Out of Depression: A Depressed Patient's Successful Self-Help

Chapter 22 In-depth analysis of depression (5)
Of course, one neurotic need always prevails over the other, but sometimes patients are caught in the conflict between the two neurotic needs and cannot extricate themselves.At this time, life is like a "battlefield" for him. He always has to worry about things that others don't worry about, always worry about things that are not worthy of attention, and always worry about things that are natural to others... Because of the conflict between different inner neurotic needs; the conflict between the true self needs and the neurotic needs will make his life miserable.

A male patient met his current girlfriend through someone's introduction. The relationship between the two is very good, and he loves her very much.But when he learned that she was not a virgin, he couldn't accept this reality and couldn't bear to separate from her, so he fell into depression, and this emotion also seriously affected the relationship between the two of them.Although he knew that he shouldn't care about such things, he just couldn't control his emotions and was caught in the inner entanglement of whether to break up all day long.Later analysis revealed that his inner conflict was actually the conflict between the needs of the true self and the needs of neurosis. For the time being, we think that "love each other" is a need of the true self, and "want to break up" is because he cannot face the neurotic need that his girlfriend is not a virgin, imperfect, and impure.In fact, he has very strict requirements on himself in life, and "shape" himself to be very pure. Such a "pure" him, of course "should" find a pure wife.So virginity isn't the real issue, the real issue is the morbid demands he places on himself and others.When the reality is inconsistent with his expectations, he can't accept it all.

Sometimes, in order to calm this contradiction, patients will also choose "ostrich mentality" (when in danger, ostriches will bury their heads in the sand, thinking that they are safe because they cannot see their eyes) to escape reality.In order to avoid failure, he will choose not to study hard, so even if he fails, he can always find a way for himself.In order not to face reality, he would rather live in a lie and prevent himself from seeing the truth.

A male patient has always played the image of a "good guy" in front of his family and friends, thinking that suffering is a blessing.As a result, he kept suffering, and even what others reminded him made him angry. His reason was: I am comfortable if you don’t say it, but I feel uncomfortable when you say it, so you might as well not say anything, and let me be in the dark in the drum.It's not that he didn't realize this, but he has been unwilling to let himself see this fact clearly.Otherwise, while playing the image of a good person, he has to face the reality that others don't appreciate it. This reality itself is a kind of irony to his "should".So he prefers to deceive himself.

When pathological "shoulds" dominate a person's life, he lacks human freedom and emotional spontaneity.He is "kind" because he "should" be kind; he likes to socialize because he "should" be noticed; he pursues a career because he "must" be successful. The degree to which "should" controls him is proportional to his fantasy. The more he falls into the idealized self, the more he can't distinguish his own "half and half", the stronger the control of "should".At this time his life is no longer real life, completely enslaved by "should".What is even more tragic is that he will find various justifications for this enslaved life and continue to maintain this enslaved life.For example, a college student, when he suspected that his father was having an affair, fell into severe anxiety because his "should" could not tolerate the incompleteness of his family; On the contrary, he despises the other party, because he thinks that a pure person should not "should" do this kind of thing; when he wants to buy a tablet computer, he also has a lot of worries, because he doesn't want to "hurt" those students with poor economic conditions; When he finds out that his toiletries have been touched by others, he never dares to use them again... Even though he has been bound by these "shoulds" as if he was wearing tights, he still uses some high-sounding reasons to support his "shoulds". ", such as sense of responsibility, kindness, empathy, and filial piety.And he just doesn't want to admit that he is merely enslaved by "shoulds" and that he maintains his morbid ego by enforcing those "laws."

When patients cannot realize their "should" in reality, they will turn to fantasy or dreams.A patient fantasizes about how successful and great he is before going to bed every day.Sometimes the patient also has a dream of flying non-stop, or in the dream he is a hero, a god who can save all living beings.When the reality finally makes him realize that he cannot achieve his "should" and cannot abide by his own "law", the whole person will fall into inferiority complex and self-hatred—hate that he has not achieved his "should".But one day he will realize that the root of all pain and tragedy is to force himself to reach his "should".

inferiority complex

When a person falls into the fantasy of an idealized self, he will regard the idealized self as the real self, and then he will put forward various "should" requirements for the real self.When you can't achieve it, you will fall into inferiority complex and self-hatred.He hates the real self, or in other words, he has never regarded the real self as himself, and the idealized self has always been the "true self" in his mouth.He has been trying to find his "true self", so he hates this "incompetent" self in reality so much.

