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How to Use What Your Depressed Client Brings

3 ways to utilize the depressed client's reality to help them find joy

When we help clients connect up to realities beyond the trance of depression, we help them back to a sense of meaning, awe, and joy.

“Life will bring you pain all by itself. Your responsibility is to create joy.”

– Milton Erickson

“It was awesome. I mean really awesome, not just the way people say it without meaning it,” Julie said.

Regularly feeling the emotion of awe – a sense of the divine or the majesty of nature – helps people experience more joy in their lives.1 And joy is important. We need to enjoy at least some parts of our existence.

Julie was talking about a time she’d scaled a mountain in Austria with her friend.

“When we reached the top it was still early morning. The air seemed to sort of hang from the heavens… it’s hard to explain. But I had this feeling of such connection and meaning. Something indescribable but all the more real for not being easily put into words.”

I thought Julie put this beautifully.

Julie was with me for help with depression. But when she described this experience she stopped, just for a moment, looking depressed. Her chin lifted, life entered her eyes, and she looked ripe to relive the experience in a deeper way.

Mini awakenings from the trance of depression

Just as a sense of awe suffuses us with powerful meaning, depression, like some Rowling-esque dementor, sucks a sense of meaning from us.

When we help clients connect to realities beyond the trance of depression, we help them back to a sense of meaning, awe, and joy.

And here’s a thought.

Your client’s many selves

When you look at someone you see mainly the surface. We might get hints of what lies beneath the surface, within the depths, but generally what someone seems in the moment can hide all kinds of things unseen… until we look for them.

When clients come to us, they bring their whole selves along too, at least in potential. We may see only the currently depressed version of them, but they have a whole other life. Remembering this can prevent us as therapists from feeling hopeless about our most depressed clients.

There have surely been times when they’ve been well and active, or at least less depressed. There may even have been times of pure awe and a genuine sense of connection, as was the case for Julie. We need to find and use these parts of our client’s experience even though – especially though – they may not be immediately evident when we meet our clients.

So clients bring into therapy their miseries and limitations. But they also bring their potential, past triumphs, interests, and incipient and past happinesses. We can utilize much of this, and we should – because this is the very material from which we can help our clients build happier lives.

And this is the basis of the ‘utilization principle’.

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The Utilization Approach

Utilization in therapy simply means using what the client brings into therapy as a natural way of facilitating solutions.

So rather than attempting to change someone’s personality, we can use their unique personality traits to bring about change. This is a natural progression for the person and also facilitates rapport.

A person’s traits, beliefs, talents, and understandings can all be utilized for therapeutic gain.

Utilization requires us to stop working from theory alone, to stop trying to get your client to fit neatly into some psychological theory. Rather, we must make an effort to see clearly who they are. Yes, we should bear in mind sensible psychological understandings, but it is equally important to recognize the uniqueness of each client and to use their resources and characteristics to help them.

So what other aspects of a client’s being and reality can we utilize to help their therapy?

Getting attuned to our clients

The first step of utilization is to attune ourselves to our clients’ associations, understandings, beliefs, values, and language. Then, once we have identified these, we can use them in order to facilitate change.

For example, if someone has a great sense of what is ‘right’ and what is ‘wrong’, this is a very powerful resource that should certainly be used. If someone feels it’s wrong to treat people badly, we might explore how treating themselves badly doesn’t really align with their values. If I feel that someone is basically decent and kind, I might start talking about being decent and kind to ourselves.

We can even use what the client brings in the form of resistance to help them overcome limitations.

I once had a volunteer hypnosis demonstration subject who was resistant to going into trance, to the point of downright antagonism. I discerned rather fast that she had a need to be thought of as professional. So I told her that she certainly wouldn’t go into trance (meeting her need for resistance) until her unconscious mind let her know it was professional enough to let her learn from the experience (utilizing her concern with professionalism). You can read more about that experience here.

So my point is, utilization can be applied in many different ways for many different people.

But getting back to depressed clients specifically, we need to help them meet their emotional needs so life feels meaningful again. When life is richer in meaning we feel more joy. But in order to help them feel more joy, we need to work in alignment with who they are and what they have experienced.

Here are a few ideas when it comes to utilizing client experience to increase joy.

Tip one: Utilize the problem

Many common emotional problems can be seen as sloppy unconscious attempts at meeting some emotional need.

Fear is the brain’s limbic system trying to keep us safe. Anger arises from the instinct to right wrongs, get our way, or survive a threat. Compulsion and obsessive thinking can be seen as attempts to meet our need for a sense of control in life.

Just as we can utilize a client’s apparent resistance, so too we can sometimes redirect what might usually be viewed as ‘problematic’ personality traits to actually help them meet their emotional needs and achieve therapeutic results.

For example, if a smoker is prone to anger we could direct the anger towards the cigarettes. This doesn’t deny the anger but utilizes it productively (though of course we would hope that ultimately the person can learn to manage their anger appropriately).

So what may cause the client problems in one context might be used therapeutically to produce good results in another.

This is exactly what Milton Erickson did in what would become one of his most famous cases.

