A Simple Graph Which Answers The Question:
“Why has my life ALWAYS been terrible?”
Seth Bernstein, Ph.D.
A common perception of clients who are experiencing major depression is that their lives have always been terrible. They are not speaking metaphorically. They are being literal. They only have memories of the times in their lives when they were feeling the way they are feeling now – depressed. How can a person answer the Miracle Question, how can they think about their Preferred Future when they have no access to an affective state that is positive? They can’t.
For over thirty years I have used the graph illustrated above to help my depressed clients understand the relationship between affect and memory. The explanation takes about five minutes and in my experience, the insight it provides emotionally opens clients to thinking about a future that contains accomplishments, meaning, and positive feelings.
I first became aware of the concept of “state-specific memory” in the 1970’s when I had an interest in para-psychology. At the time, Charles Tart was one of the foremost researchers in the field. The term he used, “state-specific memory,” has evolved since that time and is now called “state-dependent memory” or “state-specific learning.” Wikipedia defines it as “the phenomenon through which memory retrieval is most efficient when an individual is in the same state of consciousness as they were when the memory was formed.” I would suggest that those who are interested in exploring the research on state-dependent memory, which dates from 1937, start with the Wikipedia summary.
In talking with clients about this subject, it isn’t necessary to cite the research. They will trust you when you say, “there is a lot of research to support what I am about to show you.” Some clients, however, will be interested in the research. So, be prepared to provide them with directions on how to find it.
I have found that giving a handout with the graph above to a sitting client is not as effective as having the client stand up and walk over to my white board where I draw the graph as I explain it. The process is more dynamic. The physicality of changing from a sitting position to a standing position and literally moving across the room creates an unconscious metaphor for changing perspective and changing bodily sensations, both of which, currently, are rigid and stuck.
Here is my explanation:
It is not surprising that you feel hopeless. You think back on your life and all you see is blackness. When you look forward, all you can imagine is continued blackness. Why wouldn’t you – or anyone for that matter – if all they could remember when they looked back were the times they were depressed. It is logical to assume that your life, looking forward, will just be more of the same.
There is a considerable body of research which explains why people who are significantly depressed can only remember the times in their lives when they were depressed. This body of research is called ‘state-dependent’ memory.’ Let me show you how it works. <I create the diagram, above, as I talk.>
You see this wavy line? It’s a person’s mood going up and down. We all have good days and bad days. We have times when we are feeling positive about things and times that when we feel doubtful or pessimistic. When our highs and lows fall between these two lines, our memory functions effectively. When we are feeling up, we can still remember the times in our lives when we were feeling down. When our mood is in the low part of the wavy line, we can still remember the times we were feeling positive about ourselves and our lives. Also, we are able to anticipate that there will be future times in our lives when things will be looking and we will be feeling brighter.
However, when our mood drops below this black line or goes above this pink line (that’s called mania), our memory does not function effectively. When we are down, ALL we can remember is the times we were feeling down. That’s literally all our brain allows us to remember. See the tops of these inverted mountains? That’s where we live and have ALWAYS lived. We can ONLY remember the lows.
So, it is no wonder that people whose mood drops below this line cannot see a future for themselves that has any potential for being better. It all looks bleak, both looking back and looking ahead.
Does that make sense to you?
Generally, my clients answer this question in the affirmative and what follows is a slow opening up to memories and affects that had been previously locked out by state-dependent memory. I believe the mechanism which does this unlocking is hope. Where there had only been pain and fear, my explanation helps my clients reorganize their conceptualization of their experience. In so doing, a door is opened. This is very much in line with Freud’s explanation of how interpretation works.
In describing the transition from locked memory to unlocked, my colleague Yvonne Dolan observes that “I routinely watch for signs of physical relaxation in order to decide what to offer the client next. Specifically these signs usually include a slight slowing of breathing and settling further into the chair, body movements or fidgeting slowing down, accompanied by some head nods, followed by what Milton Erickson and Ernie Rossi used to call an ” expectant look,” in which the client at least briefly makes some eye contact with the therapist or otherwise appears to be comfortably waiting for the therapist to say something. Rossi viewed these signs as a signal of the client’s readiness to be invited into a therapeutic trance. With the SF approach, I have learned to view these “yes set” responses as a sign that the client is now feeling safe and calm enough to consider a SF question.”
Colleagues, I would suggest you try using this graph and this explanation. See for yourselves whether they unlock your clients’ potential to imagine a future for themselves that includes positive experiences, accomplishments, and pleasure. As we know from our training and experience in Solution-Focused Therapy, until clients can imagine a real future for themselves, the rest of what therapy has to offer will not be of much use.
Seth has a wealth of experience beginning with earning his doctorate at the California School of Professional Psychology. He has worked in many areas including as a graduate school counselor, private practice, healthcare management and consulting and as the Executive Director of the Accountable Behavioral Health Alliance. He is the founding and current Executive Director of the Institute for Behavioral Health Integration. We were fortunate to have Seth join us for our summer intensive in 2017 and are thrilled he has offered to share his article for our Summer 2018 Inspirations Newsletter. For more information on Seth, visit his website at: https://www.sethdbernstein.com/home.html