Don’t Do It chair: ‘But I’d hate it.’
Get Counselling chair: ‘Aha! Now I get it! Of course you don’t like the idea of divorce! I don’t know many people who would. But that doesn’t mean you wouldn’t be able to cope. You were okay on your own before you met Eddie, and you can do it again. Being single may not sound too great right now, but there are other men are out there, you know.’
Don’t Do It chair: ‘Okay, I get your point. I wouldn’t like a divorce, but life would probably go on. Somehow I’d find the courage to carry this option out . . . I think, anyway.’
Adele feels more resolved in her decision to seek marriage counselling after trying out the ‘Choosing sides’ technique. Nevertheless, she still quails at the thought of approaching Eddie.
Don’t Try to Kid Yourself (K)
If you decide against choosing an option for dealing with your problem, kidding yourself that this is because you can’t make up your mind won’t work. Admit it! You are in fact making a choice – you’re choosing to live with your problem ‘as it is’.
You’ve been through the first four steps (CRIC) and have reached what seems to be the best decision. But you’re oh so scared! As the popular advert says – DO IT! Don’t try and kid yourself that you can’t decide – if you DON’T do it, then admit, you HAVE nonetheless decided . . . either to do nothing, or something else – but no way can you kid yourself you aren’t making any decision. It’s helpful reminding yourself that if the first decision doesn’t work out the way you’d hoped,at least that rules that one out for now – and there’s no reason why you can’t subsequently try something else!
As you can guess, some options for solving problems can result in unpredicted reactions. Remember, it’s quite possible to both be pretty certain that your decision is the right one, but still feel really scared at the prospect of carrying it out. If that’s the case for you, you may need an emotional plan for helping you proceed. And we just happen to have one for you in the ‘Easing Your Emotions’ section that follows.
Easing Your Emotions (E)
When you choose the option(s) that look like they having the greatest chance of helping to solve your problem, troublesome emotions may still threaten to sabotage your best intentions. This step in the problem-solving process is best viewed as an aid to help you in carrying out your choice of option.
If you are feeling very uncertain about what option to choose, go back through the suggestions in ‘Running Through the Routes (R)’, ‘Investigating Outcomes (I), and ‘Committing to a Choice (C)’earlier in this chapter. Possibly you’re still going to come up with the same solution, and be feeling worried and uneasy about committing to it, but we assure you that your uneasiness is a normal, common feeling. And, given the circumstances, it can be handled with this problem-solving step.
Most solutions to difficult problems require a certain amount of courage to implement. If the solution was easy, you’d have done it ages ago. After all, we did say difficult problems.
Here are two simple techniques that can help you settle your nerves and quell the queasiness in the pit of your stomach as you anticipate acting on your solution – rehearsal and self-talk.
Holding the dress rehearsal
Imagine what a West End musical would be like if the musicians, cast, and stage crew didn’t rehearse the show. The performance is likely to be a disaster. The performers have stage fright,no one knows what they are supposed to be doing. It probably wouldn’t take long for the audience to start voting with their feet! Rehearsals not only enhance performance, they also help to deal with anxiety and apprehension.
If your problem-solving option involves coming face to face with someone or makes you feel anxious, a rehearsal may help. You can rehearse your plan:
In your mind
In front of a mirror
Through role-playing with a trusted friend
By writing out a script and using it in any of the above situations
Practising self-talk
You may be thinking, ‘Talk to myself? You think I’m crazy?’ Actually, most people talk to themselves,but seldom try controlling the content of their self-talk rather just going along on autopilot. If you’re anxious or depressed, your self-talk usually contains negative predictions and self-defeating arguments.
The short positive self-statements in the following paragraphs are no cure for depression, nor do they work for long-term issues and problems. However, they can sufficiently motivate you to work through the difficult moments.
You can decide to select new, more productive content for your self-talk. To counter-argue against your negative thinking, you may first need to rehearse the script out loud. Write down short, simple, positive statements. Possibilities include:
What I’m about to do is the right thing to do.
This is really hard, but I can do it.
I really have considered all the options.
I have the right to do this.
Just do it.
Adele decides to ask her husband Eddie to see a marriage counsellor as the first step towards solving the marital problems she’s facing. She makes an appointment for an evening when they’re both free. She then rehearses how she’s going to approach Eddie with the idea, and chooses the self-talk coping phrase, ‘I can handle whatever reaction he has.’ She uses this phrase like a mantra, repeating it over and over in her mind as she approaches her husband.
