One of my patients wrote to me this morning asking if she could get a medication to help with her anxiety. She has been trying to find a good therapist for quite a while and I think she might have found someone who could really help her. But this is making her feel anxious and irritable.
Now she has to wrestle with a sense that she has wasted so many years of her life up until now without getting the treatment that would have allowed her to live a full and healthy life.
I was reminded by this request of the dilemma that I often faced early in my years of practice: someone with a long history of depression who had never been tried on one of the newer serotonin antidepressants would come in to see me about their depression. I would suggest that we try one of those medications but they would be strangely reluctant to do so. Often their reluctance would be expressed as a fear about side effects or a possibility that it wouldn’t work, but as I addressed these concerns realistically, their reluctance didn’t seem to diminish.
What was going on?
At a certain point I found myself asking “What if it worked?” and discovered that this question tapped into the source of much of the reluctance to try this new treatment. As one of my patients said to me, “If it worked it would mean that I did not need to go through all of the pain that I have experienced from my depression.”
The paradox was, and is, that by not accepting the loss, a person ends up reluctant to act to make things better and, as a result, endures more suffering.
Accepting the losses that we have experienced in our lives and somehow making sense of the challenges we have faced is terribly hard to do but may be essential if we want to move on in life.
For More Information
Acceptance and Commitment Therapy Part 1: Acceptance and Willingness – Acceptance and commitment therapy is all about this central dilemma and Kelsey Schraufnagel, an expert in ACT writes about this new approach to therapy in this blog post.