He despises himself and despises others.Because neither he nor others have met the requirements of "should".Sometimes he also has people he admires, but these people are either historical figures, celebrities or politicians, or people he beautifies.His inferiority complex comes from the reality that he has not reached his ideal, while his conceit comes from the fact that he is perfect and unique in the fantasy world.Therefore, he often swings between inferiority complex and conceit.There is also an important reason why he dare not give up the pursuit of the idealized self: he is afraid that he will fall into the abyss of inferiority complex and cannot extricate himself.When he feels inferior, the "perfect self" in his fantasy is like a lifeboat, which can make him feel better temporarily.

In fact, both inferiority complex and conceit do not come from reality, but from fantasy.So his low self-esteem is completely unrealistic: after all, no one can always be successful, no one can be without flaws, no one can be immune to harm, no one can always surpass others and be recognized by others.If you feel inferior because you have not achieved these, it can only mean that there is a problem with the "reference" he is comparing with.Likewise, his ego lacks solid foundations, so it is easily damaged.To avoid damage to his ego, he avoids and distorts reality, while also experiencing intense anticipatory anxiety.Psychotherapy is actually to expose his ego, not to continue to maintain his ego.He begins therapy with strong "hopes," but when it turns out to be in the opposite direction of his "hopes," he also becomes violently resistant to therapy: he is uncommon for anything that undermines his ego. Terrified.Therefore, the fear and anxiety he expects are not actually from actual damage, but more of a kind of damage to self-esteem-when the self-confidence is expected to be damaged, strong anxiety will arise.For example, a person who is good at playing badminton starts to feel anxious one month before participating in the competition: firstly, he is afraid of failure; secondly, he is afraid that his shortcomings will be exposed in front of everyone.When his ego is damaged, it also creates intense anger and revenge.For example, when he lost a game of chess online, he even wanted to break the keyboard in half.Inferiority is not limited to feelings of inferiority. Intense inferiority complex can turn into self-hatred, which can also manifest as "self-torture" when self-hatred evolves into a kind of self-attack.The obvious self-torture is "self-harm", while the implicit self-torture is a "degenerate" way of life: he will engage in work that is obviously below his ability, and he will deliberately degenerate himself and fail to fulfill his responsibilities .Sometimes when you are in a high place or facing a sharp object, you will suddenly have the idea of ​​​​harming yourself.This kind of thinking will frighten him. In fact, this self-destructive impulse comes from self-hatred, and he cannot face this "stranger" in reality.

Ego comes from fantasies, not actual grades or advantages.Even if there is, it is not enough to maintain such a sense of superiority.A male patient, his mother was a cadre in the village when he was a child, so he had more authority in the village, but his mother passed away due to illness when he was 10 years old.Afterwards, his family declined, but he began to fantasize that one day he would be able to make a fortune and regain the sense of superiority he once had.In order to regain his sense of superiority, he always tries to surpass others in all aspects. Even though he is not better than others in reality, he is still very "confident" and he can always find his own "goodness" to defeat others.For example, his wife is a graduate of a famous university, but he thinks that his wife is uneducated and he reads a lot of books, so he is still better than his wife; while others are better at socializing than him, he thinks that he is highly educated and capable, so he is still better than his wife. He looks down on others; others are better-looking, but he is still unconvinced and thinks he is self-cultivated... In fact, his "confidence" is just unwilling to admit that he is an ordinary person.The source of each person's conceit is different. Some people maintain their conceit by not being hurt by others; world.A college student always has trouble with emotional issues, because he will constantly seek new goals.When the other party accepts him, that is when he loses interest in the other party.Because what he cares about is not possession, but conquest, and only this feeling can maintain his morbid conceit.

