New Cure for Depression By Barbara Kiser
New Scientist Magazine, United Kingdom
We live in mad times. The World Health Organization predicts depression will soon rank second in the global disease burden, suicide rates are rising, and the trauma caused by war, conflict or domestic abuse is everywhere. The toll is horrific: mental illness costs Britain alone £32 billion a year. And people looking for therapy face a tower of psychobabble, with 400-plus often warring schools. Enter Joe Griffin, creator of the new depression therapy, Dreamcatcher, who says there is a way to lift depression in a day, and told New Scientst Magazine that he can prove it
How can you deal with serious depression in just a day?
The important thing is to know how depression is manufactured in the brain. Once you understand that, you can correct the maladaptive cycle incredibly fast. For 40 years it's been known that depressed people have excessive REM sleep. They dream far more than healthy people. What we realised - and proved - is that the negative introspection, or ruminations, that depressed people engage in actually causes the excessive dreaming. So depression is being generated on a 24-hour cycle and we can make a difference within 24 hours to how a person feels.
But how is dream sleep responsible for depression?
My findings show that ordinarily dream sleep does a great housekeeping job for us. Each night it brings down our autonomic arousal level. Dreams are metaphorical translations of those waking introspections - emotionally arousing feelings and thoughts - that we don't act upon while we are awake. Once aroused, our brain has to complete that cycle of arousal and, if we don't complete it in the external world, we do so in our dream sleep. The patterns of arousal are metaphorically acted out and thereby deactivated. But depressed people do so much worrying and feel so stuck that the ruminations cause an overload of dreaming which uses up a lot of energy in the brain. Which is why they wake up exhausted, unable to focus their mind outwards and motivate themselves.
This is a departure from the accepted view, isn't it?
Yes, it is. We filmed hundreds of cases and you can see time and time again that when they start talking about depression, they talk about waking up tired, low and emotional, how they have difficulty getting off to sleep. And when it is explained to them how they are doing this to themselves, the explanation alone helps - and then the therapy is to help them begin to stop the negative ruminations. The common explanation that their doctors give them is that there is a chemical imbalance in their brain. But that's a half-truth: the other half is that their low serotonin level is an index that their life isn't working - their needs are not being met - not that they've got something "wrong" with their brain chemistry. Brain chemistry is not a cause, it is an effect.
So you tell your clients how they're generating their depression, then what?
We use an integrated approach combining behavioural, cognitive and interpersonal methods, relaxation, humour, suggestions or exercise - all based on what we call the "human givens", our genetic endowment of needs and resources. Any skills the person already has that can reconnect them with other people and the wider community are particularly important. Above all, we get them to use their imagination differently, and this is not as difficult as it might seem. Our job is to stop them worrying and dreaming excessively. We do all this in the first session, and for some people that is enough. Others will need a little more work.
What exactly are the human givens?
Human givens is a phrase psychotherapists, psychologists, educationalists and others are increasingly using to encompass some new, large organising ideas that are developing from what science is discovering about the workings of the brain.
We are all born with a rich natural inheritance - a partially formed mind containing a genetic treasure house of innate knowledge patterns. These patterns appear as physical and emotional needs that must be met if our minds are to unfold and develop to their fullest potential. How they connect with, and unfold in, the world determines our own particular character, the clarity of our perceptions and our own and our family's emotional health and happiness - as well as the maturity of the society we create around us.
As well as emotional needs we also are given resources to help us meet those needs in the environment. Depression is usually caused by worry about needs - for control, for meaning, for intimacy, connection to a wider community - not being met and by misusing the innate tools that help us meet those needs. Worry, for example, is a misuse of imagination.
What other techniques do you use?
We also use metaphor and storytelling. People are used to hearing stories and anecdotes. An appropriate metaphor, contained in a story, can bypass the defensiveness of the conscious mind and go in as a seed to the right neocortex, which understands patterns. Later on, when the client thinks about the therapy, that pattern in the right neocortex will fire off and makes connections spontaneously, so they have an "Aha!" experience. They can then "own" the insight, and it is easier for them to work with it.
Here's an example. A colleague's elderly client was depressed about becoming incontinent. He began telling her about his uncle and aunt who had a lovely old country house, where some of the family lived and which everybody loved. And then gradually he started to introduce the metaphor - that as the house grew older, it got damper, and there were a few damp patches and plumbing problems, but nobody seemed to mind, everybody still loved the house and they kept bringing their families and their friends there. She came out of her depression without even having known that she had had help.
Are there kinds of therapy that people suffering from depression would do well to avoid?
Research shows that any therapy or counselling that encourages people to introspect about their past will inevitably deepen depression. This type of therapy is based on a misunderstanding going right back to Freud. Freud had a model of the unconscious mind that is very like a cesspool - emotions that weren't fully expressed are held onto in this cesspool of repression, and the job of the therapist is to release the noxious emotions and thereby free the person. But research has shown quite unambiguously that dreams do this for us every night. In other words, nature actually invented the emotional flush mechanism long before Freud.
