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

Chapter 23 In-depth analysis of depression (6)
Significant avoidance obviously avoids interpersonal communication and life, and patients may end up living in a world of one person, and only when they have to communicate with others, they will bite the bullet and do it.He almost gave up all efforts and attempts, everything was too far away from him, only the pain was so real.At this time, the patient seems to be on an isolated island, and it is difficult for others to understand his feelings. This feeling of isolation will aggravate the degree of depression and despair.He wanted to do something, but he didn't know what to do to help him. He could only see himself being swallowed up by pain and despair little by little.A girl who just entered her senior year wanted to take a year off from school because she was afraid of interacting with others and fearing that others would discover her shortcomings.Although she knew that the problem was her own, she tried to solve it by avoiding it—she fantasized that everything would be resolved naturally after a year off from school.But even though she ran away from the school and the crowd, she still felt unsafe, because she couldn't relax even with her parents, and she could only get a short peace in a world of one's own.So escaping did not free her, but strengthened the fear itself, making her even more powerless to face reality.

Implicit evasion is difficult to spot without careful analysis.For example, if he doesn’t fall in love, he will explain himself as preferring lack; if he doesn’t make friends, he will explain himself as being indifferent; Many viewpoints are found in the values ​​to support one's behavior, but its root is still an escape.A female patient quit her job to help her husband run the company.But when managing the company, because she was too strict and demanding, she was disgusted and resisted by some employees.Her ambition and enthusiasm at the beginning were hit hard, and she would dream about the difficulties in the company's management in her sleep.In order to get rid of the anxiety that exists all the time, she left her husband's company.But she has been unable to find a suitable job.Because she set a lot of restrictions for herself when she was looking for a job this time: she didn't dare to enter a small company, she thought her working style was not suitable for a small company, and she didn't dare to take a position related to management, because she thought I am not suitable for management.On the surface, she seems to be very self-aware, but after in-depth analysis, it is found that her "self-knowledge" is just avoiding failure and escaping the blow to her self-esteem.It is precisely because of her conceit that she is too strict in the management of the company. Her strictness is only to avoid failure; it is also because of her conceit that she cannot tolerate setbacks at work and brings anxiety to Come in sleep... Avoidance is sometimes manifested as avoiding reality with compulsive behavior-if he is afraid of illness, he will constantly check to rule out the possibility of illness; if he is afraid of being surpassed by others, he will not He keeps forcing himself to work hard and cannot tolerate his own mistakes and failures; if he is afraid of the death of his relatives, he may keep away from those things he thinks are unlucky.All his actions are to avoid an inevitable reality, in order to reduce the anxiety and anxiety in his heart.

Such patients will also be found in the treatment. The biggest feeling they give people is not arrogance, but detachment.Although he can work and live normally like others, he doesn't want to get too deep.Because he is afraid that he will be "polluted" by others and the world, so he has been trying to "get out of the mud without pollution" in this "filthy" world.Therefore, even if he has friends by his side, they will never approach his heart; even if he has a lover, he is only with him to fulfill his responsibilities; It is a means of survival... Because they are disappointed in this world, others, and sometimes themselves, so even if he has a superior material life, he is lonely and suffers spiritually.He sometimes uses alcohol to numb himself, sometimes escapes reality through superficial entertainment, and sometimes expresses his dissatisfaction with the world by not wanting children.Because he already hated this world deeply, so he didn't want the next generation to continue to bear his own pain.Moreover, it is difficult for them to admit that they have psychological problems. Only when there is a strong conflict with their family members on the attitude of some specific events, will they be forced by their family members to undergo psychological treatment, such as not having children, using alcohol to relieve sorrow, depression and depression .Even in the counseling room, he would still defend his choices and judgments, blaming his family for interfering with his "freedom" and "independence."His "freedom" and "independence" have obviously put him in isolation, so his "transcendence" will make people feel a sense of distance with him, and he is like an "angel who fell into the world".In fact, he just uses "transcendence" to escape reality; uses "transcendence" to maintain his conceit;So "transcendence" is also a kind of escape: escape from this helpless reality, the "dirty" world and the powerless self.