According to the proportion of low self-esteem and conceit in a person's overall emotional experience, we can roughly divide patients into two categories: those with pathological low self-esteem and those with pathological conceit.The former has been pursuing the perfect self in fantasy, but has not achieved it, and he will clearly realize that the real self is far from the ideal.Therefore, in this gap between fantasy and reality, in this contradiction between "should be" and "unattainable", he fell into inferiority complex all day long.His ego, if any, was fleeting.So in life, he will envy others more: he envies other people's figure, success, eloquence, and popularity.He will also fantasize about being like others, combining the advantages of many people, and only in this way can he get rid of inferiority complex.For the latter, he has been addicted to the fantasy of an idealized self, and he has regarded himself as the "Maxima" and "White Swan" in the fantasy.Of course, he may not admit the existence of his conceit, but his behavior has exposed his "pursuit": he is pursuing the feeling of being superior and dominating the world in almost everything; Abnormal fears everywhere; inexplicable anxieties about all things beyond his control.He will only feel inferior when the reality breaks his fantasy, but he can always find a way to escape the inferiority complex: either he chooses to escape, or he will desperately transform the reality, and sometimes he will use the "Ah Q spirit" to deceive himself .Therefore, pathological conceit dominates his emotional experience, and all his efforts are to maintain his conceit and idealized self.But we must also realize that this division is only a superficial difference, not an essential difference.After all, no matter the pathological conceited person or the pathological inferiority person, its root lies in the illusion of idealized self, but the external manifestation is different.

People with pathological low self-esteem are more likely to be diagnosed with depression because they have serious self-deprecation and self-attack, and of course their mood will not be better.People with pathological conceits are more likely to be diagnosed with social phobia, obsession, or anxiety.Because he is already living in the fantasy of a perfect self, he just needs to maintain it.Compulsion is the means by which he continues to struggle to maintain his idealized self; fear and anxiety are the emotional experiences when his ego is about to be exposed.From this, we will find that psychological diagnosis is actually of little significance to treatment. It is just a convenient description, not an essential difference.Discovering our inner drives, inner contradictions and conflicts, how we live in fantasy rather than reality, has more important implications for therapy.

In order to escape the "bad" reality, in order to find a sense of superiority over others, a person slowly regards imagination as reality or imagination as the highest pursuit.Inferiority has become the "whip" that makes him run like flying, and conceit has become his reward for "cultivating Taoism and becoming immortal", but he has not lived truly.The more one lives in fantasy, the more one escapes from reality.

Give up: escape from life
Abandonment, avoidance, withdrawal, dependence, and lack of courage are common phenomena in depression.On the surface, this phenomenon seems to be caused by setbacks and failures in reality, but its root is still from the "war" in the heart.

Patients will show a tendency to avoid work and avoid interpersonal communication, and sometimes it becomes a problem to even cope with daily life.Avoidance can also be expressed in the form of "pathological dependence": only by the side of the person on whom he depends can he partially face life, and he can do nothing without the object of dependence.At first, escaping would make him feel better, at least he would have less self-struggle.But you can escape for a while, but you can't escape for a lifetime. This is a war from the heart. Even if you escape from everyone and everything, it will not end.The origin of this battle lies in two selves: the idealized self and the real self.It is precisely because the idealized self cannot be achieved and the real self cannot be accepted, so he has been struggling in the contradiction between the two selves.In the beginning, he will struggle to get rid of his true self in order to achieve his idealized self. When this struggle becomes powerless in front of the reality, he will slowly become inferior and self-hateful.When he can neither give up his fantasy nor face his true self, he will escape from reality to make himself "peace of mind".After all, he himself can't face this "ugly" self, so how dare others find out, so escaping is also a means of maintaining his idealized self.Lack of acceptance of the true self, and sometimes being moved outside, as if no one would like him like this, no one would accept him like this, if you meet people with this kind of self, you will definitely be hurt or abandoned by others .In short, because of this external transfer function (projecting his inner thoughts onto others), he can find many reasons to support his escape, such as failure, denial by others, and difficulties in reality.But running away will not solve this inner war, it will only bring more failures and setbacks.The longer you escape, the less courage you have to face life and your true self.

There are three types of avoidance: overt avoidance, implicit avoidance, and pathological dependence.

(End of this chapter)