You have also ventured into one of the biggest minefields of all, psychosis, where you suggest that it is waking reality processed by the dreaming brain. How does that work?
First you need to separate out the REM state in which dreaming occurs from the content, which is the dream. The REM state has the same characteristics as the hypnotic state - the left neocortex is generally much less activated, we have instant access to metaphor and our emotions, and we are responding to our own emotional inputs much more than we are to external reality. Now imagine someone who has been so stressed and whose brain doesn't properly click out of the REM state - the dreaming process has broken down - and who is trying to make sense of the waking world. They are going to experience all kinds of weird things.
Take hearing voices: left-hemisphere thoughts are still being generated in a psychotic person although they are overwhelmed by the power of the REM state that they are now largely operating out of. The only way the dreaming brain of the right hemisphere can make sense of left-hemisphere thoughts is to put it into a metaphor of "hearing voices". And as in the dream state, your sense of self is dissolved because you are acting out a dream script.
So if you are trying to process reality, you won't have a sense of self with which to orient the experiences coming in, and you're going to feel that somebody else must be controlling everything. We are not saying that this interpretation is absolute truth, but when it has been put to someone who has experienced psychosis, they have said, thank goodness, that makes such sense to me.
How do all these ideas go down with the psychotherapeutic community? Are people hostile?
When we first started it was relatively easy. We were getting people who were already open to our ideas. Later we met quite a significant bit of hostility. We'd get mass walkouts of people trained by the Tavistock Institute in London and places like that. Schools of therapy follow the format of cults, with sacred texts and high priests, so they tend not to be open to new ideas. But the encouraging aspect was the response of people at the coalface - occupational therapists, social workers, psychiatric nurses in the community and so on. They knew they didn't have any real tools to help people. And they were totally willing to take on board new ideas.
So how does the European Therapy Studies Institute you helped to found itself avoid becoming "religious"?
Science is based on the idea that any knowledge that we currently hold is subject to revision in the light of further facts. We incorporate the latest findings from all the sciences and we accept and recognise that all the major schools of therapy have stumbled on pieces of the truth, but what we need is to look at the information, put it in a bigger model and integrate what is of value within various scientific approaches. I must also say that perhaps one of the biggest bars to the advancement of therapy in Britain is the criterion used for recognising properly trained therapists. For instance, research shows that it is absolutely irrelevant whether or not therapists have themselves had therapy, in terms of assessing their effectiveness.
And effective therapy is crucial given the alarming rise in mental illness. Has emotion spun out of control in our culture?
Our culture doesn't really have a handle on emotions. An emotion is simply a box in which the brain initially codes incoming perception. So it is put into the anger box, the anxiety box, the sadness box. Our culture started to treat emotions as though they were something sacred and the most significant aspect of a human being, rather than seeing them as this rather primitive classification system that usually needs further refinement. That is the job of the higher cortex, which can fill in the thousand shades of grey that often exist between the black and white of emotional reasoning.
Does this explain how easily we become locked in conflicts?
Emotional arousal is the handmaiden of tyranny - in the home and on the world stage. It stops clear thinking and facilitates the rise of psychopathic personalities. The only long-term resolution of conflict is to devise a social order that enables more people to get their needs met.
And of course, conflict, whether it is on the battlefield or in the home, can result in people becoming traumatised...
It is not the amount of abuse, nor the length of the time that it went on, that is the key factor. It's the amount of damage that has taken place to the personality, the failure to develop essential life skills. It is when the whole of their life has become dysfunctional that there is usually major long-term psychological education and rebuilding of skills. That usually means that an intimate member of the family has done the abuse and that has then interfered with the unfolding of their developmental process.
What about victims of torture?
People who can retain an element of control during long-term torture or deprivation regimes are most likely to make a rapid recovery. Even if it is only control over when they scream - counting to ten, maybe, just before. We have treated people who have experienced extreme trauma in conflicts in Eastern Europe, for example, and we found them very responsive. And we have trained a team in Northern Ireland, the Nova Project, which in the past 18 months has treated more than 300 victims of the violence from both sides of the community with amazingly good results.
How do you treat trauma?
We know that not everyone develops post-traumatic stress disorder. It is a proportion of people who are more vulnerable - very often those with good imaginations. When you are exposed to a life-threatening event, your initial reaction is to freeze to ascertain what is going on. Most of us will then activate our fight-or-flight mechanism. However, a proportion of people with good imaginations go into what is essentially a hypnotic state. And they program the traumatic event into their limbic system, where it is automatically triggered by any event that resembles the original event.
How do you deal with that?
We use guided imagery to produce a deeply relaxed, dissociated, trance state, then we use a technique involving the metaphor of a video, "replaying" the memories very fast to give the person control. This pulls the trauma pattern out of the limbic system into narrative memory. It works because the limbic system is replaying the memories, but the body is physiologically relaxed. This sends a different message to the amygdala, saying this event isn't dangerous any more so it doesn't have to maintain the person in a state of hyper- vigilance. This technique will be invaluable in the aftermath of the current war, which is traumatising so many soldiers and civilians.