Testing Out Your Solution: The Test Match (T)
Okay, now you’ve worked through the previous sections, you’ve gone through all the problem-solving steps except the final one. You’ve described the problem situation, chosen an option, and you’re ready to roll. The time’s come to go out to bat in the great Test Match of you versus your depression.
The chances of solving your problem are much greater having done your homework. But CRICKET doesn’t come with a label “ success guaranteed. After implementing your solution, then review how it worked. Carefully consider what did or didn’t go according to plan. Perhaps all’s well and the problem’s resolved. But if the problem or remnants of it remain, back you go to the drawing board and start working on a new CRICKET game plan.
Here’s how Adele’s CRICKET game plan works out:
Adele repeats, ‘I can handle whatever reaction he has’ in her mind as she walks into the study where Eddie’s sitting at the computer. ‘Eddie, can we talk for a few moments?’
Eddie swivels to face her and replies, ‘Okay, but not too long, I’m in the middle of something.’
‘This won’t take very long. I’ve been worried about our marriage; neither of us seems very happy,’ Adele begins.
Eddie interrupts her, ‘Speak for yourself. I’m not unhappy. Women! They’re never satisfied. What more do you want? This isn’t paradise; it’s real life.’
Adele, who is now close to tears, continues, ‘I’m not asking for the moon, Eddie. I want us to be closer. I’ve made an appointment with a marriage counsellor. It’s next Thursday at 6 p.m. Please come with me.’
‘Forget it. I’m not going to some touchy-feely, inquisitive therapist.’ Eddie’s voice rises. ‘And I’m just fed up with you frittering away all my hard-earned money. I’m not going to waste my time talking about this!’ Eddie turns back to his computer and ignores Adele.
Darnn! Adele went through all the steps, but still had a disappointing and upsetting result. It takes her a couple of days to recover, but she works out a new CRICKET game plan. This time she decides to go to counselling on her own and explore her other options with the help of the counsellor.
After several sessions, the counsellor helps Adele see that part of the problem in the relationship has been that Eddie won’t participate and Adele is left to make decisions on her own, which have implications for Eddie. Adele explains this to Eddie, and concludes by saying that if he chooses not to go for joint counselling, the only alternative she can see is for a temporary separation. She gives Eddie a week to consider what he wants to do.
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Eddie reluctantly decides to go to marriage counselling. To his surprise, they make excellent progress, using many of the techniques you can find in Chapter 14. Over the next few months, Eddie realises how much he values Adele. Both commit to making their marriage ever stronger.
If you or someone you care about is depressed, practically all problems loom larger than life, while solutions seem amazingly elusive. Take the time to prepare a game plan. See if playing the game of CRICKET might just work for you.
Part IV
Adjusting to Changing Relationships
In this part . . .
Interpersonal therapy is another widely researched approach to the treatment of depression. The evidence shows that it works. In this part, we cover key elements of interpersonal therapy, including how to deal with change, transitions, grief, and loss.
Depression also interferes with important relationships with friends, family, and colleagues. We give you tips and tools to enhance your relationships. We review ways to prevent you becoming cut off, showing you how to build bridges, and communicate more effectively with others. With these tools, your relationships can become a source of support rather than just another set of the problems that drag you down.
Chapter 13
Working Through Loss, Grief, and Mourning
In This Chapter
Understanding the different types of loss
Overcoming your grief
Have you ever stood at the kitchen worktop with tears running down your face when slicing up onions? If so, you’re experiencing your body’s natural response to something that’s causing you discomfort and distress. As you’re well aware, your body also produces tears in response to your emotions – such as the overpowering feelings brought on by loss and grief. Tears frequently can take the edge off sorrow – helping to calm or even wash away painful feelings.
Weeping is a normal reaction to grief and loss. However, sometimes grief takes hold and disrupts life in major ways. Grief can trigger depression (go to Chapter 2 for a description of the types of depression). Loss may bring on depressed feelings without you being aware of the cause. Events in the past may be continuing to trouble you much more than you realise. Even if you haven’t experienced a major loss in decades, looking at unresolved grief and loss may shed light on why you’re experiencing feelings of depression now.
In this chapter, we explore powerful responses to loss. We discuss various types of losses you may be experiencing and how you react to them. If you’re feeling depressed, do any painful feelings stem from one of these losses? Working through your grief may help lift your depression. We offer a variety of ways of doing this, whether the emotion is one of normal, uncomplicated grief, or has been triggered by a profound, traumatic experience.
