Good Mood: The New Psychology of Overcoming Depression Chapter 18

Values Therapy: A New Systematic Approach For Tough Cases

Appendix for Good Mood: The New Psychology of Overcoming Depression. Additional technical issues of self-comparison analysis.Values Therapy suits some tough cases of depression, where the cause of the depression is not obvious and easily altered. It may be especially suitable for a person who has suffered a severe shortage of parental love as a child, or experienced over- long grief following loss of a loved one as an adult.

Values Therapy is a more radical departure from conventional modes of fighting depression than are the tactics discussed earlier. Other writers have mentioned and used some of its elements in an ad hoc fashion, and have emphasized that depression is often a philosophical problem (e.g. Erich Fromm, Carl Jung, and Viktor Frankl). Values Therapy is quite new, however, in offering a systematic method of drawing upon a person's fundamental values so as to conquer depression.

Values Therapy is especially appropriate when a person complains that life has lost its meaning--the most philosophical of depressions. You may wish to re-read Tolstoy's vivid description of this state, in Chapter 6, as well as pages 000 to 000.

The Nature of Values Therapy

The central element of Values Therapy is searching within yourself for a latent value or belief which conflicts with being depressed. Bringing such a value to the fore then causes you to modify or constrain or oppose the belief (or value) that leads to the negative self-comparisons. Russell describes his passage from a sad childhood to happy maturity in this fashion:

Now, on the contrary, I enjoy life; I might almost say that with every year that passes I enjoy it more. This is due partly to having discovered what were the things that I most desired, and having gradually acquired many of these things. Partly it is due to having successfully dismissed certain objects of desire--such as the acquisition of indubitable knowledge about something or other--as essentially unattainable.(1)

This is quite different from trying to argue away the sadness- causing way of thinking, which is the main approach of cognitive therapy.

The discovered value may be (as it was for me) the value that says directly that life should be happy rather than sad. Or it may be a value that leads indirectly to a reduction in sadness, such as the value that one's children should have a life-loving parent to imitate.

The discovered value may be that you are unwilling to subject people you love to the grief of having you respond to your depression by killing yourself, as was the case with this young woman:

My mother died seven years ago by her own hand...

I can't imagine what [my father] must have felt when he found her. I can imagine how my mother must have felt as she descended the stairs to the garage for the last time...

I know. I've been there. I tried suicide several times in my life when I was in my early 20s and was quite serious at least twice....Besides actually attempting suicide, I've wanted, wished and even prayed to die more times than I can count.

Well, I'm 32 now and I'm still alive. I'm even married and have moved from a secretarial position into entry-level management...I'm alive because of my mother's death. She taught me that in spite of my illness I had to live. Suicide just isn't worth it.

I saw the torment my mother's death caused others: my father, my brother, her neighbors and friends. When I saw their overwhelming grief, I knew I could never do the same thing she had done -- force other people to take on the burden of pain I'd leave behind if I died by my own hand. (2)

The discovered value may lead you to accept yourself for what you and your limitations are, and to go on to other aspects of your life. A person with an emotionally-scarred childhood, or a polio patient confined to a wheelchair, may finally look facts in the face, cease railing at and struggling against their fates, and decide not to let those handicaps dominate their lives but rather to pay attention to what they can contribute to others with a joyful spirit. Of they may devote themselves to being better parents by being happy instead of sad.

A Five-Step Process of Value Transformation

Values Therapy need not always proceed systematically. But a systematic procedure may be helpful to some, at least to make clear what operations are important in Values Therapy. This is the outline of such a systematic procedure:

Step 1:

Ask yourself what you want in life -- both your most important desires as well as your routine desires. Write down the answers. The list may be long, and it is likely to include very disparate items ranging from peace in the world, to professional success, to a new car every other year, to your oldest daughter being more polite to her grandmother.

Step 2:

Rank these desires corresponding to their importance to you. One method is to put numbers on each want, running from "1" (all-important) to "5" (not very important).

