chapte20 1989 88-149 January 25, 1990
The aim of this book is to better understand and cure depression--people's generally, and yours in specific. The core of depression is prolonged sadness plus a sense of worthlessness, in the context of an attitude of helplessness. To understand depression we must therefore understand how sadness is caused, and why it is prolonged in some people.
The most important idea in the book -- the key difference between modern scientifically-successful cognitive therapy and the older psychoanalysis which was never able to prove success in curing depression -- is that you have the power to alter your mood by changing your current patterns of thought. The current patterns of thought are largely under your conscious control, and are not dictated irrevocably by your childhood or your genes.
More specifically, your feelings are determined by your Mood Ratio, the comparison between what you think is your present state of affairs, and a counterfactual (hypothetical) benchmark state of affairs. You feel pain when a negative comparison -- a Rotten Ratio --- is in your mind. And when a negative comparison is combined with a sense of helplessness you feel sadness. If this occurs habitually, you will experience depression. The concept of Mood Ratio and the accompanying Self-comparisons Analysis constitute the key new theoretical and practical element presented in this book. This structure integrates and reconciles the apparently-conflicting central ideas of the main writers within the field of cognitive therapy.
The "numerator" in your Mood Ratio is what you believe your actual state of affairs to be at present. If you misconceive your actual situation to be worse than it really is, you expose yourself to a painful Rotten Ratio.
The hypothetical benchmark-state "denominator" in your Mood Ratio may be, for example, circumstances you formerly were accustomed to but lost, or a situation you expected or hoped for but that has not occurred, or a state of affairs you believe you ought to achieve but have not achieved.
Actual present conditions do not explain well why some people get sad (depressed) for a long period of time while others do not. There are a variety of factors that may be at work, singly or together, to produce a propensity for depression in an individual. These influences may usefully be thought of as existing in the present, though their causes are in the past: an example is poor methods of interpreting reality. Other influences must be seen in the context of the past, such as the death of a parent or severe parental punishment for not being sufficiently successful or dutiful. Different factors combined in a variety of ways cause depression in different individuals.
Though understanding the historical roots of one's depression may be illuminating, the main work of combatting depression deals with the contemporary thinking processes. You must reform the ways that you think so as to control the self- comparisons that you make.
Anti-depressant medications have an important part in helping some depressed people banish the pain of depression. But true cure calls for psychotherapy, by yourself or with the assistance of a therapist. A wise therapist can help you, but it is not easy to find a therapist who will be good for you, and an unwise therapist can make depression worse.
The fight against depression best begins by learning which negative self-comparisons the sufferer habitually makes. This is done by noticing and recording the self-comparisons that you make when you are depressed.
The next step is to determine why the person is making those particular negative self-comparisons; this requires an understanding of the psychological structure that is related to such negative self-comparisons. You should also ask yourself why you feel helpless to change your circumstances or the goals that you set, and why you feel that you must make the particular self- comparisons that you do make. It is possible to get rid of the sadness-causing negative self-comparisons even without understanding why you make them, but the understanding often is valuable. The causation of depression is not simple. Understanding it soundly helps point you toward successful tactics for combatting the depression.
Then you should formulate a strategy for attacking the depression. Improving the numerator in the Mood Ratio, by improving the accuracy with which you assess the actual state of your life, is often the best place to begin. If this tactic does not suffice, you may next attempt to change the denominator, the benchmark state against which you compare your actual state of affairs. If this still does not suffice, you may consider changing the dimensions on which you commonly compare yourself, away from dimensions on which you compare negatively and toward those on which you compare positively. Still a further step is to reduce the number of self-comparisons and self-evaluations you make, by immersing yourself in work or altruism, or by recourse to meditation or related devices. A combination of several intervention devices, including an effort to reduce the feeling of being helpless, may be best.
An extraordinary new (though very old) cure for some is Values Therapy. When a person's negative self-comparisons - no matter what their original cause - are expressed as shortfalls between the person's circumstances and her most fundamental beliefs (values) about what a person should be and do, Values Treatment can build on other values to defeat the depression. The method is to find within yourself other fundamental beliefs and values that call for a person not to suffer but rather to live happily and joyfully, for the sake of God or for the sake of man - oneself, family, or others. If you believe in the superordinate value of a belief which conflicts with being depressed, that belief can induce you to enjoy and cherish life rather than to be sad and depressed.
Practical exercises are important, especially recording your negative self-comparisons followed by analysing and demolishing them. And don't forget to plan and carry out lots of pleasurable experiences, an important part of therapy for depression.
Understand the key role of negative self-comparisons. Then study how you developed the propensity to construe your numerator or your denominator in such a manner that the self-comparisons are negative, and why you make self-comparisons as frequently as you do. Then decide what changes in your thinking you intend to make. Then develop the habit of thinking in these new ways which will reduce or eliminate your depression.
These are the possible tactics: (1) Improve the numerator in your Mood Ratio, by getting rid of misconceptions about yourself, or by learning that your capacities to influence events in a desirable direction are greater than you thought. (2) Alter your denominator to make it less formidable, by changing the benchmarks against which you compare your actual state of affairs. (3) Change the dimensions on which you habitually compare yourself. (4) Re-train yourself so you seem to yourself more competent and less helpless. (5) Reduce the number of comparisons you make each day, by immersing yourself in work or altruistic activity, or by recourse to meditation or related devices. (6) Examine your basic values to learn what is important to you that may influence your wanting to be depressed or wanting not to be depressed.
Others soon find their way back to joyful and productive life, and chances are you will, too. I wish you the best of luck.