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Page Contents: Whether intensive psychotherapy will make your depression worse.                    


I started going to a therapist because of depression and work problems. Up until now, the direction was that the depression was mainly due to a chemical imbalance. Now my therapist wants to go back to intensive psychotherapy to address ACOA issues. I am afraid going into these memories will send me back into deep depression. The literature says that the process is painful but nothing explains what the consequences can be. Can it send me into another depression?

We know from scientific research that the brain and the mind have a mutual influence on each other. Not only can chemical and electrical activity in the brain affect emotions, but pure psychological activity, such as meditation and hypnosis, can actually alter brain chemistry. So, even though depression may have a material cause in brain neurochemistry, it can also have a final cause in psychological conflicts, often around issues such as guilt and victimization.

Understanding all of this, then, perhaps you can realize that getting to the final cause of depression is far preferable, and or more practical benefit, than just using medications to suppress the material cause of your depression.

Psychological treatment for depression, therefore, in effect teaches you how to take command of your thoughts and other psychological processes so that you don’t end up feeling victimized by all the difficulties you have to cope with in daily life. You learn that no matter what happens in the environment around you, you still have options for how to respond honestly and responsibly.

Some persons, however, because of emotional wounds from childhood, can experience simple environmental triggers that get blown up way out of proportion to the reality of the situation. It’s as if the stimulus of the present is carried back into the past by a sort of emotional bridge, where it activates all sorts of feelings of childhood helplessness. So, one moment you’re an adult receiving a criticism from your boss, and the next moment you’re a terrified child who wants to run and hide from the world.

These sorts of irrational—that is, unconscious—triggers can make the management of depression extremely difficult. That’s why persons who have emotional wounds from childhood, such as ACOA (Adult Children of Alcoholics) issues, need to resolve those issues in psychotherapy in order to make the task of managing depression more, well . . . manageable.

Coming to terms with your ACOA issues, though, will be hard work. As an adult, it will be necessary to confront the terror you felt as a child because of a parent who, because of his or her alcoholism, was irresponsible, neglectful, critical, and, often, abusive. You will have to confront many different feelings, such as worthlessness and sadness, argumentativeness, confusion, and insecurity—and maybe even suicidal thoughts. You will often want to run and hide. It will be an often terrifying process of working past all your unconscious defense mechanisms to confront the ugliness within yourself—such as repressed anger and hatred—that you would prefer did not exist. But, if you have done the preliminary work of learning to recognize feelings of victimization when you feel them, you can accomplish the whole psychotherapy process without falling into clinical depression.


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Raymond Lloyd Richmond, Ph.D.
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