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Case Studies - Page 5

Only when these supplements, together with the rest of my approach, don't work, or if my patient explicitly requests it, do I refer her for pharmacological therapy, and I continue to work with her while she sees a
psychopharmacologist. Except when clients have debilitating chronic illnesses that may well become terminal, the time people in my practice spend on drugs is almost always relatively brief.

A spiritual perspective informs my work from my first moments with each person. Not an explicit religious orientation, this perspective encompasses an appreciation for the yet unrevealed potential of each person, a sense of sacred connection within each of us to something larger than ourselves, and moments of inexplicable grace, which can transform each person's work with me and on their own.

Not long ago on a phone call, Theresa reminded me of this dimension of her life and of our work together. She'd moved through her depression in two months of weekly sessions with me, without neurotransmitter precursors or drugs. She'd continued to see me once every month or two for "refresher sessions" for another three years. Then, two years ago, she moved away to take a position at a law school. I'd watched her grow over the years into a peacefulness that she'd never before known—meditating regularly, doing yoga, taking time for herself. Now we were catching up, and she was looking back on our work together.

"My depression and the sad state of my spiritual life were two sides of the same coin," Theresa reflected. "First, I needed to look at myself psychologically, to see that I was depressed, and that mine were ordinary human problems. I wasn't this bad, immoral woman, sleeping with guys who didn't love me, drinking too much, and smoking pot. I just needed to see how what I did, and the sad, confused way I felt, connected to my childhood—to that lonely little girl with her desperate desire to please. And I needed to get my life on a track that worked for me. But I also needed to feel my spiritual side, and by that I mean the heart, or the soul, or the divine in me."

Through her work with me, as well as meditation, yoga, and dance, Theresa said, she began to develop "some emotional radar to sense what I was feeling—whether anxious, sad, angry—to know if something was off-kilter. I learned that I didn't need to fight it, that it was okay just to let myself feel the pain. It was just passing feelings, and not something fundamentally wrong with me. I no longer have the feeling that I won't get what I want. I have what I want." Here, she emphasizes that wonderful, present-tense word, so different from all the past-tense terms of loss and longing that marked her depression, "I feel whole and happy as I am. If I find a 'significant other,' that would just add to it."

I thank Theresa out loud, and silently, too, for sharing with me what's possible. Freud wrote about replacing neurotic with ordinary unhappiness. Psychopharmacologists praise the restoration of the "premorbid personality." Theresa is showing me, telling us, what it means to move from being terribly, chronically, depressed to feeling blessed every day.

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