Step 3:

Ask yourself whether any really important wants have been left off your list. Good health for yourself and your family? The present and future happiness of your children or spouse? The feeling that you are living an honest life? Remember to include matters that might seem important when looking back on your life at age seventy that might not come to mind now, such as spending plenty of time with your children, or having the reputation as a person who is helpful to others.(3)

Step 4:

Look for the conflicts in your list of wants. Check if conflicts are resolved in a manner that contradicts the indications of importance that you accord to the various elements. For example, you may put health for yourself in the top rank, and professional success in the second rank, but you may nevertheless be working so hard for professional success that you are doing serious harm to your health, with depression as a result.

In my case, future and present happiness of my children is at the top of the list, and I believe that the chance that children will be happy in the future is much better if their parents are not depressed as the children are growing up. Close to the top for me, but not at the top, is success in my work as measured by its impact upon the society. Yet I had invested so much of myself in my work, and with such results, that my thoughts about my work depressed me. It therefore became clear to me that if I am to live in accordance with my stated values and priorities, I must treat my work in some fashion that it does not depress me, for the sake of my children even if for no other reason.

In my discussions with others about their depressions, we usually discover a conflict between a tomp-level value which demands that the person not be depressed, and one or more lower- level values that are involved in depression. The goal that life is a gift to be cherished and enjoyed is a frequent top-level value of this sort (though, unlike such writers as Abraham Maslow, Fromm, Ellis, and others, I do not consider this to be an instinct or a self-evident truth). More about this later.)

Step 5:

Take steps to resolve the conflicts between higher-order and lower-order values in such manner that higher- order values requiring you not to be depressed are put in control. If you recognize that you are working so hard that you are injuring your health and additionally depressing yourself, and that health is more important than the fruits of the extra work, you will be more likely to face up to a decision to work less, and to avoid being depressed; a wise general physician may put the matter to you in exactly this fashion. In my case I had to recognize that I owe it to my children to somehow keep my work-life from depressing me.

Many sorts of devices may be employed once you address yourself to a task such as this one. One such device is to make and enforce a less-demanding work schedule. Another device is to prepare and follow an agenda for future projects that promises a fair measure of success in completion and in reception. Another device is to refuse to allow negative self-comparisons concerned with work to remain in the mind, either by pushing them out with brute force of will, or by training yourself to switch them off with behavior-modification techniques, or by meditation techniques, or whatever.

Mapping Out Your Wants

Your wants, goals, values, beliefs, preferences, or desires by any other name are a most complex subject for anyone. Counselors often ask people, "What do you really want?" This question tends to confuse and mislead the person of whom it is asked. The question suggests that (a) there is one most- important want that (b) the person can discover if she will only be sufficiently honest and sincere, the word "really" suggesting such honesty and truth. In fact there usually are several important wants, and no amount of "sincere" searching can determine which one is "really" most important.

The key point here is that we must aim at learning the structure of our many wants, rather than fruitlessly chasing after just one most-important want.

We must also recognize that our wants cannot easily be sorted out. Consider this curiosity: No matter how depressed a person is, he usually would not say that he would prefer to change places with other individuals who are not depressed, even super-happy or super-successful people. Why? Is there some deep confusion here about the meaning of "I" in the sentence "I would like to change places with X"? What can one make of this? Does it show some greater self-affection than we attribute to depression sufferers? Or is it simply the impossibility or meaninglessness of "changing places"? Would memories remain with the person after the change? Is there just a problem of misfitting, as a beggar would not prefer the clothes of a rich man if the clothes are a grossly bad fit to the beggar? I do not urge you to break your head on this curious question, but only to recognize that the structure of wants is more complex than a shopping list.

Behavior-modification therapy can offer help in Values Therapy by building the habit of interposing the discovered value in front of the depression-causing value whenever you feel sad.

The result of the values-discovery process may be that a person becomes "twice born," as in the cases described by William James. Clearly this is radical therapy, like surgery that implants a second heart in a person to aid the leaky and failing original heart.

What About Innate Wants?