Losing What’s Important to You
Everyone experiences loss of one kind or another during their lives. People grieve about all different types of losses. Yet the response to each particular loss varies between people. There are no hard and fast rules for predicting how someone is going to react when something awful happens. And there’s no right or wrong way to handle loss. Some people seem to bounce back surprisingly quickly, while others remain stuck in prolonged, intense grief.
If your grief lasts for months without a break, if you’re overwhelmed by thoughts of yearning and loss, if you have thoughts that the life is pointless, or if you feel worthless and excessively guilty, you may have a complicated grief and/or a major depressive disorder (Chapter 2 gives more information about grief and various types of depression). If you have any of these symptoms, please ask for professional help.
We can’t possibly give you a complete list of the types of losses that lead to grief, but the three major kinds are:
Death
Life transitions
Relationship loss
In the following sections, we discuss death, life transitions, and relationship loss in detail. There is no right or wrong way to deal with such losses. Understanding how each event affects you is what’s important. With awareness, or insight, you can draw on your resources for coping. In the ‘Working Through Grief’ section, later in this chapter, we give you ideas for handling these losses effectively.
Dealing with death
Death is never easy to deal with. Even people with strong religious convictions feel great sadness upon the loss of a loved one. Unexpected death is generally more difficult to accept than death following a prolonged illness. But the period of anticipation before the loss isn’t the only factor affecting the response to death. For example, the person’s age, the difficulty of the dying process, whether there was an opportunity to say goodbye, and the amount and type of support from friends and family available to the bereaved person all contribute to the reaction in complicated ways.
Are there stages of grief?
Elisabeth Kubler-Ross is a psychiatrist who has devoted most of her professional career to the care of the dying. Her widely cited book, On Death and Dying (Scribner), suggests that people go through a series of stages when they face terminal illness:
Denial: No way, I’m not ill; it can’t be me!
Anger: Damn it! Why me?
Bargaining: God, help me! I’ll do anything to get out of this.
Depression: I just can’t go on, I can’t stand it. I give up.
Acceptance: This is the end; I’ll try to go in peace with dignity.
These stages have been widened to include reactions to other types of loss, such as death of a loved one, loss of physical health, or relationship break ups. However, each person is unique, and it appears that not everyone goes through all the stages reported by Kubler-Ross. People can also bounce from one stage to another, skipping some or even returning to an earlier stage. In that sense, the best way to view the process is as a series of emotional reactions that people frequently experience, rather than a regular sequence of events.
Some mental health practitioners insist grief only resolves after experiencing all these stages, starting from denial through to acceptance. But no single, healthy way of going through the grief process exists. Each person grieves in their own unique way. Kubler-Ross’s work has helped people around the world handle difficult transitions. However, grief is complicated, takes many forms, and isn’t easily categorised.
Your relationship to the person plays a huge role in how the loss affects you:
Death of a life partner: This type of loss is often thought to be one of the most difficult to get through. It requires major adjustments.
Death of a child: Most experts believe that of all losses, this probably involves the most painful, lengthy recovery. Somehow it feels as though it’s against the laws of nature for a child to die before the parent does.
Death of a parent: The difficulty of this loss hinges on many factors, such as the age of the parent and child at the time of the death, the nature of the relationship, and unresolved issues. Sometimes the grief is actually intensified if the relationship was stormy and conflicted.
Death of a friend or relative: Again, the difficulty of dealing with the loss of this type of relationship varies considerably.
Death of a pet: The attachments people form with their pets can be very strong. Pets can become special family members. Others may not fully appreciate or understand the intensity of the bereavement that the loss of a pet can bring, especially when the person losing the pet is childless, by choice or otherwise. This lack of understanding by others can add to the sense of isolation.
Death of a stranger: Sometimes a traumatic event witnessed by uninvolved parties can cause grief reactions. For example, when a drunk driver kills a child, it may bring back painful and vivid reminders to an already traumatised family who lost a child years before. Or witnessing a violent crime may also have an enormous impact on the observer. There are also issues surrounding whether you could/should have attempted to intervene.
Changing with the times
Change is the only certainty in life. Nothing ever remains
completely the same. You play many roles, often simultaneously, throughout your life: parent, child, employer, employee, student, spouse, partner, to name but a few. Much of the way people see themselves comes from such roles, and these roles change over time.
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