Rachel is 41 and has never really let herself enjoy life.  She is a risk taker, who can’t take the risk, a pleasure seeker, for whom pleasure feels very insecure – something is bound to go wrong.  She feels deeply but can never show her feelings.  She needs intimacy, but cannot let anybody close to her.  So her existence is orchestrated in a minor key.  She took a job that was dull and safe rather then challenging and interesting.  She was too scared to marry the man she fell in love with.  She never felt able to take on the responsibility of children.  Life has been a sequence of missed opportunities. She is a creative poet, but rarely reads her work in public and has never submitted it for publication.  She cannot let herself be free to express herself.  On the few occasions she has tried, a voice in her mind, perhaps an echo of her critical mother, would sneer, ‘Just who do you think you are?’  She constantly monitors her behaviour, censors every impulse. So she has never developed confidence is herself and she cannot trust people. Ever fearful of implied criticism, she feels worthless.    


So Rachel spends most of her time alone, preoccupied with her ailments.  She suspects she has a terminal illness that nobody can diagnose. She has.  It’s called melancholy.  She has starved herself of life and like Eeyore, the doleful donkey in Winnie the Pooh, has become a caricature of her own misery. 


So many of my patients come to see me because they are unhappy.  Why else would anybody wish to see a therapist?  They want to talk about it and some may want to feel better so much that they are willing to risk the change.      


Depression, which is the commonest illness in the western world is not just a disease of the mind or the brain, it is a depletion of the spirit – the meaning and purpose of life, an erosion of hope.  For the majority of depressed people, the changes in mood and brain chemistry occur as a result of what has happened to them.  It is crucial, therefore, to look for the causes of depression in a person’s individual narrative; their life script.     


Why do they tend to take the blame for everything?   Why are they so shy and scared of other people?  What has happened to make them feel so ashamed of themselves?  Why do they constantly compare themselves to others and feel inadequate?  Why do they always feel in the way?   Is it related to the way they were treated as a child or has something happened to shatter their confidence later in life?  Is their behaviour still relevant now?  


We are social animals.  We all need to feel we belong – to feel comfortable with ourselves in the company of others.  If we are feeling ashamed, guilty, insecure or inadequate,  it can affect the way others treat us and unerringly bring about what we are most frightened of, inviting a spiral of inadequacy, rejection and depression.  So fear of abandonment and isolation can cause us to behave in a needy way, causing others to feel obligated.  If we are so obsessed with our own inadequacies, then people perceive us as a burden.  If we can’t trust others and are closed and secretive, they will not trust us.  If we feel in the way and are constantly making excuses for ourselves, then we put demands on others to rescue us.  If we are too aware of the unfairness in life, then our grievances will irritate others.  If we become too assertive of our own rights, then others will feel ignored and rejected.  If we are so preoccupied with our own misery,  we will take others’ behaviour personally. If we are always questioning another’s love for us, they will begin to question it too.  If we envy another’s success,  then they may feel they have to demean themselves to be in our company.  To cure our depression, we need to escape from our own morbid  obsession with ourselves.  We need to change the script.   


Traditional healers, such as the Sangoma in South Africa are story tellers.  They heal by enacting a new script, a script for change.  Stories carry meaning.  They can make people feel better.  If something they feel guilty or ashamed of can be explained in ways they can understand,  then they can forgive and forget and move on with resolve not to make the same mistakes again.   Psychotherapists also need to be interpreters and tellers of stories.  They need to understand the meaning behind the depression and  help their clients change it.  In order to do that, they must conduct sufficient analysis for their client to appreciate fully the narrative that they illness is expressing.  Then the two of them need to edit the script in a way that makes sense and offers a credible route for healing to take place.


Change occurs slowly and starts with a change in attitude; a redrafting of the life script.  As well as providing an acceptable understanding for perceived misdemeanours,  the altered life script might include emphasising areas of life where people have a role, a purpose,  where they can rediscover a sense of value.  It might suggest enterprises that can inspire, ways of being creative, opportunities to become more interested in others while not minding too much how they are perceived.  In these ways and many others people can stop the morbid self destruction and dare to embrace life.  This is not a catch all formula for change.  The script has to be authentic, to relate to their own history, but presented in a  more hopeful manner that draws strength from their experience and brings out the best of their personal resources of family, work and interests.


Rachel has starved herself of life, because she has feared her mother’s critical envy.  But her mother died some years ago.  In reality, there is nothing to fear except the fear that is in her head.  She now has an opportunity to change the story.