I am in the process of reading your book, Depression is a Choice, and I love what you have to say. It is such a refreshing point of view, as compared with all the other depression literature I have seen.

If you have some time, I was hoping you could take a stab at a question I have.

I am a good friend of a young man in his 20's who has been battling depression. We are good friends largely due to my own initiatives, but we have developed a very real bond. I have read A LOT about depression and have applied what I've learned to try to help him, with some success, it appears. He still has bad days, but no longer exclusively bad days, and he says that he has hope now (he was suicidal at one time). He is such a beautiful person, especially on his good days.

Unfortunately, my friend is also pretty self-absorbed person. At the same time, he is also possibly the kindest and most gentle and principled person I have ever met. So his gentle nature and his desire to help people are my avenues to get through to him.

When he believes that something is an obligation, he is excellent at getting himself to do it, and he never whines or complains. He doesn't skip work, he always returns calls promptly, he always shows up on time, etc. He is very dependable and will do just about anything I ask. I believe that he is self-absorbed because he just doesn't know any better. His mother is mentally ill, and she is the one that raised him. I am guessing he grew up with some really bad examples on which to model his behavior.

It is very obvious that my friend wants very badly to always do the right thing. If he knew that he was self-absorbed beyond the norm and that his behavior was "unprincipled", I know he would try to change it. He is not the least bit mean-spirited, and I believe that if he understood that it was an obligation for him to look at others' needs without being asked, he would make every effort to do so. He is very open to improving himself when I take an approach that registers with him. I can see that he tries hard, but he doesn't always seem to understand what's required.

So my question is: How can I help him understand

1. that he is exceedingly self-absorbed, and
2. how to change that behavior to be more outwardly-focused--and all this without hurting his feelings or putting him down. I want to be as encouraging as possible.

In theory, it seems such a simple thing to do to pay attention to others, but it isn't simple. When I try to figure out how to break that down into smaller steps, I realize that it is a skill that I take for granted. I really don't know how to explain it to him. If I try to explain it, he may not understand what I mean or what it is exactly that he should do differently. I don't want him to get frustrated with himself just because I'm not able to explain what is required and why. I know that if I find a good way to explain it to him, he will do everything he can to change his behavior, once he understands this as an obligation.

I wonder if you have any ideas. By the way, he also just started reading your book, upon my suggestion. He takes most of my suggestions and ideas very seriously. He really is trying hard, and if there is anything I can do to help him, I'll absolutely do it.

Thank you. J.D. 7/2/02

Very best regards to you! I think you are an amazing woman.

Response: Dear D.J.,

Your question is how does one tell another person about their faults. Very Carefully. It is the hardest thing in the world to see one's own "stuff." So first, how does one do that? One thing that helps is to see other people's "stuff" and then look for it in your own life. For instance. It is hard to see yourself as constantly interrupting people in conversation, or always talking about yourself instead of listening. But you can see it easily when it happens in other people. So if you are ready to assume that you probably do some of it, and look for it, you may find you do more of it than you think.

To see our own stuff is hard. To get someone else to see their stuff is even harder. But friends are supposed to help each other. Perhaps you could do it in a similar way. It takes a bit of patience. Point to other people displaying a particular behavior and talk about what the other person is doing. Do this several times for each trait. Tell your friend that the person has no idea what they are doing and you wonder if maybe you do some of that and if your friend ever notices it to please call you on it. This may elicit a similar response from your friend that you should tell him as well if he shows those traits.

Then when you see your friend doing the same thing, and it seems appropriate, you can delicately and deftly relate his behavior to the other person's behavior which you have already discussed. "Hey for a minute there you almost sounded like Joe Blow just now, you know how self-focused he is. ("That's better than saying "you know how self-focused you are.") And, by the way, when your friend calls you on your stuff, you'll be surprised how annoying it is. Who me?

Another thing you could do is decide to improve your own conversational skills and decide to be less self-focused yourself (nobody is perfect, we can all improve ourselves) and ask your friend if he would like to join you in your own efforts to improve yourself. You could both join Toastmaster's International for instance. It's in most cities and is very inexpensive. I would recommend this to anyone. It is a great way to get in touch with your fear. Most people are afraid of public speaking and to get over that fear is a life-changing experience for people. And seeing how other people shake in their boots with fear is helpful as well. You know you are not alone. We can decide to be a good conversationalist, and decide to be not so self-focused even without studying ourselves to see how bad a conversationalist and how terribly self-focused we might be.

