How to break the rules of depression using CBT

No Country for Old Men is the title of a novel by Cormac McCarthy.  The central character, Sheriff Bell, in the midst of the mayhem perpetrated by the killer Anton, realises that the rules of life that he grew up with no longer apply to this new and changed world.

We all need rules for living. However the rules that apply in depression ultimately lead to us to feeling bad. They take two forms.  They can be commands: “I must always be good”. And/or conditional statements: “If I strive to be good at my job then I will prove that I am not a failure.”

Reframing the rules

What can we do when these rules begin to break down because of circumstances outside of our control?

 The first thing we can do is reframe what we mean by the rules. Albert Ellis who developed Rational Emotive Therapy says that what we are really thinking of when we speak of rules are preferences. Rather than, “People should be nice to me” we may try saying:“I prefer people being nice to me”.

What are the consequences of living by our rules?

We might also think of following through the consequences of our rules.

If we had a rule of being 100% perfect, how would this rule apply to everyone not just us? A world of 100% perfect human beings may be a good sci-fi plot for a film but feels unbearable in real life.

If we know that this is the case, then why do we apply this rule to ourselves?

Breaking the rules

CBT encourages us to test our thoughts and feelings by breaking our rules. This is useful because if any bad events happen, how can we be sure it is linked to breaking our rules?

Rather than look at rules it might help to look at our ethics. The Seedhouse Ethical grid is a tool used in nurse education which balances each of the categories of ethics from deontology – “doing what seems to be the right thing” to utilitarianism, actions which focus on the greatest good for the greatest number.

The grid also takes into account more specific ethical factors such as the law, and risk. 

The rules that counter depression

The rules that counter the rules which bring about depression need to be flexible.

The grid helps us see that in any given situation one set of ethical principles will be more predominant than others. So it helps to create rules which are both realistic and flexible.

The role of mindfulness

Mindfulness emphasises the value of staying in the present and can help us see our rules from a distance. It can also help us manage our rumination.

By being more mindful we may begin to discover rules that will help us live the lives we want.

The line “No country for old men” comes from the poem by W.B. Yeats-“Sailing to Byzantium”.  This poem focuses less on depression and more on the importance of a life focussed on living in the “here and now”.

This is when we are less likely to be trapped by our rules and live life as we want to.