Clive's party
Clive had been suffering depression for 12 years when he first went to see Pamela. He had been for therapy before but, as it was of the type where the client is expected to start talking and the therapist mainly listens, this hadn’t gotten him anywhere at all: his main problem being that he was tongue-tied. He found it extremely difficult to open up in social situations, especially if he didn’t know people well. In the therapy room, he just sat silently or nodded if the therapist tried to prompt him. As a result, he had given up on therapy as a waste of time. But his boss, who was concerned about his well-being, urged him to see Pamela, knowing that she worked in a different way.
Having built rapport with Clive and got him relaxed, Pamela asked if any significant change had happened in his life 12 years ago. This is a very important question because, in most cases, it usually uncovers what triggered the depression straight away. It certainly did in Clive’s case. His marriage had ended 12 years ago. He had thought of himself as very happily married and adored his wife, with whom he did everything. They had three children, Jack, Richard and Charlotte, now in their early to late teens. Then suddenly, inexplicably as far as he was concerned, his wife left him.
His world had collapsed overnight. Because his social shyness was so severe, he had always depended on his wife to lift him out of it, enabling him to enjoy seeing friends in her company. When they parted, however, he no longer saw the friends they had shared. As he was highly nervous of meeting people socially, and of new social situations, he had, at nearly 40, become totally isolated. He then revealed that every evening he played computer games alone and drank a whole bottle of wine. Even though he still saw his children, he feared he had become wooden and boring and that they didn’t enjoy the time they spent with him. Sometimes, at the weekends, he would go into crowded shopping centres, just to have the sense of life and bustle around him. “I feel I’ve been given a prison sentence for something I didn’t do,” he told her.
The only – and therefore highly important – redeeming feature in his life was his work. He was a computer salesman, and an extremely good one, happy to work long hours as it helped to fill his empty time.
Pamela asked him what he had been like before he met his wife. It soon became clear that he had always been very nervous and unsure of himself. School had been difficult for him but things took a major downturn when all the children in his class were asked to go up on the stage, one by one, and talk about themselves, as a means of auditioning for the school play. He heard other children talking confidently about themselves but, when it was his turn, he suddenly panicked, convinced no one would find what he had to say interesting. He had felt as though someone’s hands were squeezing his neck and he couldn’t utter a word. Eventually, humiliated, he was told to sit down. Pamela recognised that this childhood traumatic experience was still affecting his life in the present day. From his halting speech, he clearly found it difficult to talk easily or participate in conversation.
By the end of the first session, she and Clive had identified Clive’s resources – for instance, he was effective at work and that showed that he had motivation and also ‘stickability’. Also, he could be creative (he used to do DIY when the family was still together). They had looked at his needs (as per the list here) and Clive recognised that few of them were being met. So, together, they set three goals for his therapy: to develop a social life; to make some friends and invite them round; and to develop or re-establish some hobbies.
Pamela set him some tasks to complete before the next session: he was to write down 20 achievements, 10 personality attributes and six things he had learned through life. (“You can always learn something from the good things and the bad things that happen,” she told him. “For instance, a child may scramble up a wall to see a spectacular view, while another child stays on the ground. The child on the wall falls off and scrapes his knee, which is not so good, but he has also enjoyed an experience that the other child had not dared to have.”) To start countering his tendency towards negative thinking, she also suggested that he try deliberately to look for the positive aspect in things and write down three such thoughts – for instance, “It’s raining, but at least that’s good for the garden”. Her final suggestion was that he should choose simple subjects – such as cleaning your teeth, gardening or topics in the news – and practise talking about them, as if telling someone else.
When Clive returned for his next session, he had managed to write down about 15 achievements. He had had difficulty finding good things to say about his personality, mainly reproducing the attributes that Pamela had identified as his resources the previous week. But he had put down one very significant learned life skill – that he had to be there for his children, whatever happened. (In this, he had identified something that gave meaning and purpose to his life, which was also a spur for working to improve his relationship with them.) As he had decided that he would like to take up scuba-diving for a hobby, Pamela suggested he involve the children too, and that struck him as a very good idea.
He had also recognised that, although he lived in a very friendly neighbourhood, he kept himself to himself. He had decided that his goal of making and inviting friends around would take the form of a get-together for the neighbours at his house, in a month’s time. This was an adventurous target, but one he was enthusiastic about.
Pamela decided it was time to use the rewind technique to neutralise the traumatic memory of the school audition that was still getting in his way, so that it would become just an ordinary (if unpleasant) memory and not an emotionally arousing, traumatic one. Before they started, Clive scaled at 8 the level of fear that the incident aroused in him (on a scale where 1 was no fear and 10 was terror). Afterwards, he scaled it at 2. The rewind technique is carried out when a person is in a deeply relaxed state. So, while he was still deeply relaxed afterwards, Pamela built up his confidence, using metaphors such as free-flowing streams for free-flowing words. She also made much of his ability to sell, highlighting how he spoke easily in such situations and getting him to imagine doing this in social situations too.
Over the remaining few sessions, Clive’s confidence rose in leaps and bounds. He kept adding to his achievements, personality attributes and positives lists, without even being asked. Pamela encouraged him to engage in a practical talking exercise; making use of the fact that he was a highly competent salesman, she asked him to ‘sell’ to her, in turn, a particular wine, an imagined hotel and the benefits she could derive from listening to music. (Clive had wanted to develop an interest in music but had been put off by his own lack of knowledge. Pamela used the occasion to reinforce the fact that people don’t have to be experts to be interested. Indeed, it is a useful conversational aid to be able to say, “I’ve never heard of that composer. Can you tell me about him? What makes you like him so?”)
As he had so enjoyed and benefited from the deep relaxation, she relaxed him again and asked him to visualise the bottle of wine he had been ‘selling’ – its appearance, the feel of the bottle, the sound of wine being poured into a glass, etc – and the same for the hotel. In this way she was helping him to be fully present and focused on what he talked about, and thus more animated and interesting – simple skills, simply taught.
His task at the end of one session was to phone three people (not connected with work) whom he hadn’t spoken to in a while. At the next session, he told Pamela that he had tried to contact an old school friend. He had ended up having to contact a number of people in order to track him down and eventually reached him in Australia (quite a task for someone previously tongue-tied). The school friend had been impressed by his persistence and pleased by the contact – Clive was elated.
In another session of deep relaxation, Pamela made use of Clive’s knowledge of computers by offering him the metaphor that he needed to ‘reprogram’ his brain with the new information necessary to enable it to carry out the new tasks he wanted it to do. She encouraged him to visualise himself comfortably sitting and chatting with people, initiating conversations and so on. Clive was extremely anxious about the intended get-together with the neighbours but he decided that, before the next session, he would make invitations on the computer and deliver them. Pamela suggested he invite his children to the party too. The next week, he told her that he had not only made the invitations but had knocked at each door and handed them over personally. Ten people were due to attend – a mixture of couples, families with children and older people who lived alone.
When she had relaxed him, Pamela encouraged him to visualise success on the day – seeing himself collecting his children from school, enjoying working with them to prepare snacks, then warmly greeting his guests, confidently offering around drinks and making conversation. It was the last of their six therapy sessions. He rang her afterwards to tell her the party had been a complete success; that he had booked up for an evening class in Spanish conversation (to build on his school Spanish) and that he was taking his children on a scuba-diving holiday at Easter. He was also considering joining a dating agency. This man, who had previously been living a hopeless, joyless life, sustained only by his work, was now confident of his relationship with his children and of moving forward again in his life.