Pathological dependence is to "fake the power of the tiger" by attaching to a more powerful individual.This has also become a means of maintaining an idealized self.At this time, he can no longer be responsible for his own life, and shift the responsibility of life to others.In treatment, some female patients (of course, not limited to women) will be found to be overly dependent on their lover, and sometimes this dependence is completely pathological.For example, you can't live alone without the company of your lover, you can't do anything without the company of your lover, and everything in life without your lover is meaningless.Although she said it was "love," this "love" had been distorted by her neurotic needs and turned into a pathological dependence.Sometimes, in addition to "love" giving people this "shelter" function, some people will also devote themselves to religion.The purpose of his belief in religion is not only to be convinced of the teachings, but also to use a stronger "power" to wash away his "sin" and enhance his "power" to achieve "control" over himself and his life. force".In fact, this is also an implicit escape, escaping from the limitations of oneself as a person in reality, and still maintaining a fantasy world and oneself.

Almost all escapes are due to lack of courage to face reality, but patients can always find various "reasonable" excuses for their lack of courage.Significant avoiders will find all kinds of practical reasons: others don't like me; I can't be my "true" self; others will hurt me and reject me; ...implied escaper "IQ"

Even more, in order to avoid damage to his self-esteem, even if he escapes, he can find "reasonable" reasons for himself: if he doesn't study hard, he will complain about the unfair examination system; if he dare not take risks, he will call himself "steady" ; he does not have a certain quality, so he will underestimate this quality; It is a kind of closeness and a good relationship), she will be considered "noble personality", and she can also find a sense of superiority from it.When others achieve the success she expected, she will continue to beautify herself: "I didn't try my best" or "That result is not important to me, I don't like it at all".The pathologically dependent person seldom reflects on his own problems. When the dependent person does not treat him as "gentle" and "considerate" as he thinks, he will think that the other party does not "love" him enough.Sometimes, there is no need to continue the relationship, and he will hold on to the other party for "eternal love".He will also try to beautify the dependent, only in this way can "love" bring him more power.Under the effect of this kind of morbid dependence, he no longer knows what true love is, and he doesn't know what kind of person he likes.As long as the other party has a solid "arm" and can take up the responsibility of life for him, he will "love".So he is extremely worried about being abandoned by the other party. If he is abandoned by the other party, he will become an "empty shell" with no value and no strength.

Trying to use escape to resolve the inner conflict can only make the inner "war" more intense.Because what is escaping is reality, what is maintained is fantasy, and the war between the two selves will become more intense and irreconcilable.When the war between the two selves cannot be stopped, when all attempts to eliminate the real self fail, and all attempts to achieve the idealized self end in failure, more intense self-hatred: self-harm and suicide.

Self-Mutilation and Suicide: Deep Self-Hate

"I've had enough of this world, and I've had enough of myself. I can't help, and I can't save myself. The person I feel most sorry for is myself. I can't help myself fulfill all my wishes, and I can't even fulfill one. Wish. I can't make myself happy, I can't make myself successful, I want to love myself and others, but I can't do all of this. I'm afraid of death, I'm really afraid, but what am I living for? There is no purpose, no direction, and no happiness. I just live in anxiety and fear. I really want to save myself, I really want to... But I really can't do it alone, no one can help me, No one understands my feeling of being alone, and I don’t know how to connect with others. Over the years, death has become an expectation for me.” — A patient’s letter to himself during a depressive episode .

When in depression, sometimes the patient will show self-harm and suicide behaviors, which actually reflect his self-hatred.The more I hate the real self, the more unreachable the idealized self is, the more desperate I will be, and the more cruel I will be to my body.It's like treating an outsider's body instead of your own.It is precisely because he does not regard the real self as himself, but has been living in the fantasy of an idealized self, so he turns a blind eye to the real self, and even hates it to the bone.In his consciousness, he will think that his real self is an obstacle to his idealized self, which prevents him from living the life he wants.

