DEPRESSION AS HEALING OF OUR SENSE OF SELF
How gaps in our sense of self contribute to depression
‘When we lie to ourselves about the truth of our feelings, we cannot simply be ourselves. We force ourselves to play a role, indeed to play many roles. All these roles serve to deny to ourselves who we actually are’ (Rowe, 1983).
Many clients with depression have limiting beliefs about their self, such as: “I am nothing”, “I am pointless”, “I am bad”, “I am unloveable”, “I am worthless”, “I am inadequate”. These negative beliefs at identity level, represent a limited and incomplete definition of self and are accompanied by a particular unpleasant embodied ‘felt sense’. When individuals have such limited concepts of their self, they have a relationship with their self based on rejection and chronic lack of unconditional positive regard.
It is because on some level people experience a badness within them, a sense of ‘I’m not ok’, that they have to create a persona that is the polar opposite of this badness or nothingness or unloveable-ness. Yet in the moments where the ‘badness’ seeps through people feel the lack of worth, the despair and ultimately feel that they have no right to exist, so in order to exist they decide they need to do or be something to justify their existence (Rowe, 1983).
Because on some level, the person believes himself to be ‘not ok’, he decides to play the role of the strong one – the ‘be strong’ driver in TA (Stewart & Joines, 1987 -) or the one who pleases others, the ‘placater’ in Satir’s categories (Satir, 1991)) or many other roles, but all of these roles only offer incomplete maps of self.
The culmination of a chronic disregard for the self is at the root of depression, and can make individuals spend a lot of energy hiding the badness within them and punishing themselves for being bad. This can lead to the ultimate expression of anger against self, suicide or self-harm (Parker-Hall, 2009).
Know thy Self, know thy feelings
The functional origins of the self lie in the body. Damasio (1999) posits that the development of core consciousness (out of which the sense of self develops) is dependent on older brain structures beginning in the brain stem (reptilian brain) and ending with the somatosensory and cingulated cortices (limbic brain) all of which are involved in body regulation and representation.
So the representation of the current bodily states from the body are involved in creating the conscious mind and the self – albeit at the unconscious proto-self level, below core consciousness which is then represented by the ‘map’ in consciousness (Damasio, 1999). This is the realm of feelings and emotion, the latter of which Damasio posits as easier to experience than the former. He posits feelings as being higher order in that to feel a feeling (to know a feeling) requires a self (a knower). So having a feeling (emotion) is not the same as knowing a feeling – the latter being another order of abstraction (Damasio, 1999). He proposes that consciousness arose out of a need for organisms to to feel their feelings, know their emotions; and the very knowing of feelings can change consciousness and the sense of self.
Developmental psychologists such as Jerome Kagan suggest that humans develop a “self” by the time they are 18 months old and perhaps even earlier. Events in our past as well as memories past, present and anticipated in the future contribute to development of our self-concept.
The Role of the Therapeutic relationship in transformational healing of the Self
However this sense of self, which evolves out of extended consciousness, only emerges from the activity of the brain in interaction with other selves. Early attachment experiences shape the right brain, and form the neurobiological core of the unconscious (Schore, 2008). Through interaction and imitation with a sensitive and responsive mother during sequences of attunement, misattunement and reattunment, the infant is given a ‘psychological birth’. This psychological ‘birth’ of self, forms the core self (Schore, 2008) which is initially regulated by others and then increasingly becomes self-regulated but is nevertheless built on the foundation given by others.
There is good evidence that this reciprocal imitation of child with mother plays an important role in the early development of an implicit sense of self (Chaminade and Decety, 2003). As well as impacting on psychic development, early attachment interactions actually generate brain development, specifically of the synaptic connections and circuits of the right brain, which means that if the mother is not sufficiently responsive to the child or is abusive, the actual functional structure of the right hemisphere of the brain can be adversely affected.
Therefore building a more resilient self who can really honour one’s own unique potential for fulfilment in life, can be formed in a transformational psychotherapeutic relationship. Such a transformational relationship is not just talking therapy, but a limbic brain to limbic brain connection that actually builds new synaptic connections and circuits in our brain (we grow or repair our brain!). This is the foundation of deep seated healing and change at the highest level – that of the self.