We can, in principle, decide what practices a good conversationalist would adhere to or what principles an out-ward focused person would live by and head in that direction. I can forge new neuronal patterns and just leave the old ones behind. I could make decisions by doing some research, (for instance,reading Dale Carnegie's book How to Win Friends and Influence People (A book I heartily recommend and which talks about self-focus and conversation), by joining Toastmaster's International or some other speaking group or even starting a formal speaking group of my own.

Or, I could plan my own self-improvement program. I might decide what principles a good conversationalist or an outward focused person might have and adapt them myself. I may decide a good principle is: I will be a one-story person from now one. So I will discipline myself to make only one comment, or tell one story and not tell a second one until every one else in the group has told their story. And I might ask my friend to check up on this and let me know if I actually succeed in doing it. Say, for instance, that there are four people and one person has made a comment, then I make a comment and there is a silence, I don't fill the silence with my second story. I let someone else tell one, or ask the third or fourth person a question they can answer.

Or, I can decide a good principle would be: Able to abstain from telling a Great story when a lot of other great stories have just been told and mine would be the same even if a little better. The next time I think of a story that would be GREAT to tell, I refrain and don't tell it and let the conversation go on to something else. There, that didn't hurt too much did it? Maybe it was a great story but it was only great to me. I would tell my friend about my small triumph of not telling my story and see if he decides to try that. Probably everybody else can live without hearing my great story. But notice how agitated we get when we don't let ourselves burst out with our great story (It's fear). It is quite invigorating and character strengthening to learn to refrain from telling a good story when there are plenty of good stories already "out there."

Okay that is the answer to your specific question. Here's another thought. People who have difficult childhoods have a lot of repressed fear. Fear that does not proceed to action or is not felt directly as fear settles in the body as repressed rage/anger/fear. People either project their rage on others or turn the rage within. Thus a nice person who is always nice to people and never is angry or aggressive may be doing it out of fear (repressed rage). Anything done out of fear will tend to be inappropriate in some way. The trick is to get in touch with our fear so that it does not run our lives. One way to do this is to become aware of what kind of thing we do that is inappropriate, stop doing the inappropriate thing and feel the fear. Hope this helps. Good luck and keep in touch. Arline Curtiss

Thank you SO much for your very prompt and very detailed response. Clearly, I CAN improve my communication skills quite a bit, as I did not do a very good job of communicating my question. My self-focused friend is not much of a talker. The last paragraph you wrote applies most accurately to him. He is "a nice person who is always nice to people and is never angry or aggressive." One of the skills he needs to work on is asserting himself, which he almost never does.

By self-absorbed, I don't mean self-absorbed in a chatty way, but rather self-absorbed in that he does not reciprocate. You can call him and he will always come out, but he will never call you to ask you to do anything. Likewise, you can get him a gift, but he won't put much thought into doing anything similar for you. Since he always tries so hard to do the right thing, it seems that he doesn't understand that reciprocating is "the right thing." Otherwise, I know he would do it. It isn't that he tries to monopolize the conversation. If anything, he tends to just sit in the background. It's that he doesn't seem to understand that he needs to reach out to people and do things for people, as almost an obligation to himself and to them. Obviously, when he does not reciprocate, his friends drift away, and then, when he is depressed and needs friends the most, he doesn't have too many who are there for him. In a way, it's almost dangerous.

Thanks again for any insights you can provide.

Best regards.

JD

Response: Dear DJ,

About your friend’s self-assertiveness. One of the problems with our society is that we are constantly selling ourselves, through media, that there is a definite template of what people should be and if they are not that way, something is terribly wrong with them. Women are supposed to be beautiful. So young girls who are not tall and thin with a great figure try their best to push, pull and pummel their off-template bodies into one that will be more acceptable.

We see, much more readily, that some people are not physically beautiful and no matter what they do they will never have stereotypical "good looks." But we don’t see so easily that this is also true for the way we behave. There is a psychological template for the beautiful personality too Men are supposed to be assertive and forceful as well as sensitive and flexible The fact that men are becoming more thoughtful, flexible, and more socially aware says more about today’s woman’s insistence upon them developing these capacities than that a man who doesn’t have them is not normal

We are making great progress but sometimes we have become a very unaccepting society, unaccepting of those on the other side of the bell curve from us. The truth is that most of us have severe shortcomings, little crippled up places where we are hunkered down in fear and don’t work.