There is a school of thought--two prominent representatives of which are Maslow4 and Selye5--who believe that the most important and basic values are biologically inherent in the human animal. This implies that there are inherent goals which are the same for all people. For this school of thought the explanation of depression and other ills is that "life must be allowed to run its natural course toward the fulfillment of its innate potential."(6) Or in Frankl's words, "I think the meaning of our existence is not invented by ourselves, but rather detected."(7) For Selye, one's innate potential is a capacity to do productive work with a feeling of success. For Maslow8 the potential is for "self-actualization," which is basically the state of freedom to experience one's life fully and enjoyably.

I think the better view is that though one's values and aims are inevitably influenced by the physical make-up of homo sapiens and the social conditions of human society, there is a wide range of possible basic values. And I think one will do better in discovering what one's own values are, and what they ought to be, by looking into oneself, rather than by looking at human experience in general and then deducing what one's basic values "really" are or ought to be.

The very fact that different observers such as Maslow and Selye point to different basic "innate" values should warn us of the difficulty or impossibility of making such deductions soundly. And if a person exhibits basic values that do not jibe with Maslow's self-actualization--for example, if a person sacrifices family for religion or country, and is never sorry afterward--Maslow simply assumes that this is not healthy and that the person will inevitably have to pay a price later on. But that kind of reasoning only proves what one wishes to prove. I prefer to accept the simple evidence of my eyes that people differ greatly in their values. I believe that neither I nor anyone else can determine which values are "inherent" and hence "healthy," and which are not.

I recommend, therefore, that you look into yourself--but with diligence and with the urge to find some truth--to determine what are your basic values and priorities. This is quite consistent with believing that a more fundamental source of one's values is outside oneself, of religious or natural or cultural origin.

The Value of Doing Good For Others

Saying that a person should look into herself or himself for one's basic values does not imply that the basic values are, or ought to be, those that refer only to the individual or the family. With the possible exception of Maslow, all the philosophical-psychological writers--whether or not they believe in "inherent" values, and whether they are religious or secular-- make clear that a person's best chance to shake off depression and instead lead a satisfying life is to seek life meaning in contributing to others. As Frankl put it:

We have to beware of the tendency to deal with values in terms of the mere self-expression of man himself. For logos, or "meaning," is not only an emergence from existence itself but rather something confronting existence. If the meaning that is waiting to be fulfilled by man were really nothing but a mere expression of self, or no more than a projection of his wishful thinking, it would immediately lose its demanding and challenging character, it could no longer call man forth or summon him...

I wish to stress that the true meaning of life is to be found in the world rather than within man or his own psyche, as though it were a closed system. By the same token, the real aim of human existence cannot be found in what is called self-actualization. Human existence is essentially self-transcendence rather than self-actualization. Self-actualization is not a possible aim at all, for the simple reason that the more a man would strive for it, the more he would miss it. For only to the extent to which man commits himself to the fulfillment of his life's meaning, to this extent he also actualizes himself. In other words, self-actualization cannot be attained if it is made an end in itself, but only as a side effect of self- transcendence.(9)

Britain's brilliant and famous writer Oscar Wilde descended into the depths of despair when he was sent to jail for perjury, sex offenses, and complicity in England's underworld. His story of how he came "out of the depths" (as he titled his essay in Latin) reveals how his salvation lay in re-ordering his priorities:

I have lain in prison for nearly two years. Out of my nature has come wild despair; an abandonment to grief that was piteous even to look at; terrible and impotent rage; bitterness and scorn; anguish that wept aloud; misery that could find no voice; sorrow that was dumb. I have passed through every possible mood of suffering. Better than Wordsworth himself I know what Wordsworth meant when he said, "Suffering is permanent, obscure, and dark, and has the nature of infinity." But while there were times when I rejoiced in the idea that my sufferings were to be endless, I could not bear them to be without meaning. Now I find hidden somewhere away in my nature something that tells me that nothing in the whole world is meaningless, and suffering least of all. That something hidden away in my nature, like a treasure in a field, is Humility.

It is the last thing left in me, and the best: the ultimate discovery at which I have arrived, the starting- point for a fresh development. It has come to me right out of myself, so I know that it has come at the proper time. It could not have come before, nor later. Had any one told me of it, I would have rejected it. Had it been brought to me, I would have refused it. As I found it, I want to keep it. I must do so. It is the one thing that has in it the elements of life, of a new life, a Vita Nuova for me. Of all things it is the strangest; one cannot give it away and another may not give it to one. One cannot acquire it except by surrendering every- thing that one has. It is only when one has lost all things, that one knows that one possesses it.

