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DEPRESSION AND REALITY THERAPY

By Alec Watson

This article originally appeared in the September 1998 Newsletter of the William Glasser Institute Ireland and is reproduced by permission of the author. In it, Alec Watson refers to the "behavioural car." This is a way of illustrating a key aspect of Reality Therapy: imagine that our total behaviour is like a car in which the two wheels at the back represent feeling and physiology and the two front wheels represent doing and thinking. It is by changing the direction of the two front wheels that we change the direction of the car. In other words, to change how you feel, change what you do and/or what you are thinking.

Before I came to Reality Therapy I asked the Counsellor Teacher of our evening class what she had to offer us on the subject of depression.

"I find," I said, "That sometimes people come to you and say,'Iíve got depression. What are you going to do about it?'"

"Yes," she said, "I know what you mean. Iíll get back to you on it." But she didnít.

However, since discovering Reality Therapy I believe I have found the answer. I say that R.T. is a most useful tool for anyone who wishes to cease depressing and choose a more positive behaviour. Unfortunately this is not yet widely known or accepted and orthodox medicine tends to stuff people with drugs and considers that a good dayís work is done! To be fair they donít rule out counselling altogether but claim that a patient with severe depression needs to have their chemical imbalance corrected before they are able to benefit from counselling. Glasser, in his old book Control Theory, allows for drugs in hard cases as a temporary prop though he himself never uses them.

When working for an orthodox medicine helpline for depression, I had to be wary of saying too much about my Reality Therapy background. Our brief was to be a listening ear and to advise people to see their GP. On one occasion a twenty-two year old girl told me that she was not going to see a doctor and she would not take medication but wished to stop depressing herself. Under these circumstances I felt quite happy about explaining the behavioural car to her and how she might help herself by positive thoughts and happy actions.

Another time a lady detailed her depressing week, "Monday I stayed in all day, Tuesday my sister took me shopping and I went to bed early, Wednesday we went for a drive" and then her tone lightened a little and she said, "and we played crazy golf in Portmarnock." She continued the week with depressing blankness and then she stopped suddenly and turned to me and said, "What do you think?" I said, "Well, I rather liked the crazy golf." She sounded interested and said, "What do you mean?" I said, "Well you werenít depressed then were you?" "No" she said in a tone that suggested sheíd like to hear more. So I suggested maybe she could schedule crazy golf in a regular itinerary and maybe some other joyful pursuits as well. Both ladies left thanking me for the helpful insights.

Orthodox medicine holds that people are depressed because of a chemical imbalance. Glasser says that that is like saying a man was running because he was sweating. In each case the chemical imbalance and the sweat are the physiological component of the total behaviours chosen to depress and to run.

All cases are, of course, different. It is often necessary to build involvement, trust and empathy first rather than just thrusting a formula at a new client. Their hurt or whatever Ďdroveí them to depress may very well need to be expressed and accepted as genuinely painful.

Glasserís rule that it is better to do something rather than nothing and it is better to do something enjoyable rather than just "do" applies. That is to say it is better to walk up and down than just sit and it is better to go out for a walk with the dog or play tennis or whatever turns you on than just walk up and down.

Glasserís principle of tiny bites also applies. If the client feels they cannot manage a long walk how about the garden?

Much attention has been focussed on how to overcome depression. I think it is often forgotten that it is not always wrong to depress. Glasser himself has said, "I depress three or four times a day". It is often a wise choice: it is wiser than anger, which could have physical consequences. Often we need time to withdraw: bereavement is an obvious example. Depressing here and there is quite legitimate. It is only when the behaviour continues and no longer provides effective control that it needs to be addressed.

The point is that it is a choice.


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