A Somatic Approach on Working with Depression and Negative Self-Talk By Payam Ghassemlou MFT, Ph.D.

Depression is common and treatable. It can strike anyone at any age. Consulting with your physician or a licensed mental health provider is the best way to find out if you are suffering from depression and the type of depression you might be having.

A person with depression can experience a few or many of the following symptoms:

Feelings of sadness and emptiness

Feelings of anxiety

Experiencing restlessness or irritability

Losing interest in all or most activities

Problems with appetite that can lead to weight gain or weight loss

Sleeping problems

Loss of interest in sex

Low energy that can include feeling tired much of the time

Difficulty with concentration or making decisions

Feeling negative towards oneself including worthlessness or excessive guilt

Feeling hopeless or helplessness

Crying spells

Increased use of alcohol or drug use in order to cope with a depressed mood

Thoughts of death/suicidal ideation

Many people might not have the awareness that the underlying cause of the above-mentioned symptoms is depression; therefore, they cannot get the treatment they need. It is difficult to treat something that one has not identified yet. Over time, serious levels of depression that are not addressed get worse and can lead to other health-related issues. It can even lead to suicide.

There are different kinds of depression; hence, one person’s needs will differ from those of someone else. Psychotherapy is the most common treatment for depression. Psychotherapy can help on many different levels including integration of the clients’ body experiences in relation to their thoughts and emotions along with resolving or coping with issues that may contribute to their depression. Most mental health providers agree treatments for depression with suicidal ideation or other serious symptoms require a combination of antidepressants and psychotherapy. Some patients who might not show progress with standard treatments for depression might need additional resources.

In my counseling work with people who suffer from depression, I often notice that they have an inner critic which constantly makes them feel discouraged, inadequate and in many cases worthless. When the inner critic is the dominant voice inside a person, depression is likely to be present. Identifying the inner critic can be done by encouraging clients to pay attention to their body and their nervous system activation. For example, when Jack noticed his neck and shoulders curved forward, his head looking down, and unpleasant tension in his jaw, he was invited to become curious about this body language. The body language is a voice that does not use words and always tells the truth. He discovered an inner dialogue associated with this body posture, and it involved the following thought, “I am going to lose my job.” He realized how often he tells himself that his job is at jeopardy. When he was invited to examine all the reasons that he won’t lose his job, and all the resources that can help him to find another job in case he was let go, he noticed a shift in his body. He started sitting up straight with his shoulder pushing out, his jaw loosened, and he reported feeling more confident. He was encouraged to embody this new level of confidence by noticing all the positive shifts in his body including his deeper breath and feeling more relaxed in his shoulders. By tracking his pleasant bodily sensations that he was experiencing as result of identifying helpful resources, he was creating a physiological event in his body which led to regulating his nervous system. This can be a powerful approach to help someone suffering from negative self talk to use their body as a resource to modify such self-defeating dialogue.

There are many ways to work with negative inner dialogues and painful emotions that accompany them. It is helpful for clients and therapists to explore different treatment options as they work together. A collaborative therapeutic approach helps people to feel empowered and  in control of their recovery from depression.

Working with a mental health therapist to explore treatment options for depression is an important step toward healing. I hope anyone who is suffering from depression reaches out and gets the help they need. Everyone’s pain is unique, and no one deserves to suffer in silence. Reaching out and asking for help is a courageous act that people can do in response to suffering from depression.

 © Dr. Payam Ghassemlou MFT, Ph.D., is  a marriage and family therapist in private practice in West Hollywood, California. www.DrPayam.com 
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