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Case Studies

By James Gordon

Educating Theresa
Sometimes therapy means total commitment

Theresa, a 37-year-old African-American civil-rights lawyer, tells me in our first session together that she's been miserable for a month. During that time, she's lost weight she can ill afford to lose, and has been sleeping only four to five hours a night. Alternately listless and agitated, she's been unable to concentrate at work. She leaves her office late, feeling guilty for what she hasn't done, anxious that she'll have to make up for it the next day. She used to go dancing with friends in the evenings, but now she tells them she's tired. At home, she watches TV and eats frozen dinners. Sometimes, she measures her wine in bottles, not glasses. She's feeling increasingly hopeless. She's clearly clinically depressed, and her internist and psychotherapist have urged her to take antidepressants, but she doesn't want to. She's come to me to find a better way.

Theresa knows I view depression differently from how her doctor and therapist do. "Depression isn't a disease," I explained to her on the phone when she called to make an appointment. "It's not the end point of a pathological process. It's a sign that our lives are out of balance—that we're stuck. It's a wakeup call, potentially the start of a journey that can help us become whole and happy, a journey that can change and transform our lives." Before any patients visit my office or pay me a fee, I speak on the phone with them, letting them know who I am, what my perspective is, and how I work, and make sure they want to participate in what I have to offer. I usually suggest that before the first appointment, they read something I've written about my practice, to get to know more about the meditative, eclectic, active, and engaged "Unstuck" approach I'll offer.

The fit between what I'm offering and what my patient is hoping for will be the springboard for all our work. It'll provide the shared vision on which we can draw in the difficulties and challenges that may come in any therapy. Commitment to an integrative approach—and the urgency that may fuel that commitment—help provide the energy that sustains us in meeting the challenges of our work together.

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