Posts Tagged ‘SFBT’

Depression and exercise. What’s your view?

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June 13, 2012 · by Deborah · Depression, Solutions, Therapy

You may have picked up on the recent debates in the press on depression and the efficacy of exercise as a cure.  If you suffer from depression this could well have piqued your interest (or ire!).  Findings cited in a research article published in the BMJ and widely reported (http://www in the press on the beneficial effects of exercise on depression state that, contrary to popular opinion, these effects are negligible.  This runs counter also to advice often given to depressives by doctors and mental health workers.   It produced an irate response (http://www in an article in the Guardian by Simon Hattenstone  – himself a sufferer of depression.

What was so illuminating were the comments following Hattenstone’s article.  These views from readers reinforce the views and findings of many of my own clients, both past and present, who work so hard towards finding ways of either eliminating or coping with depression.  What emerges very clearly is that there is no one-size-fits-all solution or cure for depression; depression means different things to different people, and since it has so many variables the solutions to coping with it are also variable.  At the risk of sounding simplistic what this means for clients is: whatever works for you, do it.   In this way, any effects and gains can be sustained.

These are some of my clients’ discoveries:

  • Exercise of any kind helps, particularly if it takes place outdoors, because you force yourself to go out into the world and so feel more a part of it; you feel more in control of your life;
  • For some the beneficial effects of  exercise may not be lasting, clients therefore consider it as one of a range of activities which help;
  • Others have found that exercise only helps if  it’s a group activity – for these clients lone walking or running only increases their sense of isolation  and muddled thinking;
  • Exercise like jogging or going to the gym isn’t a chosen solution for some clients because they can’t sustain it, it can therefore compound a sense of failure;
  • Yet other clients report that at least trying to exercise is important for them, they feel less guilty about being depressed, and they enjoy feeling physically healthier;
  • Other of my clients who have active, high-profile lives often find that sitting in a heap or going to bed for a while helps them – they need to bunk off from the world for a bit.  For them knowing when and how to re-emerge becomes the skill they hone;
  • A client who cycles to work in the city (he has given me permission to cite his experience here) finds the activity requires him to be so alert in the interests of his safety that it helps his depressive episodes and ‘takes him out of himself’, giving him, in addition, a sense of achievement and boosting his confidence;
  • Others report that any activity, be it undertaken individually or in a group,  is helpful if it provides another focus, establishes a routine and breaks the patterns which have developed around the depression;

What happens in solution-focused therapy sessions where the problem is depression, is that I facilitate clients to find an individual solution to a highly individual problem.  Helpful in this search for solutions is the consideration of  instances and exceptions in clients’ lives when depression doesn’t have so much of a grip.  What was and is happening at these times and how can these exceptions and instances be built upon  to improve quality of life and deprive depression of it’s sting?

P.S  For those interested in the above debates here’s another vexed question about depression: how much is depression learned?   You may wish to read this article in the New Scientist (http://www NULL.newscientist NULL.html) as well.    See what you think…





About Depression

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May 8, 2012 · by Deborah · Choices, Depression, Therapy

Signs and Symptoms

There is no question that depression is extremely debilitating and has many symptoms : fatigue, lack of motivation, a deep despair, lack of confidence and self-esteem,  anger, inability to sleep, suicidal thoughts (or attempts), forgetfulness, overwork and hyper-activity  – the list is endless.  Depression can strike at any time in our lives and for a number of reasons; it can be triggered by a particular event, or be a condition you have lived with for many years.

Sometimes those living with depression can be good at hiding it and often feel guilty that they are depressed, particularly when all factors in their lives appear to indicate that they have nothing to be depressed about – as described by Stephen Fry in an article (http://www NULL.telegraph NULL.html) in the Telegraph.   For those whose depression isn’t hidden, not only they but also their loved ones are often at their wits end, believing that nothing they do will ever help.  Guilt abounds all round and vicious patterns and cycles are repeated endlessly.

Is There a Cure?

Most clients who see me for depression have said that seeking help for depression was a vital step in the right direction.  Although self-help books and many of the talking therapies available can give you an insight into your condition, this is not enough.  Some of my clients have found also that just taking medication is not enough and they have needed good, professional help to find a workable solution that can be maintained and built upon – these last two factors being of prime importance to those with depression.

