Coaching a person who is receiving psychiatric care
Recently a client visited me for coaching because of her depression even though she had received psychiatric care for the last 9 years. We started talking and she told me that she was originally admitted due to a serious compulsion.
I somewhat knew what to expect, we had a profound talk.
“Neurotics are experts in creating problems, psychotics in making up unreal solutions.” – Unknown
She didn’t have an easy life. Medicines to counteract her compulsion for blood. Medicines to counteract the side effects of these medicines. And many years of cognitive and behavioral therapies. Up until recently this seemed fairly effective, until she woke up one morning, started to cry and couldn’t stop any more. She was swiftly diagnosed with depression. Because if one cries all the time that seems like a logical conclusion and even quicker a pill was found to counteract the problem. What struck me was the fact that the psychiatrist approached her depression as a disease. In other words her depression was like contracting cancer. A disease without apparent cause and as we cannot ‘cut away’ depression or treat it with chemotherapy, we need to give medicine to solve this problem.
I must admit I was kind of surprised by this approach and started to ask her questions about when she woke up like this.
‘So when did this begin exactly?’
‘One morning i just started to cry and couldn’t stop any more.’
‘Okay, I don’t understand completely, you started crying just like that?’
‘Yes I woke up, it was unstoppable.’
‘No nothing at all, I don’t understand it myself.’
‘What happened right before you started crying?’
‘I mean right before the first tear?’
’Yes then I had to think about my business going bankrupt.’
‘Yes, I had a dog grooming business and after 6 months I had to close it because I couldn’t do it. And things were just going so well with me after the behavioural therapy for my compulsion.’
‘So you had a dog grooming business were able to function independently after your behavioural therapy and then you business went bankrupt?’
‘Yeah and I gained an enormous amount of weight just when I had lost 14 kilograms.’ ’14… just imagine.’ ‚
‘My goodness that as well, what did that mean to you?’
‘Well I was disappointing my husband even more.’
‘What do you mean, exactly?’
‘Well we have been together for 12 years now and the last 9 of those years it has all been about me. I mean I have been unable to function for the last 9 years you see.’
‘And you feel sad about that?’
‘Please explain, what is the relationship between your sorrow, disappointing your husband, your body and weight and the bankruptcy of your business right at the moment things were going so well for you?’
‘I feel guilty all the time and about lots of things.’
‘I might sound a bit dumb but I don’t understand what your saying, guilty?’
‘Yeah I feel guilty about the bankruptcy, being to fat, about demanding all this attention from my husband and being unable to function for all these years.’
‘Well that is quite a bit, how do you feel about that?’
‘Sadness that sticks around all day?’
‘Yes, I need to cry all day.’
‘What your saying right now is that depression is not your primary problem?’
‘Well it sounds like you feel sad about feeling guilty, meaning that your sorrow is not your primary problem, but actually the consequence of your guilt. And that means you are getting medicines not for the problem but the symptoms.’
Silence. Suddenly a tremendous shift in facial expression.
‘What you are saying is true actually, this is not one big sad blur I can’t come out of…’
‘Well probably your sad feelings are your unique internal reaction to you feeling guilty. How would you call your attitude, the attitude you have when you feel so sad about feeling guilty?’
‘Hmm I feel sorry for myself.’
‘Ah Self-pity, I would feel depressed too. What is the effect of self-pity on the rest of your life?’
‘Well you can’t see any perspective, not one opening. Things just turn black and you don’t feel like moving forward anymore.’
‘Because it’s useless, why would you move if you can’t go anywhere, if there is no point, no purpose..?’
Yes that’s useless and heavy.’
‘Yeah as if life has no meaning, and there is so much sorrow in the world…’
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