On Depression: How Self-Esteem, Worthlessness and the Self-Critic Work (Video)

Today I want to explore some ideas around depression and different levels of depression intervention from superficial ones to deeper ones, having to do with self esteem and negative self-critic and worthlessness, things like that.

The Roots of Depression

So a lot of people come to our practice to try to help alleviate themselves from depression and sometimes people get stuck in these cycles. They might alleviate their depression for some time and it might make them feel better, but they might quickly fall backward or they get into this chronic cycle of feeling better but then going back to feeling worse. I've always thought about that because depression has touched me growing up, I had a parent who was depressed chronically, and it always struck me as something really powerless inducing for those people experiencing depression, but also the people who were living with depressed people.

How People Get Stuck in Their Depression

So one of the things that I look at in therapy is what are you doing in terms of depression and interventions to alleviate that depression? Are they helping you? Are they getting deep enough into the root of what might be driving the depression? I'm not a medical doctor and I certainly would ask you to consult with your psychiatrist or your psychiatric nurse practitioner or other medical provider but I do think that psychiatric medications, psychotropic medications, are very effective, but they're most effective when used in combination with something like talk therapy.

A lot of times people do take drugs for several years and maybe it worked in the beginning, maybe a tailed off, and they have to keep upping their dosage, but they never really get to the core or the root of their suffering, that's what I'm interested in.

The Negative Self-Critic

So when people come in, one of the things that we do end up exploring a lot is this idea of a negative self critic, it's the voice in our heads, essentially, that is telling us we're not enough. We could be better. We're failing in some way as a child, as a husband, as a partner, as an employee. It's this constant grading mill of self-criticism self-blame judgment of self and it's an inner voice that we tend to take for granted because we think it's always been there or we think this is just who we are. When in actuality, it's a voice that we have adopted that's become so ingrained, so unique to us that a lot of the times we don't even know it's there.

In therapy, I use Gestalt empty chair exercises, and I split those sides of someone's personality up to help pit them against each other and look at that as a relationship, a broken relationship or a dysfunctional relationship, the way that people are talking to themselves, and I help them become more aware of just how harsh their treatment is on their selves and what it generates in terms of shut down, depression, feelings of worthlessness, not feeling good enough.

I think when people feel worthless or not good enough, they're not going to take actions in the world as what a person who feels good enough about themselves, they're not going to be motivated, they're going to constantly think that they're worthless so anything that they're going to try to produce might be worthless, so why would I even pick myself up and put myself into the world to just set myself up for failure? If what my core belief is that I'm worthless and things that I'm going to produce are worthless. Really getting at those core beliefs, getting into the dirt, if you will, and really identifying what those roots are, is really important in terms of at least considering that that's a major driver of depression.

Growing Up Depressed

A lot of the times, these types of messages come from growing up with our caregivers, our parents, a lot of the time, either giving us messages like that explicitly or implicitly through their behavior, like prioritizing other siblings of ours growing up or not being there, having parents who were always gone or working all the time or drinking all the time or generally abusive parents, either emotionally, verbally, physically abusive, and in some cases, sexually. But the vast majority of the time, it's that there's an emotional abandonment and because we feel emotionally abandoned or rejected by our partners, we tend to adopt that belief about ourselves that we're worthless, we are failures and those inherently are simply not true. There are just so deeply ingrained beliefs that that's how we've learned to operate in our lives.

So even if you've been struggling with this for 20 or 30 years, it doesn't mean that it's a sacred cow, meaning you can challenge that and again, it's a tape or a program that you may be running that is subject to some challenge or some debate just because it's been there the whole time doesn't mean it couldn't be changed.

Learning about the self critic is an adopted voice, that it's not really you, learning how to challenge that relationship, learning what some of the antecedents are growing up in a household that maybe produced those messages for you that you're not good enough, or that you're worthless, or you're a failure.

Considering those roots and really committing to finding a good therapist who can work with you around those things to help you identify and work through those issues so that you don't have to resort to treating your depression on superficial levels, like with medication or positive affirmations or things that are temporary and albeit they're helpful, but they're temporary and they only last for a certain amount of time.

These are some thoughts about depression and self esteem, feelings of worthlessness and rejection that are all mixed up in this kind of stew. One of the things that therapy does is help to pull out all the elements to help you, to organize them and identify which are important and which needs to be worked through. So I thank you for joining us today. It's been a bit of a longer video, but I'm happy to talk to you today on this subject and thanks for tuning in. Take care.

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