Now I have realized that it is in me, I see quite clearly what I ought to do; in fact, must do. And when I use such a phrase as that, I need not say that I am not alluding to any external sanction or command. I admit none. I am far more of an individualist than I ever was. Nothing seems to me of the smallest value except what one gets out of oneself. My nature is seeking a fresh mode of self-realization. That is all I am concerned with. And the first thing that I have got to do is to free myself from any possible bitterness of feeling against the world.

Morality does not help me. I am a born antinomian. I am one of those who are made for exceptions, not for laws. But while I see that there is nothing wrong in what one does, I see that there is something wrong in what one becomes. It is well to have learned that...

The fact of my having been a common prisoner of a common jail I must frankly accept, and, curious as it may seem, one of the things I shall have to teach myself is not to be ashamed of it. I must accept it as a punishment, and if one is ashamed of having been punished, one might just as well never have been punished at all. Of course there are many things of which I was convicted that I have not done, but then there are many things of which I was convicted that I had done, and a still greater number of things in my life for which I was never indicted at all. And as the gods are strange, and punish us for what is good and humane in us as much as for what is evil and perverse, I must accept the fact that one is punished for the good as well as for the evil that one does. I have no doubt that it is quite right one should be. It helps one, or should help one, to realize both, and not to be too conceited about either. And if I then am not ashamed of my punishment, as I hope not to be, I shall be able to think, and walk, and live with freedom.(10)

Wilde's story reveals how different values are fundamental for different people. Wilde found that for him the most basic value was the "ultimate realization of the artistic life [which] is simply self-development."(11)

Values and Religion

Values Therapy frequently has connections with religion. This is sometimes problematic from the standpoint of communication, because even the word "religion" alienates many people. Religious experience has a very specific God-orientation for some people, whereas for others it is any experience of the awesome mysteries of life and the universe.

Suggesting as I will that religious values and spiritual (though not supernatural) experience may be the solution for some people may alienate those who are militantly anti-religion. On the other hand, suggesting as I will that rejecting the concept of a historical father-like God may help for others may alienate those who have a traditional Judeo-Christian belief in an active God. But if I can reach and help some sufferers, alienation or no, then I'll have done the best I can and I'll be satisfied.

(Alcoholics Anonymous seems to have little problem with this sort of problem, as mentioned earlier. Its minimum requirement - - that members have faith that there is some power greater than the individual -- seems to be widely acceptable because almost anyone can accept the idea that the "greater" power may simply be the strength and energy of "the group". So perhaps the problem is not grave.)

A religious value, or a value for being a religious person, can be the discovered value in Values Therapy. For a person who discovers the value of being a Christian, the discovery implies believing that God forgives you for all your sins, and you must hand over to God responsibility for both your decisions and your actions. If this is the case with you, as long as you live in such manner as you believe a Christian ought to live, any negative comparison between what you are and what you ought to be is inappropriate. In other words, even if you have low status in the daily world, or if you have been a sinner, you may still feel worthy if you believe as a Christian.

Christianity says that if you love Jesus, Jesus will love you in return--no matter how low you are; this is crucial for the Christian depressive. It means that if one accepts Christian values, one is bound to feel loved in return. This operates to diminish the force of negative self-comparisons, both by making one feel less bad because all are equal in Jesus, and because the feeling of love tends to diminish any sadness.

Believing that Jesus suffered for you--and hence that you should not suffer -- keeps some people out of the clutches of depression. In this way Christianity offers unusual succor to those afflicted by sadness.

For a Jew, a religious value that works against depression is the Jewish commitment to cherish life. A traditional Jew accepts as a religious duty that one must enjoy her or his life, both materially and spiritually. Of course, "cherishing" life does not mean just "fun"; rather it means being constantly aware that life is good and all-important. A Jew is not permitted by religious dictates to be inordinately sad; for example, one is not allowed to mourn more than thirty days, and to do so is to sin.