Self-mutilation and suicide often become the last choice for patients to escape from reality.At the beginning, the patient often spends a lot of energy to "reform himself", which includes almost any aspect that makes him feel inferior.For example, if he feels inferior because he is introverted, he will try to be outgoing and talkative; if he feels inferior because he does not have enough friends, then he will try to make more friends; He will desperately lose weight, or ignore the risks of plastic surgery to achieve his ideal body; if he feels that he is not successful enough, then he will desperately pursue the success he expects...Anything he is tired of needs to be changed. What you don't want to see needs to be hidden.For example, he will try to hide his nervousness, his unhappiness, his blushing, his failure, his anger, anything that upsets him.Although this would make him live a very unreal life, he just dared not live out his true self.Because the real self in his heart is too failed, too wretched, too incompetent, too unlovable, and too easily rejected and denied by others.Sometimes, even if he "succeeds," he manages to change or hide some trait he hates, he experiences a momentary surge of elation and pride, as if he had overcome depression.But the good times don't last long. After all, one cannot succeed in all aspects, one cannot turn all aspects into what one expects, and one cannot cover up all the shortcomings or so-called defects that he does not want to see.When he finally realizes that he can't be what he expected in his heart, he will fall into deep inferiority complex and self-hatred again.At this time, he will repeat the above steps again, hoping for a miracle, and his mood will improve miraculously.But people in depression often "expect" too much, as if negotiating with fate: only if you (fate) meet my expectations, can I show you happiness.But fate does not accept this, and reality will not change because of your "expectation".When all the struggle and pain are of no avail, this struggle will turn into a denial of yourself in reality.When this kind of self-denial accumulates to a certain extent, it will change from quantitative to qualitative, from inferiority complex to self-hatred.What he hates is that in reality he can't become his ideal, and what he hates is that the life in reality is not the life he wants.When he can't change himself in reality, and can't get the life he expects, he will fall into deeper despair.Of course, at this time, he will also have a little fantasy: he thinks that it is depression that makes him unable to do what he wants, and that it is depression that makes him so "failed".In the end he could only imagine that without the depression, everything would be different.

Gradually, from the unsuccessful struggle in the first stage, the patient slowly becomes like a general who has been defeated repeatedly.In the end he became dejected and hardly put up mass resistance anymore.When he realizes that he can't change himself, can't get out of depression, no matter how hard he tries, it won't help, the motivation to change himself will gradually weaken due to low self-esteem, and then self-hatred will take over the "handsome position".Of course, this does not mean that the patient has given up the pursuit of the idealized self, but that self-destructive actions and performances have gradually increased.Because constant disappointment will bring deep despair, and this despair will deepen the degree of self-hatred, and then thoughts and behaviors of self-harm and suicide will appear.

In the beginning, this kind of self-destruction only stays at the level of thoughts, and will be directly or indirectly manifested in daily life.The patient's relatives and few remaining friends will also feel this, but it will not be paid enough attention. After all, people around the patient cannot be expected to be as sensitive to it as psychologists.When this kind of thought continues to accumulate in the patient's brain, and when the thought finally rises to the level of behavior, the people around the patient start to worry and worry about it.Some were unfortunate enough to lose their lives in the very first act of self-destruct.But more people don't really want to kill themselves, they just use this behavior to express their self-hate and a silent struggle against the unchangeable reality!

After that, more self-harm and suicide behaviors will appear.The frequency of occurrence is directly proportional to the degree of self-hatred, the more you hate yourself in reality, the more you will commit suicide.This behavior is informal and can range from mild self-harm to suicide.People around the patient are also worried about this, fearing that the patient will suddenly end his life.At this time, the patient also showed helplessness: I don't want to treat myself like this, but I can't change myself.There is still hope in the patient's heart, but his hope is still to "get rid of depression", and then he can become his ideal self.The more you can't achieve it, the more you struggle; the more you can't achieve it, the more you hate yourself and depression... In the end, only death can help you solve all this: since you can't change it, then end this losing game!This seems to be the "subtext" in the minds of patients with suicidal thoughts and behaviors.

In fact, patients do not realize that the question is not whether to end life, but whether the reasons for ending life are worthy of scrutiny.People who are in a state of depression, although they do not want to end their lives deep down in their hearts, because they cannot get rid of the hatred for their real self, they are "contradictory" and continue to hurt themselves.Although deep in his heart he could not give up his yearning for a better life in the future and his loved ones and friends, but the inner conflicts and struggles made him unable to calm down. Only physical pain and the idea of ​​giving up all these things could make him feel better temporarily.The conflict between his real self (a failed and incompetent self who even hates himself) and his ideal self (a capable, flawless, good enough self) prevents him from quitting this endless war.

(End of this chapter)