A very emotional occasion. Most valuable evening. Public lecture from AWARE in Cork
It was the Thursday when it rained and led the ESB to release water from their dam. At one stage, it looked as if there would be no audience for Eddie Egan & David Carton. A foul and drenching night to talk about depression.
But those are the kind of nights when the best things happen.
Eddie Egan, a psychotherapist, summarised his approach to a person in depression. I made notes as best I could.
(1) How depressed is the person? Measurement is essential: Eddie uses a "depression inventory" to let people see where their feeling fall on a scale. Some are relieved to see they are only 1/3 up the scale.
(2) No depressed person likes themselves. Dislike of self, self-loathing, self-hatred - all feature highly in the minds of depressed people.
(3) Depressed people tend to isolate themselves: sit in their own rooms, walk down side streets, keep their heads down, avoid eye contract. Eddie Egan strives to get people to lift their heads up "eyes up". "You have to start somewhere."
(4) Goals matter: plan to achieve something, however small.
(5) Thinking & feeling are tied up together. Eddie asks "What are you getting from being the way your are?" "What are you losing?" "What do you want to change?"
(6) The belief of the therapist matters… The therapist can keep the client stuck. Eddie said he didn’t believe the chemical imbalance theory. If the therapist subscribed to such a theory, they therapist could be responsible for keeping the client stuck.
(7) The belief of the client is also vital. If the client believes they are stuck with depression for the rest of their life, that will influence the outcome. [I remembered the term ‘self-fulfilling prophesy‘]
(8) Start with what the person presents. It’s never the full story but if you disregard the problem which they first present, you’ll find it hard to build the rapport you need to work together.
(9) Negative automatic thinking: the fuel for depression. "Catch it. Stop it. Say ‘you’re doing the best you can’."
(10) What the underlying issue? It could be anything. Something traumatic or something that seems trivial to another. I remembered the phrase "non-judgmental acceptance": it seemed to fit what Eddie Egan was describing and advocating.
(11) Anxiety or Depression? Eddie said he usually goes for what’s primary. Focus on that… the other slips away.
(12) Catastrophic thinking: it’s all heading for an awful end… Eddie gave some lovely examples of the way people with depression think, the way their minds are taken over.
Questions from the floor:
One person said "sadly I don’t have the guts to kill myself" - what do you do with someone like that? While he was answering that, Eddie said "I (the therapist) don’t need to hear the story; the client might need to tell their story…" For me, this is one of the key qualities of a good therapist: everything they do is designed to help the client. The therapist has no need in the situation, except the desire to help.
- Someone who was in a mental hospital (or a mental health ward in the hospital) said "I got better after 12 days; they kept me in for 6 weeks…"
- Confession came up: is the decline of confession the removal of a great support? To whom can you tell your story these days?
- Drugs, of course drugs came up. Eddie Egan said "if you’re not on it, you don’t have to come off it." He also said he saw situations where short term use of a drug could help. But there are people who think medication is the answer, "that leads to disappointment".
I asked Eddie Egan about where you could get therapy, counselling in Cork. He teaches on the "Counselling & Psychotherapy" BA honours course in Cork Institute of Technology (CIT). There are students in training who look for clients. Trainees are supervised and they charge a nominal rate.
He also said the Irish Association of Counselling & Psychotherapy (IACP.ie) website was a userul place to start looking for a therapist.
I’ll put up a separate post about David Carton’s contribution.