Most likely, if we work together, there will be a moment when I will invite you to join one of my therapy groups. I will listen very closely to your reaction. This is because my invitation is not only an invitation to actually join, but also an invitation to deepen our exploration of your inner thoughts and feelings. The invitation becomes a metaphor for how you feel about being invited to belong to something, becomes symbolic of how you feel about emotional intimacy, and represents significant relationships from your past.
For example, sometimes when I invite someone to join one of my therapy groups, they are absolutely terrified of the idea of sitting in a circle and sharing with others. When I bring it up to them for the first time, they immediately feel anxious and overwhelmed with the idea. They may anticipate feeling unsafe, controlled or humiliated. As we explore this further, we come to fully realize just how powerfully negative the imagined group is in their mind. The group in this case may remind this person of their overbearing parent who took control over everything in front of everyone, and had to have the last word. This person may be reacting to the invitation to join the group with an old fear that they had in their family as a child. A fear that any intimacy in a group setting comes with a price of being controlled and feeling humiliated. What we come to learn from this conversation is that this person may be afraid of showing any vulnerability in relationships because it has not been safe before.
Others may be initially really intrigued by the invitation and immediately want to know more about it. Perhaps they were in the role of entertainer in their family and love to perform. Maybe they got a lot of attention, admiration and love when they were funny or joking around when with their family. Maybe they developed being in the role of entertainer in all kinds of groups. Belonging in a group to this person stimulates excitement with an imagined opportunity to have some fun or to show off how funny they are. This person may be afraid of showing their vulnerability in a more serious way because they are afraid that they are unlovable or will be neglected unless they are entertaining others.
Alternatively, some may be interested in joining a group, but are hesitant to join because they don’t want to have to share their leader (who may represent a parent) with others. Perhaps they didn’t feel they got enough love or enough of a feeling of being special from their mother or father, and were somewhat neglected in their family. Maybe their parents favored a younger sibling, and they imagine that they’d have to share the attention and love from the leader with their siblings. They may worry that their leader will neglect them, just as how their parents neglected them, and will have to either put up with crumbs of affection or will have to compete for the love of the leader.
No matter what a your reaction may be to my invitation to join one of my therapy groups, I have found that simply thinking about joining a therapy group has proved to be extremely useful to deepen and further our therapeutic work. Discussing your reactions to joining a group may help us to learn a lot more about how your past relationships have shaped your fears, your desire, your capacity and your interest for emotional connection and intimacy.
Are you wondering if you may be depressed?
Here are some questions to ask yourself in order to see if you may be suffering from depression:
1. Do you feel sad or down most days of the week? For 2 weeks or more?
2. Do you find that you've lost interest in things you used to enjoy?
3. Have you lost your appetite, and/or are you having trouble sleeping?
4. Do you feel hopeless?
5. Do you find yourself crying frequently?
6. Do you feel worthless?
7. Have you thought about wanting to die?
While it's normal to feel down or sad sometimes, if you have been have been experiencing the above mentioned symptoms for 2 weeks or more, it is likely that you may be suffering from a depressive disorder.
Different types of Depressive Disorders
There are several types of depressive disorders. They vary in severity, length of time and root cause.
Major depressive disorder (MDD) is the most common form of depression. It is a mood disorder that is involves sadness or loss of pleasure or interest in most things, and can vary from mild to severe. There are an estimated 15 million Americans who have suffered at least one major depressive episode in their lifetime. Unfortunately, in spite of numerous advances in treatment, both psychological and medical, many people suffer in silence and never seek help.
If you have symptoms of mania then you may be suffering from Bipolar Disorder, formerly known as manic-depressive disorder. There are two types of Bipolar disorder, Bipolar disorder I and Bipolar disorder II. Bipolar disorder I is considered to be more severe. Often times when someone has a severe manic episode, they experience psychotic symptoms, and may need to be hospitalized. Bipolar II can often go untreated because people who have manic symptoms can often continue function in their daily lives, even though it may be a strain. There is a strong biological and genetic component to Bipolar disorder.
Technically, an Adjustment disorder is not a mood disorder, but I included it in this list because I think it is important to be able to distinguish between a mood disorder like MDD versus experiencing some symptoms of depression due to a recent adjustment. We all go through changes in life that we need to adjust to - move to a new city, state or country, a death, job change or relationship status such as getting married, going through a divorce, or watching our children grow up and move out of the house. It is normal to feel some depressive symptoms when going through these changes.
Postpartum depression occurs in women after childbirth. Usually, symptoms of depression appear within the first four weeks of childbirth. Some specialists believe, however, that they can first occur anytime within the first year after childbirth.
Seasonal affective disorder (SAD)
SAD is diagnosed when symptoms of depression appear in the fall and winter - when sunlight is reduced. People with SAD usually feel better with the onset of spring.
This type of depression is considered to be a chronic or long standing depression. People suffer from Dysthymia when they have had some symptoms of depression for at least two years. The depressive symptoms are less severe. However, the fact that depressive symptoms are chronic and last for so long, it can be quite debilitating.
If you think that one or more of these depressive disorders sounds like what you could be going through, I'd like to strongly encourage you to reach out to someone for help. You do not need to suffer in silence. While it may be difficult and scary to make initial contact with a therapist, your life is worth it.
Unfortunately, depression is very common. 1 in 3 women suffer from depression at some point in their lives. Men get depressed almost as frequently. But, depression is something that you can overcome with help. While there are a lot of things that can help you, weekly talk therapy is one thing that really does help. Again, I want to encourage you to talk to someone about how you are feeling. While it can be very difficult at times mainly because there is a stigma about feeling depressed - in many families and in many countries - living a life full of shame is miserable. Feelings of shame, guilt, and embarrassment all to often get in the way of reaching out for help.