One must be careful, of course, that the religious "requirement" of enjoying life does not turn into just another "must" that you fail to achieve and therefore leads to additional negative self-comparisons. If you tie yourself into this sort of a knot, then you obviously are better off without this religious commitment. But this is not a black mark against this religious idea; no set of guidelines for living is without its own dangers, just as the kitchen knife that is so useful for cutting food can be the instrument of a self-inflicted injury, accidental or intentional.

In the Epilogue, I describe at length how Values Therapy saved me from depression. The highlights relevant to this particular section are as follows: I first learned to keep depression at bay on the Sabbath, following the Jewish injunction that one must not be sad on the Sabbath. Then I recognized that a more general Jewish value demands that one must not throw away the largest part of one's life in sadness. Then, and perhaps most important, I faced up to the conflict between my depression and my children's future happiness. These discoveries cracked my depression and permitted me to enter into a period (lasting until now) when I am basically unrepressed and even happy (sometimes very happy), though I must continue to fight against depression on a day-to-day basis.

It is interesting that Tolstoy invented for himself (though he ostensibly took the value from Catholicism) a value which resolved his depression and which is like the Jewish value concerning life. Tolstoy concluded that life itself is its own meaning for the peasant, whom he proceeded to try to imitate:

...the life of the whole labouring people, the whole of mankind who produce life, appeared to me in its true significance. I understood that that is life itself, and that the meaning given to that life is true: and I accepted it...a bird is so made that it must fly, collect food, and build a nest, and when I see that a bird does this, I have pleasure in its joy...The meaning of human life lies in supporting it...(12)

(If one realizes that the question "What is the meaning of life?" probably is semantically meaningless, one can be free to find other values and philosophical constructions.)

Another Jewish value is that a person must respect oneself. For example, a great Talmudic sage asserted: "Be not wicked in thine own esteem".(13) And a recent scholar amplified this as follows:

Be not wicked in thine own esteem.

This saying preaches the duty of self-respect. Do not think yourself so abandoned that it is useless for you to make "an appeal for mercy and grace" before God. "Regard not thyself as wholly wicked, since by so doing thou givest up hope of repentance" (Maimonides). Communities, like individuals, are under the obligation not to be wicked in their own esteem. Achad Ha-am wrote: "Nothing is more dangerous for a nation or for an individual than to plead guilty to imaginary sins. Where the sin is real--by honest endeavor the sinner can purify himself. But when a man has been persuaded to suspect himself unjustly--what can he do? Our greatest need is emancipation from self-contempt, from this idea that we are really worse than all the world. Otherwise, we may in course of time become in reality what we now imagine ourselves to be."(14)

This saying preaches the duty of self-respect. Do not think yourself so abandoned that it is useless for you to make "an appeal for mercy and grace" before God. "Regard not thyself as wholly wicked, since by so doing thou givest up hope of repentance" (Maimonides). Communities, like individuals, are under the obligation not to be wicked in their own esteem. Achad Ha-am wrote: "Nothing is more dangerous for a nation or for an individual than to plead guilty to imaginary sins. Where the sin is real--by honest endeavor the sinner can purify himself. But when a man has been persuaded to suspect himself unjustly--what can he do? Our greatest need is emancipation from self-contempt, from this idea that we are really worse than all the world. Otherwise, we may in course of time become in reality what we now imagine ourselves to be."(14)

Some Examples of Value Therapy

Frankl provides interesting examples of how depression can be relieved by a procedure like Values Therapy:

Once, an elderly general practitioner consulted me because of his severe depression. He could not overcome the loss of his wife who had died two years before and whom he had loved above all else. Now how could I help him? What should I tell him? Well, I refrained from telling him anything, but instead confronted him with the question, "What would have happened, Doctor, if you had died first, and your wife would have had to survive you? "Oh," he said, "for her this would have been terrible; how she would have suffered!" Whereupon I replied, "You see, Doctor, such a suffering has been spared her, and it is you who have spared her this suffering, but now, you have to pay for it by surviving and mourning her." He said no word but shook my hand and calmly left my office. Suffering ceases to be suffering in some way at the moment it finds a meaning, such as the meaning of a sacrifice.(15)