Those who are both physically beautiful and have great personalities are rare and they’re all on television making us feel inadequate and thinking that our friends need fixing. We forget that there is a normal bell curve for male assertiveness as there is a normal bell curve for women’s physical beauty.

As for getting your friend to improve himself. You can drag him around to awareness centers and motivational speakers when you go, and something might "take" and it will be fun for you. I say "drag" because most men don’t opt for these type of things. Psychological self-improvement generally is a feminine thing. Men are not naturally self-questioning the way women are which is why they are not so adaptable. Of course some men have developed their feminine side and are very into self-improvement. Most men only improve themselves out of necessity.

It's much more difficult for them also as they have a greater fear of failure. I used to drag my husband to these things and he went begrudgingly but he will be the first to admit, after the fact, that he always learned something, But he would never have gone on his own.

Marriage used to provide a natural school for psychological self-improvement. In the past men couldn’t get sex unless they married. And after marriage they needed to learn how to get along with their wives to continue to get it. So the wife and husband made alterations in their natural proclivities in order to work things out. We improved each other by having to get along and needing to moderate our off-the-bell-curve quirks because our more way-out behavior was met with strong resistance on the part of our partners.

This is the only way to hands-on change behavior in someone else. You provide negative consequences for behavior you don’t like and positive consequences for behavior you do like. But in earlier years people adapted themselves to marriage itself, putting up with a lot of each other's off-beat quirks like everybody else did. Of course women, being more adaptable, were adapting to more. This didn’t use to be such a problem. Now we are adapting marriage to us. This leaves less time and opportunity for the process of a working marriage to improve us. We don’t want working marriages. We want marriages that work.

About gift-giving. Men, by nature (unless they have been somewhat feminized or are natural-born speakers, motivators and leaders) are not "chatty," not self-questioning, and are not naturally responsive to the give-and-take of exchanging gifts (until they can see that it gets them something they want–love, sex, etc.). Gift-giving is a woman thing. It’s not naturally fun for men. Just like shopping isn’t fun for men. Men can be taught gift-giving. But in general, if something works for a man once, he’s likely to give that same thing over and over. I just gave up with my husband and handle gift-giving for the both of us. He is just too awkward at it. I had the devil of a time getting my son to give gifts. Finally the idea sunk in "never go empty handed when you are invited to a party or celebration." Now that he has a girlfriend, I suspect she is on him about it.

Men also fear making a mistake much more than women do. They are biologically scripted that way. That’s why women are quick to apologize and men hardly ever do a good job of apologizing.

Woman are naturally, biologically programmed to be nurturers and gift-givers and self-improvers, and women are naturally more inclusive in their focus because they are the child-bearers and child nurturers. Men in general are not biologically scripted to be as considerate, nourishing and thoughtful as women. They are biologically scripted to be self-focused, single-minded and stubborn. These are the qualities that kept the cave man alive, his female safe from predators, and these are the genes that were passed down to modern man. The thoughtful, considerate, you-go-first cave man didn’t make it. Men are naturally and biologically programmed to be self-focused and uncompromising.

Men are simply not naturally adaptable as women are. They must be socialized to be adaptable and compromising, or learn it in business. Men become adaptable, compromising and gift-givers because they have to, to get something they want. That’s why you see them in all those seminars. Something is not working for them and they need to find a solution. Women do self-improvement to improve themselves. For fun.

We are no longer cave-men but we have the same cave-man genes. We are in a changing society now where technological-society women no longer tolerate men’s self-focus so the men are having to change. So our standards are changing. Men now have to be sensitive gift-givers as well as assertive. But people want their mates "finished" before they marry. And when psychological problems come up they divorce if they can't change the other person. The new generation doesn’t tolerate relationship frustration for very long, unless they are coached to do so by counselors or older friends.

In my own marriage, my husband has a hot temper and I was a very fearful person when we first married. I tried marriage counseling for years to get my husband to change–to negotiate a change. Forget it. Nothing worked until I decided not to change him but to decide what I was going to do to take care of myself when he lost his temper. When I decided that the trouble for me was my fear of his temper and I became more self-responsible during these times, I became less fearful, my action became more appropriate and my husbands behavior changed because he didn’t like the consequences of it. I love my husband but when I told one of my friends about a recent temper outburst and what my husband said to me, she told me she wouldn’t stay married to him for two seconds. She has no idea about his other endearing qualities.

