Steven Pinker, the psychologist suggested that we are “evolved” to tell stories to ourselves and others. I believe this to be true. In CBT we use a particular type of story called a formulation.
Formulations look at how people’s personal histories lead them develop negative beliefs about themselves. They live these stories until they reach a point when their way of coping breaks down and they become depressed. The story then changes. The depressed story is one about not “belonging”. It is one of loneliness and it is one where the “buck stops” with them. They are to blame for their depression.
The CBT formulation aims at telling a different story. It is one which seeks to explain how things happened rather than judging the person with depression.
Predisposing factors are the ways in which our background make us vulnerable to depression. The depressed person’s story is in many ways a ghost story. In the film “The Sixth sense”, the child Cole, says that “ghosts” do not know they are dead.
In Depression, the past returns to “haunt” us in our present. We might be successful in our adult life but when if we are triggered by a memory or a chance comment, the ghosts return and we are “back there”, in the past when the original trauma happens.
If we are vulnerable to depression we try to cope in ways which make sense but do not help. If depression is about failure we may “overcompensate” by trying to be successful at everything we do. If depression is overwhelming we may use drugs to numb the feelings.
If we fully believe our negative opinion about ourselves we may try to cope by surrendering, and putting our needs to one side. Ultimately, all of these approaches fail and the “ghosts” return. However, rather than change, we respond by doing more of the same and perpetuating our depression.
These are the triggers to the depression. They can be significant life events when we realise that our ways of coping are not working, and we realise how vulnerable we are.
These will be those factors which allow us to come to terms with the past. They are also those behaviors which lift our mood and give us the energy to carry on. We need to find out more about these behaviors and patterns of thinking and do them more often.
In the Sixth Sense, Malcolm the therapist played by Bruce Willis is a ghost, and his wife who is experiencing her own bereavement is depressed, following his death at the start. At the end, he fades into the past and his wife “moves on” with her life. She has come to terms with the past. The CBT formulation echoes the words of the philosopher Kierkegaard- Life can only be understood backwards; but it must be lived forwards
Only be understanding the past, can we change.