Frankl says that "in logotherapy [his name for a process like Values Therapy] the patient is actually confronted with and reoriented toward the meaning of his life...The logotherapist's role consists in widening and broadening the visual field of the patient so that the whole spectrum of meaning and values becomes conscious and visible to him."(16)

Frankl calls his method "paradoxical intention." His procedure can be understood in terms of altering negative self-comparisons. As noted in Chapter 10, Frankl asks the patient to imagine that his actual state of affairs is different than what it is. For example (17), he asks the man whose wife died to imagine that the man himself had died first and that the wife is suffering from losing him. Then he leads the person to compare the actual with that imagined state, and to see that the actual state is preferable to the imagined state on the basis of some deeper value--in this case, the man's value that his wife not suffer from losing him. This produces a positive self-comparison in place of the former negative self-comparison, and hence removes sadness and depression.

Values Therapy may be thought of as a systematic and understandable form of what used to be called "changing one's philosophy of life". It operates directly on the person's view of the world and himself.

Based on his personal experience, Bertrand Russell urged us not to underestimate the curative power of such philosophical thinking. "My purpose is to suggest a cure for the ordinary day- to-day unhappiness from which most people in civilized countries suffer...I believe this unhappiness to be very largely due to mistaken views of the world, mistaken ethics..."(18)

Many psychologists--particularly those with psychoanalytic training--will question whether such "deep" problems as depression can be solved with such "superficial" treatments. But Values Therapy is not superficial--indeed, just the opposite. Of course it is not a perfect therapy, even for those whose depression is not well-handled with other therapeutic approaches. In some cases it may be that the struggle to make one value dominate another requires too much energy of a person, and perhaps a complete psychoanalytic cleansing would bring the person to easier ground (though psychoanalysis' track record with depression is poor). In other cases, the person may lack the powers of reasoning to carry out Values Therapy, at least by himself. Or, a person may have a strong motivation to stay miserable. Lastly, a person's hunger for love and approval may be unshakable.

The Role For A Counselor

A counselor can certainly help many people in their struggles to get their values in order and hence overcome depression. The counselor's role here is that of good teacher, clarifying your thoughts for you, helping you concentrate on the task, pushing you to stay at it rather than running away from the hard work. For some people who lack the discipline and mental clarity to do their own Values Therapy, a counselor may be indispensable. For others, however, a counselor may be unnecessary or even a distraction, especially if you cannot find a counselor who will help you do what needs to be done for you. Too many therapists insist on doing what they are accustomed to doing, or cannot work within your value structure but insists on inserting their own values into the process.

Other drawbacks of working with a therapist are discussed in Chapter 00. Before you try a therapist, you might first consider working with the computer program OVERCOMING DEPRESSION that comes free with this book.

Making It Happen

Is Values Therapy an easy and comfortable cure for depression? Usually it is not, just as all other anti-depression tactics require effort and stamina. At the beginning, Values Therapy requires considerable mental hard work and discipline, even with the help of a counselor, in constructing an honest and inclusive graded list of your desires in life. After you have decided which are your most fundamental values, you must remind yourself of those values when you start to make negative self- comparisons and get depressed. But it takes effort and dedication to keep reminding yourself of those values--just as it takes effort to remind another person of important matters when they are being forgotten.

So staying unrepressed with Values Therapy is not perfectly easy. But did you really expect otherwise? As the lady said, I never promised you a rose garden. You'll have to judge for yourself whether this is too high a price to pay for being free of depression.

The list of steps given above for Values Therapy may seem pedestrian (a modest play on words, for which I trust you will forgive me) because it is stated in simple, operational terms. You may also assume that this procedure is standard and well- known. In fact, Values Therapy as embodied in these operational steps is quite new. And I hope that you will consider the procedure seriously if other procedures have not managed to overcome your depression. I also hope that theoreticians and empirical workers in psychology will recognize the newness of this approach and will consider it with some gravity, even though it is not simply an extension of the approaches they are accustomed to.

Postscript: Values Treatment As Upside-Down Spectacles

Depressives see the world differently than do non- depressives. Where others see a glass as half-full, depressives see the glass as half-empty. Hence depressives need devices to turn many of their perceptions upside down. Values Therapy often can provide the impetus for the reversal of viewpoint.