My son-in-law is terribly shy, introverted, non-assertive and doesn’t say a word unless he’s at his own home among close friends. My daughter laughs and says he is afraid to answer the door when the pizza boy comes because he doesn’t know what to say. She good-naturedly always answers the door for the pizza boy. My son-in-law doesn’t have men friends the way my daughter has woman friends who "talk about relationship stuff." He has male acquaintances. The couple friends they have come from my daughter's friends. He has a good relationship with his co-workers, he works out in a gym on his body-building hobby, he has some give-and-take with relatives that is amicable. He spends most of his time working, being with his wife and two children, at the gym and pursuing his other hobby diving–they live in Maui. His closest man friend was originally my daughter’s friend and the three dive together. My daughter is socially fearless and can be at ease and charming in any social situation. My son-in-law has other endearing and excellent qualities but my daughter is much more self-assertive out in the world than my son-in-law although at home he is most often (not always) the stubborn emotional one and my daughter has learned to adapt to it and let it ride by rather than cross him in those moments.

I don’t know that much about your friend but I do know that you like him and are willing to go to a great deal of effort because you care about him. There are many out-going people who have never had one really good friend. So already I know that your friend is capable of inspiring friendship in at least one person. That says a lot. And we can help our friends as long as whatever we do is out of love for them instead of out of our fear for them or out of our anger with them. But I don’t know of any good way of changing somebody for their own good (except one’s children whom one is duty bound to socialize.) You can lead a horse to water but you can’t make him drink.

In general men who are not sufficiently assertive learn how to be assertive because they become motivated by something–because it will get them what they want–the girl, the job. I’m a great fan of Toastmaster’s International. It is the best place in the world to learn how to be more self-assertive and if you can drag your friend there with you enough times you will learn something extremely valuable yourself and your friend might get motivated to improve himself. And read Dale Carnegie's classic book How to Win Friends and Influence People. I think it is one of the best books ever written.

One last word. In this culture, forbearance is a word not much in fashion. Not everything that we can see is wrong needs to be fixed by us. Sometimes we need to learn from it. You are on the right track in asking questions. And one question we should always ask ourselves when anticipating any action is: am I doing this out of love for something or out of fear of something. Life is tricky. Keep in touch. Arline Curtiss

Thank you so much again for your insight. I had never considered it in that way before.

I do want to make one final point about my friend, relating to something you wrote. Whereas most people tend to adjust their behavior in response to negative feedback, my friend does not always do that. Instead, there are times when, if he gets negative feedback, he runs away from the person giving him the feedback and falls off the face of the earth. If I did not come back to "bug" him after he did this to me, we would not be friends today, because he would not have made the effort. I have done a lot of bugging, because after he ran away, he sank into a depression, and would not make any initiative to call me--ever, even though he would usually come out when invited. He says that while he sometimes feels annoyed that I "bug" him, he also knows I care and appreciates that a lot. I suppose that his usual modus operandi is based on fear, due to his very difficult childhood. I hope that with time, he will learn that negative feedback is not an attack on him as a person.

Thank you again. J. D. 7/11/02

Response: Dear DJ,

Most people never do learn the positives of negative feedback and are barely comfortable with criticism in a formal situation where they themselves have set it up as a learning tool, or as part of a group self improvement therapy of some kind. Even some millionaire heads of corporations are known for "killing the messenger" who comes with bad news so no one wants to approach the boss with problems. Which is why those corporate management consultants get so much money when they point out why a company's real problems were never addressed. Most men are not "Dr. Phil". Most men don’t take criticism as well as women. And we don’t like it that much ourselves.

A very low-key example of this is my sister-in-law. We were at an outdoor summer concert and chatting before it got started. I guess we chatted too long and didn't quite finish before the conductor appeared on stage because the woman behind us said to my sister-in-law, "You're being very rude." I love my sister-in-law. She turned around to the women and said "Well, that's very rude of you to say so."

And in a way it makes sense. Negative feedback by its very nature is a psychological "hit." We naturally defend ourselves from hits. We all want to be hugged not mugged. And, technically speaking, the seed of any kind of negative feedback really comes from fear. Some stalwart souls can take it. But most people take negative feedback personally and receive it as some kind of a wound from which they either have to recover or from which they attack, either immediately or later. It's easier to see other people's mistakes and learn from them which is what makes a therapist's job so valuable to the therapist.

Nobody likes negative criticism really, even me, especially in a context when I am not ready for it and it comes "out of the blue." Even when I get negative feedback when I ask for it, unless it is a pretty specific answer to something in particular, it is more annoying than enlightening. And it's only human to have to get over the annoyance part before we can get to the enlightening part. Our psychological defense mechanism is just set up that way. It may be that most people set up their whole lives very cleverly to avoid negative feedback like the plague.

