Escaping the Trance of Depression

Using Bill O'Hanlon's Marbling Technique with Clients

Bill O'Hanlon

PNND-03[1]When I was a psychology student, I learned about a phenomenon called “state-dependent learning,” based on the idea that our brains associate certain memories with specific environments, sensory experiences (smells, tastes, sounds, etc.), and internal experiences (emotions, thoughts, images, etc.). For example, if you study in a blue room, you’re likely to recall the studied material better if you take the test in a blue room or with something blue nearby. If music is playing when you fall in love, hearing that song again will take you back to those memories. The brain works by association, and certain associations bring up other associations.

This extends to emotions as well. If you’re happy, you’ll more easily recall happy memories. Thus it follows that if you’re depressed, it will probably be more difficult for you to recall happier memories. So, when you’re feeling helpless and resourceless, it’s harder to get in touch with resources.

And what happens when a depressed person seeks help from a mental health professional? Most of us therapists tend to ask our clients to talk in detail about their depression. Now, of course, that is part of our task: to assess the level and history of depression. But an inadvertent side effect can be a deepening of the depressive experience as we bring it to the foreground. Indeed, a recent study shows that extensive discussions of problems, encouragement of ‘‘problem talk,’’ rehashing the details of problems, speculating about problems, and dwelling on negative affect lead to a significant increase in the stress hormone cortisol, which predicts increased depression and anxiety over time.

In recent years, we’ve learned that repeating patterns of experience, attention, conversation, and behavior can “groove” the brain; that is, your brain gets better and faster at doing whatever you do over and over again. This includes “doing” depression, feeling depressed feelings, talking about depression, and so forth. Thus, we can unintentionally help our clients get better at doing depression by focusing exclusively on it.

To counter this effect, I like to use a method that I call “marbling.” My father owned several meat-packing plants, and early on I learned that marbling refers to the fat streaks embedded in the leaner meat in a cut of steak. It gives the steak more flavor. In a similar way, but with less cholesterol, in therapy I suggest marbling discussions and evocation of non-depressed times and experiences in with discussion of depressed times and experiences. This way we don’t just evoke and deepen the depression, and we avoid losing contact with the depressed person by not listening to her or invalidating or minimizing her suffering. By going back and forth between investigations of depressed experience and non-depressed experience and times, the person who’s been depressed is reminded of resources and different experiences, and often begins to feel better during the conversation.

In his book Darkness Visible, William Styron, who almost killed himself while going through a serious depression because he’d become convinced that he’d never come out of that painful state, put it this way after he recovered: “Mysterious in its coming, mysterious in its going, the affliction runs its course, and one finds peace.” But in the middle of it, one often forgets that there’s any other place, or any experience other than unremitting bleakness and pain. It can be a lifeline to people in the midst of depression to have even a glimmer of the possibility that there will be experiences outside depression.

One of the first ways I suggest implementing marbling is to discover, with the depressed person, a map of her depressed times, thoughts, actions, and experiences, as well as a map of her non-depressed times, thoughts, actions, and experiences. This is like asking the person to join you as a co-anthropologist of her life so that she can help you not only learn about the contours and geography of her suffering, but also about her competence and better moments.

We often talk about “depression” as if it were a uniform experience, but although many depressed experiences share common features, they always occur in specific and particular ways for the person in front of us. The non-depressed features are also very particular and specific. But we’re so often focused on the suffering (as is the person experiencing depression) that we neglect to investigate and discover other experiences that don’t fit with depression. In Zen and the Art of Motorcycle Maintenance, author Robert Pirsig said that when an artist draws a tree, he doesn’t draw the branches and the leaves. Instead, as he draws the spaces between the branches and leaves, a picture of the tree emerges. This resonated with me because that’s what I do when approaching depression. I’m interested in discovering and detailing non-depressed experiences, actions, thoughts, and experiences. That way, I learn about the person’s abilities, competence, and good feelings as well as get a sense of her suffering.

This blog is excerpted from “Out of the Tunnel.” The full version is available in the Nov/Dec 2014 issue. To subscribe, click here. >>

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Topic: Anxiety/Depression

Tags: conversation | depression | depression and anxiety | emotion | HEAL | learning | mental health | mental health profession | mental health professional | neglect | psychology | psychotherapy | talking | TED | therapist | therapists | therapy

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1 Comment

Sunday, November 30, 2014 12:14:03 AM | posted by Rana
The "marbling" technique already exists; it's called dialectical behavior therapy or DBT.