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Olivia* was a 42-year-old working mother, married with three children, when she entered psychodynamic therapy—a form of traditional talk therapy—with Peggy Edwards, a licensed clinical social worker in Indianapolis. Here, Olivia and Peggy tell O how, for the past five years, therapy has been a safe place for Olivia to address her depression and, in the process, figure out how to trust herself and feel satisfied with the direction she has chosen for her life.

Olivia: At first I was a little embarrassed at the thought of going into therapy, because I hadn't suffered any major traumatic life event that seemed to warrant seeing someone. I had a loving husband and three wonderful daughters and a job that I enjoyed, but I just didn't feel content and I couldn't understand why I wasn't happier. There were times when I was depressed. It wasn't so bad that I gained weight or couldn't eat or get out of bed, but certainly I wasn't myself. I'm pretty positive and happy-go-lucky, but the light had just seemed to go out of me. I had also suffered from postpartum depression, so I was on an antidepressant before I saw Peggy. I think at this point it may be more socially acceptable to be on an antidepressant than to go to therapy. But I felt it was necessary to take a two-pronged approach.

Peggy: People enter therapy for so many different reasons. They might feel stuck in their career or relationships. They might feel unhappy or anxious. They might find themselves getting mired in the same kinds of conflicts over and over. They might lack the ability to figure out how to do things differently so they don't keep stepping in the same hole. My training has been in psychodynamic therapy, which attributes a person's emotional problems to her unconscious motives and conflicts. Often those motives and conflicts have roots in one's childhood. In therapy we try to develop insight by bringing what was unconscious into consciousness. I help people look at the patterns in their relationships and the ways in which those patterns create glitches in their life. The patient gains insight into her behaviors and can begin to work on changing them.

Olivia: One of my problems had always been accepting criticism from my mother, because she can be hypercritical. She'd criticize me, I'd bristle and become confrontational, and we'd both walk away unhappy. I thought our interactions would go on the same way until the day I died or she died. But Peggy helped me see that while I couldn't control her criticism, I could control the way I reacted.

Peggy: We've worked a lot on that. With a mother who pushed her to be the best and placed great importance on looks and how people perceived her, Olivia was always looking for affirmation from others to feel good about herself. Despite success in many areas of her life, she felt empty and unfulfilled.

Olivia: I think I was almost obsessed with what other people thought of me. But Peggy has never been judgmental. Of course, opening up to someone you don't know that well is challenging. You have to get beyond the fact that you're telling someone the most personal things about your life, and you have to feel confident that they won't be spilling your secrets at a cocktail party. With Peggy I had that trust.

Our sessions have always felt like a place of refuge, and right away I felt accepted by her. I don't have to impress her. Before therapy, I always believed that to get people to like me, I had to accomplish things. But she'll say, "Look, you're relating to people. They like who you are, and it doesn't matter to them what you accomplish."

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