A person's capacity to alter his or her perspective of the world by effort and practice is astonishing. An interesting example comes from a long-ago experiment in which subjects were given "upside down" eyeglasses that inverted everything seen; what normally is seen below appeared above, and vice versa. Within a period of weeks the subjects had grown so accustomed to the glasses that they responded quite normally to visual cues. Depressives need to put on psychological spectacles which turn their comparisons upside down and make them perceive the glass as half full rather than half empty, and invert a "failure" into a "challenge."

Values Therapy radically alters one's life perspective. Humor, too, changes one's perspective, and a little humor about one's depression can help you. Not the black humor of "I wasn't cut out to be a human being," but rather amusement at how one twists reality to give oneself a ridiculously bad shake. For example, at 9:30 a.m. today, I've now been at my desk for 1-1/4 hours, working on notes for this book, a bit of stuff for class, some filing, etc. But then I notice I haven't written anything yet. I haven't done something both creative and solid, haven't created any pages yet. So I tell myself that I can't let myself have breakfast yet, because I don't deserve it, as if all the other things I have done have not been useful work. When I catch myself in this kind of willful rotten interpretation of reality, I'm amused, and it relaxes me.

Another example: As I was looking for the elevator on the sixth floor of an apartment house while I was depressed, I saw a sign on the wall that said, "Incinerator -- Trash and Garbage". I immediately said to myself, "Ah, that's the way I should go down." This amused me and reminded me how silly is my lack of self-esteem that led me to have such thoughts.

In the case above of the man whose wife had died, we saw an example of how Frankl's paradoxical intention turns the world upside down. Here is another example of his upside-down technique:

W. S., aged thirty-five, developed the phobia that he would die of a heart attack, particularly after intercourse, as well as a phobic fear of not being able to go to sleep. When Dr. Gerz asked the patient in his office to "try as hard as possible" to make his heart beat fast and die of a heart attack" right on the spot," he laughed and replied: "Doc, I'm trying hard, but I can't do it." Following my technique, Dr. Gerz instructed him "to go ahead and try to die from a heart attack" each time his anticipatory anxiety troubled him. When the patient began laughing about his neurotic symptoms, humor entered in and helped him to put distance between himself and his neurosis. He left the office relieved, with instructions to "die at least three times a day of a heart attack"; and instead of "trying hard to go to sleep," he should "try to remain awake." This patient was seen three days later -- symptom-free. He had succeeded in using paradoxical intention effectively.19 Ellis stresses the importance of humor in getting you to see how ridiculous are many of our "ought's" and "must's". He has written funny songs for the depressive to sing to help change your mood.

Still another example of how turning your picture of the world upside-down can help you: A good rule for depressives much of the time is the opposite of the Hillel-Jesus Golden Rule. The "Sunshine Rule for Depressives" is: "Do unto yourself as you would do unto others."

To illustrate the Sunshine Rule: Let's say that good and wise friends point out to you your better traits and successes, and encourage you even to the extent of giving you the benefit of the doubt when the facts are not clear. But enemies do the opposite. Depressives dwell on their own shortcomings, as does an enemy. The Sunshine Rule implies that one has a moral obligation to act as a friend to yourself, truly makes.


Values Treatment is an extraordinary new (though very old) cure for depression. When a person's negative self-comparisons - no matter what their original cause - are expressed as shortfalls between the person's circumstances and her most fundamental beliefs (values) about what a person should be and do, Values Treatment can build on other values to defeat the depression. The method is to find within yourself other fundamental beliefs and values that call for a person not to suffer but rather to live happily and joyfully, for the sake of God or for the sake of man - oneself, family, or others. If you believe in the super ordinate value of a belief which conflicts with being depressed, that belief can induce you to enjoy and cherish life rather than to be sad and depressed.

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APA Reference
Staff, H. (2008, December 21). Good Mood: The New Psychology of Overcoming Depression Chapter 18, HealthyPlace. Retrieved on 2024, June 20 from

Last Updated: June 18, 2016

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