Assertiveness training is not a part of CBT. Nevertheless, for me, it is something which matters profoundly in any therapeutic change. Assertiveness is fundamentally about relationships and depression is a relational disorder. The personal histories of people with depression are ones where their early relationships have left the 'stamp'. The players on the stage of their lives may have been abusing, negligent or just plain absent.

Albert Bandura, whose work informed the development of CBT said that we learn from the significant people in our lives. For people with depression, there are two lessons. Firstly, the 'stamps' that these relationships leave on us mean that we learn to avoid close and intimate relationships through a fear of reproducing the same pain from those earlier relationships. Secondly, in withdrawing from relationships we become passive. We learn that whatever we do makes no difference. We still have relationships of course, but they are mediated through 'masks'. We never get close to others. We never feel close to others.

Price of placation

By being passive in our relationships we end up putting our needs to one side, constantly pleasing others. The price of placation is that we feel used and taken for granted. In the relationship game, we have already lost. Sometimes we decide to respond. We try to regain control through anger. The bottled up feelings behind the mask explode and we lose it. We alienate other people and we end up feeling guilty. We retreat back behind the mask and the vicious circle keeps turning.

Assertiveness is not about winning or losing in any interaction. It is about a greater sense of control in how we respond in our relationships. It is not a technique for manipulating others to get what you want. Indeed, the people who you are being assertive to may not even validate how you feel or change their behaviour. This does not matter because saying what you want to say and how you feel is in many ways its emotional reward. It is also about asserting our rights.

Manuel J. Smith, who wrote one of the first self-help books on assertiveness, When I say No I feel Guilty, spoke about an 'Assertive Bill of Rights'. If we are passive we have no rights whilst everyone else has rights. If we are aggressive our rights alone are the ones that matter. Assertiveness states that my rights and your rights matter. The skill set of assertiveness ranges from the disclosure of feelings to accepting compliments and giving and receiving criticism. It is a total communication style, which focuses on body language, vocal tone and the content of what is said. It also emphasises specificity whereas passive or aggressive communication is very general. If for example, we are criticised for our work we can ask for the details, and we can accept that in this one area perhaps the other person may have a point.

Ultimately, assertiveness can empower us to break away from 'stamps' that our past have left on us. We are independent of our past. Indeed we may need our own declaration of independence as well as a bill of rights. Any country that breaks away from its colonial past has to declare its independence.