I may be one of those people myself. Certainly I realize that I generally look for negative feedback very carefully. Like, how do you like this sentence rather than how do you like this book.

In general, it's better to give positive feedback in the context of one's normal relationships, especially if it's not asked for at that moment, and inspire rather than criticize. But you have to get creative to do that. And it takes a whole lot more energy out of you. To criticize someone is very easy. To inspire someone is much harder. Nevertheless, the old saying is still true no matter how sophisticated we get and can cite diagnoses and symptoms right out of the DSMIV, "you really can catch more flies with honey than you can with vinegar."

If you have to criticize someone make it very specific and "in the moment.". It's all right to be emotional, maybe even better than clinical. Like: "I love you madly, but I hate it when you clank your teeth together when you eat oatmeal as if you are attacking it, enough already!" Instead of : "I'm just telling you this for your own good, you really need to improve your table manners." The main thing is that there is no "right thing to say." The most appropriate responses come from love rather than from fear so check out your gut now and then. How enraged are you? If highly enraged, best to remain silent.

My advice is that if you are heading in a good way, invite somebody along rather than tell them they are going in the wrong direction. Invite a fat person for a walk in the park rather than criticize them for not exercising. Invite an introverted person to join a speaker's group with you rather than tell them that they need to be more outgoing. Books are a sneaky way to get things across that you can't come right out and tell people. Books tell us about other's people mistakes and what they did to fix them. We're all just people here on planet Earth. We have to jolly each other along. It's more fun, less desperate. Arline Curtiss 7/17/02

Letter: Ms. Curtiss,

I have another question. There is a lot of literature (maybe too much) about the feeling of depression, and considerably less literature about the feeling of happiness and fulfillment (though there is still plenty). But there seems to be almost no literature on the transitional phase that must undoubtedly occur when one is emerging from a long period of depression. I can't imagine that someone who has been depressed for years can suddenly adapt to resuming life as "normal" as soon as they are no longer weighed down by the depression. This seems like common sense. Someone who has been in prison for years won't just be immediately able to jump back into society even though they are suddenly free to do what they want. I wonder if you can comment on how best to support someone who is in that unsettling place--in the territory between depression and normalcy. Thanks.

You are right about getting familiar with living the depressive life. It is like living the prison life. If you have been there a long time, prison seems like home and the world "out there" seems strange and unnatural when your time is up and you are set free. It takes a while to make the transition for long-timers. And some people never do make the transition; they insist on getting back to prison as soon as possible.

Depression is a prison of sorts. It is not a normal state, it is a state of alarm. The body is in the fight-or-flight mode, the sympathetic mode of intense anxiety. When depression lifts the body reverts to its normal at-rest mode, the para-sympathetic mode. So there is some emotional sub-cortical support for the after-depression life. But unless neo-cortical effort is made, old thought patterns in the neocortex can reverse the emotional balance. But here again, it is education rather than medication that helps the most.

Although the thought processes during depression can make neuronal patterns in the brain very entrenched, entrenched is not the same thing as havingabsolute power over us; new neuronal patterns of thought can be committed to as an act of will, adhered to by exercising them, and the old patterns, though still existent, will take a back seat. It is a matter of discipline to adhere to new thought patterns. It takes an effort and unless you know it takes effort, you will believe that it is your basic nature to think the old depressive thought patterns and that you are helpless to do anything about it.

It is much easier to slide back to old thought patterns. So very , very, easy. This is the addictive nature of depression. It is hard to insist on more positive thought patterns at first. The new thought patterns seem a little foreign, don't seem "like us." And indeed, they are not "us;" we are making a new life and a new us by literally changing the neuronal patterns in our brain brain by changing our thought patterns.

We are, as adults, doing work which could have been done much more easily and happily as children by our loving relationship with our parents. Now we are parenting ourselves, birthing the enhanced emotional self which was stunted in our earlier lives for whatever reason. But if we know that, if we understand the process, and are forearmed, we can be successful. And of course, with practice, the new thought patterns themselves become habitual after a time and grow to become more and more "like us." How about the old depressive thinking patterns? The old patterns will still be there and we will tap into them sometimes, but they will seem less and less powerful and compulsive. Ultimately when they pop up we will just scurry away from them and get on to other thinking. Ultimately they will just remind us of something we no longer have to do because we have other alternatives. You are asking good questions. Arline Curtiss