Case Studies

Case Studies

Educating Theresa: Sometimes therapy means total commitment

January/February 2010

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…

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