As a solution-focused therapist I believe the details of your depression are unique to you and need to be resolved as they relate particularly to you.  A solution  can be found if you are willing to do the work involved in finding out what solution will suit you. My experience of  working with depression  is that it is possible to beat both mild and severe depression, or at the very least find effective ways of coping with it.  Once you find the best solution for you, you will be able to use that tool whenever it’s required, so that you can experience a more fulfilled and successful life.  I won’t pretend it’s easy, but there is no doubt that you don’t have to be the victim of your depression. Sometimes just knowing that you are working on the problem, brings relief.  I would be happy to help you find and maintain a workable solution.


It’s SO Embarrassing – Reflections on Therapy

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March 12, 2012 · by Deborah · Solutions, Therapy

Some clients are embarrassed and ashamed about coming to therapy.  They have described their need to seek therapy variously as “weak”, “self-indulgent” or “insane”!

Invariably clients come to therapy when they are in crisis or at an impasse in their lives; sometimes they feel ‘co-erced’ into coming by a parent, partner, or agency.  Many are apprehensive, not being sure whether they will encounter Madame Arkati with her fringed shawl and weeja board, or a sappy nutter in sandals and a jumper, muttering about karma and handing out snakeoil.  One relieved young client stated to me :  “I thought you would look like my nan and nag like my mum!”

Clients are quite right to be apprehensive and cautious – you take a bit of a risk when you wade out into the therapy waters, looking for a cure.  It’s difficult to be sure that you will get the ideal: objective help from someone who is well qualified, and professional and prepared to help you sort things out rather than keep you chatting or poking about in areas you feel are irrelevant to your issues.

It is also time consuming to investigate all the different therapies and it can be difficult to decide if what they offer would really be useful to you in your quest to solve your problem.

One fundamental difference which sets solution-focused brief therapy (SFBT) apart from other approaches is that the solution-focused therapist doesn’t make any interpretations or analyses about your problem.  There are no ‘hypotheses’ or ‘fantasies’ or ‘theories’ about why you are as you are and why the problem exists.   We avoid trying to lead you down a path that is irrelevant to your problem, and we don’t give advice, since this would get in the way of listening to you and helping you to discover what you want.  We will of course make suggestions if desirable and appropriate and if they fit into the context of what your situation is.  In this way we lead from behind rather than in front.

Our main way of facilitating is to ask questions, which we hope will help you to look at the problem in ways you may not have thought of before, so you gain a new perspective on your problem.  We work from the premise that if you have a vision of the sort of life you wish to have when the problem isn’t there any more, then you can set about finding the solutions to achieving this.

Clients often ask me: “Is there a solution to this problem”, and the answer is, of course there is, if you want to find one.  There is a solution to every problem, it may not be the one you think you’re looking for, but it is there to be found.  The steps to changing a situation can be small and incremental, or taken in great leaps.

What helps clients a great deal is the discovery that no problem is there all the time; this way of looking at a problem is another strength of the SFBT approach which is different to other therapies.  If you look for them there are always exceptions when the problem isn’t happening: times when you’re not arguing as a couple, times when you’re not depressed, times when you have been able to have fun and feel less anxious, times when your teenager is happy and communicative.

One elderly couple declared miserably that they never seem to get things right.  On closer examination they were surprised to be able to acknowledge, that amongst other things, they had successfully brought up three children, who were leading happy and fulfilled lives and could cite countless times when they had contributed significantly to the wellbeing of  friends and their work places over the years.  This way of addressing problems in SFBT is not to deny the problem, but rather to avoid being bogged down by the whys and wherefores.  Whilst it may be helpful to have this understanding (most people have a good understanding of cause anyway)  it doesn’t actually help you to deal with things and try to put them right.

As a solution-focused therapist, I believe people are resourceful, resilient and perfectly capable of finding solutions to their problems and I am often filled with admiration at their perseverance.  I never feel depressed about my clients or exhausted or bored by their problems, since talking with people who are taking control of their problems and working through them logically is an energising process.

Therapy should not be about creating a victim mentality and scraping the problem-pot so hard we fall into it and drown in the lard. It also shouldn’t be a gossipy chat around the village well, where advice is swapped and fingers wagged.  And whilst a heart-to-heart with a sympathetic friend can help it is easier to talk to a personally ‘disinterested’ party who will let you work out, in your own time, the solution that’s most fitting for you and your life.  Problems are a natural part of living – everyone encounters problems (even therapists) and searching for another perspective on difficulties which are proving intractable can be helpful in moving us forward.  Therapy can and should be a positive and affirming experience.

With words to this effect, one client, who had been to three therapists previously, aptly commented to me: “I just want to sort it out, not trawl forever through the dustbin of my life, being overwhelmed by the fumes”.