What does counselling for depression look like, when it is enriched by philosophy?
To answer this question, the first thing we need to do is distinguish between 1)depression that represents a medical disorder, and 2)depression that reflects a life problem. Some depressed people have chemical disorders which cause the problem. Others go through a loss, experience bullying, or struggle to find meaning or purpose, or some other problem in their life, and become depressed. The first is treated by GPs, clinical psychologists, and psychiatrists. The second is often addressed by counsellors who help you create improvements in yourself and your life. As a counsellor I help with the second, life-based depression.
To understand life-based depression, we might consider philosophical and psychological theories of what makes for happiness and a good life. Such theories usually point to love, work, and play. As we all know, things can go wrong in one or more of these, leaving you unhappy and even struggling for meaning. The problem can take many forms. It might involve a sudden crisis in life. Or it might be something more general, slower - say, regarding the direction of your life. For example you might not know what you want in life - will I have children? - and you feel distressed by your inability to decide. Or you do know what you want, but it involves contradicting goals. Or it involves one goal, but you can never seem to make that happen. Again, perhaps you do know what you want, and life is working out, but you are haunted by some old emotional struggle that won't let you be. At some point you collapse into a depression. For people with such depression, I will offer examples to describe how counselling - especially counselling with a dose of philosophy - can help you move forward.
Depression can be a kind of confused mourning. You might be mourning a person, or certain hopes, or even the future loss of things ("anticipatory mourning"). Depression and grief look alike, but so long as you are clear about the object of your feelings, then you are grieving. But you can lose sight of your lost object, and your emotions can shift from purposeful grief into to meaningless depression. You are sad and despairing but you don't know why, and so you are stuck.
Depression can also be a hatred for yourself. If you have felt unloved, especially as a child, you may have concluded that, rather than something being wrong with others or with life - which is scary, because we can't change those - that something is wrong with you. Strangely enough, this guilt and self-loathing feels safer than the sensatio of lacking control in an unloving world. But it morphs into a guilty depression.
Perhaps you have experienced a life trauma: you were betrayed, or assaulted, or bullied, or in some way your trust in life and sense of security was shattered, and now you feel isolated, unsafe, and deeply sad.
People often don't see these things clearly in themselves. Often the problem is implicit, and need to be made explicit. In my case I have learned most about myself through my dreams, especially at occassions in my life when I was suffering. I have reshaped aspects of my basic way of being in response, and it has made life better. In counselling others, I often help people to focus on the felt sense of things (if you come to counselling with me, you will probably hear that phrase), unfolding and unpacking your inner structures of emotion and thought, making the implicit explicit.
You could say that we are looking, rather than merely thinking. We go deeper than you may have gone before, and in a way you cannot achieve when by yourself. (People tend to do introspection in a vague, fuzzy way, whereas in counselling we do it in a much sharper way.) We look more and more deeply into your inner life, to see what's there, how things are connected, the structures and patterns that shape your thinking, emotions, and actions. Sometimes this activity in itself makes all the difference. By shining a light, you may find yourself able to let go of some things, move past others, and recognise and abandon old patterns. That's the great power of insight. For example, to use the three examples I offered of depression, you recognise what you are mourning and you now work through it. Or you see how you hate yourself and you workn on finding greater self-love and self-respect. Or you face your trauma with my support, and find the understanding and courage to withstand it.
Of course insight is not always enough. Implicit in what I just said, you may need to go further, working through those emotional problems, straightening them out, resolving them, shifting things, changing things, and growing. By paying deep attention - through our dialogue and your introspection - we get down to the root level of your emotional patterns in order to understand but also to do such work. It is hard to describe the practice for it is different to thinking - it is an active kind of feeling and sensing and then finding words - but if you have ever suddenly seen something painful in yourself, and in doing so felt an emotional release that helped, then you have some sense of what I am talking about.
Depression in the context of Direction and Purpose
An overarching area in which I help people with depression, regards depression which reflects problems of finding direction or purpose in life. As a philosophical counsellor I often focus on these two themes. So I will say something more specific about them before wrapping up.
