By concentrating on asking the question “how”, not “why”, we become less judgmental on ourselves.
David Servan-Schreiber | June/July 2009 issue
Gail is no stranger to depression, so she finds the psychiatrist’s advice puzzling. He suggests that instead of wondering why she feels powerless and sad, she concentrate on how she experiences these feelings. Gail casts her mind back to her last bout of depression, when she spent an entire Sunday sitting at home, unable to get off the sofa or even watch TV. All the time, she was overwhelmed by anxiety: “I’ve made so many bad choices in my life. I never should have gone into sales; I’m not cut out for it. And that’s how I met that guy who dumped me. And now it’s too late to have a child. And anyway, at my age, the risk of having a child with birth defects is four times higher.” Black thoughts tumble through her head, one after another, each one feeling so real and consuming that any kind of activity seems pointless.
Now that Gail has shaken off the latest bout of depression, and is anxious to avoid another, she’s come to a therapist from the psychology department at Louvain University in Belgium. He suggests a new approach: Avoid dark thoughts and temporary distractions; neither confronts nor prevents the feelings. Instead, he suggests, each time the physical symptoms and dark thoughts return, adopt an anthropological approach to exploring the workings of body and mind.
The instructions are unbelievably simple: “Sit on the edge of a chair with your back straight and your hands resting on your thighs, comfortable and poised. Fix your attention on the physical sensations of your body and on finding an image or words that best describe the nature of those feelings. If thoughts come into your mind unbidden, observe them and let them fade. Then look out for the next thought or image that follows, but don’t judge it as ‘good’ or ‘bad.’ Simply note it. If you become aware you’ve let yourself be drawn into a chain of thought, bring your attention back to your breathing and observe what new flow of thoughts is taking the place of the last. It’s all about learning to be conscious of what’s happening for you here and now. Don’t worry about why you feel what you feel or why you think what you think; concentrate purely on how.”
Gail notes that when she focuses her attention on the physical symptoms of depression, or observes an anxious thought without letting it take hold, the depression gradually lifts. She understands she isn’t her depression, that it’s only one part of her.
“How” instead of “why” is so simple, yet so important. If you’re unconvinced, imagine the difference between a doctor who asks, “Why did you put on 10 pounds?” and one who says, “How are you feeling about your body?” It’s the difference between feeling judged and feeling heard.
That little word “how” is a gesture that opens the door to deeper understanding. At Cambridge University in the U.K., former professor John Teasdale showed that patients who’d suffered episodes of depression could learn to develop such trust and understanding of themselves through meditating. When he started teaching this meditation method, inspired by ancient Buddhist practice, with people who suffered from depression, Teasdale showed it was possible to reduce relapses by more than 50 percent, a success rate comparable to that of antidepressants. We all need to develop this depth of understanding of ourselves and others. All we have to do is avoid the intimidating ‘”Why?” and offer our trust with the kindly “How?”
David Servan-Schreiber is a French psychiatry professor and the author of Healing without Freud or Prozac: Natural Approaches to Curing Stress, Anxiety and Depression without Drugs and without Psychoanalysis
