could find and to take up creative writing and yoga. I listened to music--all kinds of music at all hours of the day and night. Charlie Byrd, Vivaldi, Johann Strauss, Stan Getz--all played a role in my self-styled therapy.
Although I had never been a good dancer, I began to twirl around the living room, fantasizing I was in Vienna in a gorgeous ballgown, waltzing the night away.
In my fantasy, I imagined that there was a mangy black dog on my shoulders, but I waltzed so fast that he finally couldn't hang on any longer, so he fell to the floor and ran off. And I just kept on dancing the whole night through.
The visualization was so powerful that I literally felt myself to be there in Vienna, in that ballroom. No one could be depressed in that ballroom. I would not be depressed; I would be well and happy. I told myself this over and over again while listening to the music. After several weeks, the depression lifted and I was well once more...
For over three years now, I have managed to keep my illness at arm's length by taking my medication and using these various techniques.
Two years ago, while vacationing with my husband on the Hawaiian island of Kauai, severe depression struck once again. But I made up my mind to try to control it. Although barely functioning, I drove 30 miles to the nearest drugstore, where I located some dusty tapes of Strauss waltzes, which I then played day and night. At first, I could only move one finger slowly to the music, but I kept on playing the tapes over and over. I told myself that I would not be depressed in Hawaii, I would be joyful in Vienna. The music and visualization worked and the depression disappeared in a few weeks.
That mangy black dog is still there; he didn't die
CONTINUE INSERT 211V
and I know it. I can sometimes feel him lurking around. But as he approaches me and begins to pounce, I take out my medication, my writing notebook and my waltz tapes and I scare him off. It's all I can do, but I do it so faithfully and fiercely that I like to believe that I've gotten rid of him forever. And maybe, just maybe, I have. (Chevalier, 1990, pp. 12-14.)
My own is another story of learning that I could control the depression - though at first only one day a week - and then successfully doing so for more than 17 years now without relapse, after 13 years of depression. (See the Introduction and Epilogue for more details.)@@@
Self-comparisons are the final common path through which all depressing forces exert their influence. And if the person feels helpless to improve her situation, the sense of helplessness combines with the negative self-comparisons to cause sadness; this is the core mechanism of depression. A helpless, hopeless attitude along with neg-comps leads to sadness and depression.
Often people feel helpless because they have "learned" to think that they are helpless in circumstances which another person would feel capable of changing in order to improve the neg-comp.
One obvious tactic is to realize that you are not helpless and you can change your actual state of affairs so that the comparison will be less negative. Sometimes this requires gradual re-learning through a graded series of tasks which show you that you can be successful, eventually leading to success in tasks that at the beginning seemed overwhelmingly difficult to you.
Sometimes you can change your state of belief about what you can do so, in order to feel less helpless.
Another way to increase your sense of mastery and decrease your sense of being helpless is by a graded series of practice exercises which demonstrate that you can indeed do more than you think you can. It is important to arrange the practices in such fashion that they do not arouse the very sense of helplessness that is being attacked.
page 1 \depressi \bhapte17 88-149 January 29, 1993