For those individuals struggling with major depression, life can seem like a dark cavern of despair. The hopelessness of their situation is continually reinforced by the pervasive negative thinking that dominates the space they occupy. Those negative thoughts continually pull the shades of darkness on their world and prevent the person from realizing the pleasures of life.
The depressed person tends to minimize accomplishments and maximize failures. Asking a depressed person to simply “see the bright side of things” is analogous to asking someone to view a beautiful picture in total darkness. However, if the person can be assisted to verbalize positive traits attributable to self, he or she may begin turning on the lights necessary to illuminate a path to recovery.
Negative Thinking and Depression
According to Beck (1991), negative automatic thoughts tend to arise in the person with depression without conscious awareness. When these negative thoughts become connected to events in one’s life, the individual begins to develop a negative view of the present, past and future.
In more severely depressed people, Beck found those negative thoughts become more consciously apparent to the person and a part of the individual’s self-monitoring or self-communication system. As negative thoughts begin dominating the person’s internal communication network, it affects self-evaluation, attributional tendencies and what a person tends to expect outcomes to be.
Ultimately, negative thinking increases self-blame and self-criticism, while reducing a person’s self-esteem.
Beck (1991) further discovered that depressed patients often interpret positive events as negative through exaggerated or dichotomous thinking. For example, if the depressed person received a positive evaluation at work or school, he or she might respond, “the supervisor or teacher was just being easy on me.”
At the same time, if the person received a poor evaluation or grade, he or she might say, “they are getting ready to fire me or I might as well drop out of school.”
In other words, the depressed patient tends to minimize his or her accomplishments or positives and maximize failures or negatives. The pattern of negative thinking becomes so engrained in the depressed patient’s mind, the individual may also begin interpreting future outcomes as negative, while filtering out any possibility of a positive result.
Identifying Positive Traits About Self
If the individual with depression is incapable of identifying positive attributes about self, he or she is unlikely to realize the rational consequences of successes or failures. When first trying to elicit positive traits from the client during the initial phases of psychotherapy, he or she will likely struggle to identity positive traits about self.
After several moments of silence, he or she will often name external qualities, skills or activities they can perform well such as cooking, sporting skills or work-related activities. Although a good starting point, the client will frequently avoid naming positive internal traits or attributes about self.
Psychotherapy can be an ideal time for reflection and discovery for the client with depression.
Positive change may be realized during therapy by emphasizing the person’s strengths and competence, which could be related to progress attained during time in therapy (Fitzpatrick & Stalikas, 2008).
Further, by reflecting on every day events and tasks, clients can often be helped to discover successes and positive attributes they may have taken for granted or neglected to take credit for because of their pervasive pattern of negative self-talk.
For example, a homemaker who has a negative perception of self, may have overlooked the many tasks she does on a daily basis in caring for her children, such as preparing meals, caring for a sick child or making sure the children all have clean clothes.
Identifying and accepting previously disregarded accomplishments and internal attributes as worthy of praise is an important first step in diminishing the negative patterns of self-evaluation.
Restructuring of Thought
During cognitive therapy, the patients learn to identify negative thoughts and how they impact their emotional state of mind. These negative thoughts are then challenged with evidence to reveal their distorted view of self, the environment, and their future. Finally, the clients learn to replace the negative maladaptive thoughts with more positive and realistic cognitions.
It is a goal of therapy that the patients will eventually begin to identify, challenge and replace the negative thoughts as they become present during therapeutic conversation (Beck, 1979).
The restructuring of thought occurs during therapy through a process known as Socratic questioning. During Socratic questioning, the client’s negative thoughts are regarded as hypotheses and evaluated for validity, through careful consideration of the available evidence (Barlow & Craske, 2008).
By helping the client identify positive attributes of self at the outset of therapy, the identification and replacement of irrational negative self-thoughts becomes less challenging. Furthermore, if the client identifies positives about self, it also serves as a reality guidepost for the therapist to use during Socratic questioning.
A homemaker with depression may claim to be “totally worthless” during a session. The therapist could then make the statement, “a worthless person cares for her children, takes care of them when they are sick and makes sure they have clean clothes?”
Since the patient has already committed to the fact she does these tasks on a daily basis, it is difficult for her to disavow the contradictory statements, thus invalidating the statement of “worthlessness.” If she can be helped to internalize positive attributes of self, then the previous cascade of negative automatic thoughts can autonomously be identified and replaced and the negative thoughts may become sparser in occurrence.
Pervasive negative and maladaptive thought is generally associated with major depression in those diagnosed with the disorder. In order to cognitively restructure and replace irrational negative thinking into adaptive thought patterns, one needs to first accept his or her own positive attributes.
Perhaps the most difficult task for the individual with depression is identifying and accepting positive qualities, which often requires the assistance of the therapist. Identifying and accepting those positive attributes can then provide alternatives to negative thoughts, which the depressed individual can implement during the therapeutic and recovery process.
Positive thoughts regarding self may be the light switches that can transform the person’s negative thoughts and depressive existence from perpetual darkness into the illumination of reality, leading to a happier and more fulfilling life.
Barlow, D. H. & Craske, M.G. (2008). Panic disorder and agoraphobia. In Barlow, D. H. (Ed.), Clinical handbook of psychological disorders: A step-by-step treatment manual (4th edition). Guilford publications.
Beck, A. T. (Ed.). (1979). Cognitive therapy of depression. Guilford press.
Beck, A.T. (1991). Cognitive therapy: A 30-year retrospective. American Psychologist, 46, 368-375.
Fitzpatrick, M. R., & Stalikas, A. (2008). Positive emotions as generators of therapeutic change. Journal of Psychotherapy Integration, 18, 137.