Gap tooth

Milton Erickson was treating a suicidal young woman who believed she was hopelessly unattractive. She was certain she’d always be alone because of the way she looked.

Erickson, who was evidently a master of persuasion, ‘utilized’ her problem by getting her to squirt water at a young man through the ‘ugly’ gap in her teeth as they drank at a water fountain.

The man perceived this as flirtatious and asked her out on a date. The gap in the woman’s teeth that had contributed to her feelings of unattractiveness were now, through Erickson’s intervention, a catalyst for positive romantic contact.

Erickson reframed this woman’s perception of herself and the possibilities open to her by utilizing what she had seen as a problem. Not once did Erickson try to talk the woman into believing that her gap really was attractive or that she really was capable of dating.

What a wonderful example of utilizing a depressed client’s reality to help them find joy! Other examples might include:

  • If someone is a maladaptive perfectionist, we can utilize their hyper-conscientiousness to help them carry out therapeutic tasks properly.
  • If the addicted client is prone to fear, we might build up a sense of a frightening future if they continue to be enslaved to the addiction years down the line. We may then link that fear to the impulse of temptation, thus polluting temptation itself.
  • As previously mentioned, if a smoker tends to smoke when they’re angry or resentful, we can begin to direct these feelings towards the cigarettes, which have been ‘pretending’ to help with those feelings.

When you look at your client, you see the tip of the iceberg, so to speak. There’s an ocean of potential beneath the surface. So plumb that ocean!

Tip two: Evoke colour from the past

Julie had become depressed because she couldn’t stand her job, her relationship was on the rocks, and she felt hopeless generally that things could ever improve. It wasn’t a terribly deep depression, but certainly the colour of life had faded. She had been prescribed antidepressants, but had not yet taken any.

I asked her, of course, about the depression, its genesis, and possible causes. But then we started talking about when times had been good. She told me that some parts of her life had been really “colourful”.

This is when we came upon that memory of climbing the alpine peak all those years earlier. I helped her hypnotically re-evoke that time, being careful to emphasize all the colours around her as she and her friend reached the peak.

But I’d like to offer a caveat.

Bittersweet memories of a lost time

There exists a risk of re-evoking a memory from the past that is really happy, but also signifies loss for the client. It might be a rapturous time with a lost love, or a wonderful time during a career they no longer have.

So we should be careful to work with times that have no particular association with loss. We can also suggest that similar feelings can emerge in the future.

When utilizing a client’s past joys or enjoyments, we can draw on all types of times. It doesn’t have to be as dramatic as scaling a peak. It might be an afternoon riding a bike through a forest, or gardening, or a particular time relaxing with friends.

The point is, by hypnotically re-experiencing enjoyment, the client breaks out of the depression trance for a while. They may go back into it again pretty soon, but the more time they can spend apart from it, the less likely they are to find their way back in again.

Tip three: Use your client’s values

Lastly, we can identify our client’s values and demonstrate how their current behaviour might conflict with those values (or how a new behaviour might align better).

So if a smoker tells me, as one particular client did, that “no one takes me for a sucker!” then I can begin, a little later, to talk about how cigarettes con people. If integrity and honesty is important to a client with low self-esteem, then we can talk about the honesty of being assertive (with the implication that not being more assertive is, in a sense, not being ‘real’ with people).

Some clients feel a kind of guilt and shame around experiencing joy or even simple pleasures. So we can remind clients they have every right, as human beings, to experience joy – and again, we can do this by appealing to their values.

No shame in joy

A very orthodox religious woman came to see me for depression and anxiety. She had given up many of the things she enjoyed – simple pleasures like playing cards with friends and going dancing. She said at one point, “Why should I be able to enjoy myself when so many people in the world are suffering?”

I didn’t argue with her, but in another session I suggested that joy was people’s “God-given right and privilege”, and to squander and reject enjoyment almost seemed like a sin, especially when joy isn’t always open to us or others.

Notice how I utilized her beliefs around joy: I didn’t challenge them at the time, but I came back to them later. And I spoke generally about joy, so that it was an idea that need not be automatically rejected.

I took the idea of joy being ‘sinful’ and turned it on its head, suggesting that because it’s natural and a gift it might be a bit sinful not to experience it when it’s available. To reject something given by God went against everything the woman believed in. So for her, recognizing joy as the gift that it is was the first step towards enjoying life again.

So we can work within client values and help widen the context in which those values hold good – and create good – for our clients.

We human beings devalue all kinds of experiences, from great romantic gestures degrading into swipe-right culture to the ‘everydayifying’ of the word awesome (not that I particularly have anything against these aspects of life).

But sometimes, just sometimes, we find real romance and genuine awesomeness – and so do our clients.

And that’s when real meaning floods in.

We humans devalue all kinds of experiences, from great romantic gestures degrading into swipe-right culture to the 'everydayifying' of the word awesome. But it's when we find genuine romance and awesomeness that real meaning floods in. Click to Tweet

How to Lift Depression Fast

Mark regularly delivers his online course on brief therapy for depression on our custom built online platform Uncommon U. As a student you get access to our app, which makes the course easy to access wherever you are. Learn more about Mark’s depression course here.

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Mark Tyrrell

About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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