Direction is about what you will do with your life. For example, what relationships will you create, will you have kids, and what work you will do. It is about emodying a movement toward a concrete future which is good for you and which you want. In short, you need to be able to make life work for you, to satisfy your desires at both the conscious level and at the deeper levels of your being. There is much that you cannot predict or control, but nonetheless, for most of us and by a certain time in life, we need a sense of direction. However many of us are poorly trained in finding this. Maybe we need better guides or mentors. Most people need help getting in touch with their real potential, and with the fundamental desires, which lie inside them. They need this kbnowledge so they can pursue a realistic future which matches their talents and deeper desires and motivations. When we lack this clarity and contact with ourselves, when we cannot work out what we want, or when we cannot make the life we deeply desire actually work, or when we have gone down the wrong path regarding these things, then we can easily become depressed.
This means that we need help to get in touch with what we most want. And that means we may need help integrating our contrasting desires. And we need help creating coherent and realistic direction that expresses that. We may need help getting past other obstructions such as fear or guilt. And we may need help more generally, in taking the steps forward in practical terms. In this way, counselling can help us get things in order - inwardly and outwardly - and to move forward, and in this way it can also cure our depression if that is based on being stuck about these things.
I spoke of both direction and purpose. Purpose is about having meaning beyond the things you will do with your life. It is about the deeper values you live by. And your sense of what life means, of why you should be alive. Of course, despite these distinctions, purpose intersects with direction. For example if your direction includes being in a committed relationship, your purpose may include loving others generously. Many questions about meaning, many existential crises, dissipate when love, work, and play are in good shape in a person's life - when we have a good direction and it is working. But there are legitimate needs that many of us feel regardless for a deeper philosophical, spiritual, or religious orientation toward life. Many of us have a hunger for deeper meaning no matter how good our life is. Of course we don’t want somebody to dictate our perspectives or values to us, but we do want help in developing our own orientation to life. For example I help people to hone their perspective so that it is a true to reality as possible and also as beneficial as possible. I may challenge them to develop it so that it supports them in the blindspots of their life, or in the challenges they may be yet to face in life. This is where a counsellor who draws on philosophy can really help.
I've spoken in some of my writing about my own struggles with depression in the past. It runs in my family, which in previous generations was full of violence and neglect - trauma that has been passed down - and my experience of an abusive stepfather exacerbated it. I've known some real darkness. This is why philosophy became such a passion for me, despite the fact I have little interest in scholarship. It is also why counselling, psychology, and spirituality are so important to me. I am speaking personally here in order to make a more general point: depression has been a real teacher to me. It has deepened my wisdom and understanding, and led me into many good places in life (rather than follow the usual family route and become a tradesman, I went and had a great adventure, spending time in a monastery, studying and teaching philosophy, and then becoming a therapist). It has made me more compassionate. And even in its worst, it has become a catalyst, a dark energy which has afterward propelled me and which I have channeled, leading me to grow into a much stronger and happier person. It has even led to wonderful changes in my outer life; I am writing this reflection from my office in a century-old cottage in central Victoria by the forest - my dream home - and the impetus to risk everything and buy this, which worked wonderfully, happened as part of a broader effort to make life better in the face of such affliction. I have never been happier, and much of that has to do with how I have responded to my own sufferings over time. Over time I have become increasingly strong and skillful at dissipating the storm clouds.
A depression such as I have been speaking about, which is rooted in an emotional problem or an existential one - a life-based depression - has this potential built into it. There is far more on offer than a mere cure. It's an old adage and can seem like a cliche, but it is profoundly true that sometimes we needed to sink low, and hit what feels like rock bottom, in order to change everything for the better. The strengths we need to make the journey upward can become increasingly muscular and permanent in us. We can become changed, much for the better. So don't romanticse it, but also, don't waste your depression. Use it as an impetus to make life better, and to grow inwardly. After all, this may be its purpose in your life.