Talk Therapy and Mental Health

Three Women, Three Problems, Three Therapies
By Christine Montross

Therapy can help you beat depression.

Whether you've tripped into a black hole of depression or simply feel that your life has become one big rut, therapy can help you get back on solid ground. Three women and their therapists talk candidly about how the process works.

Olivia: "The light had just seemed to go out of me."

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."

Peggy: One of the things Olivia has always been very good at—and it's sometimes very hard for people—is a necessary component of therapy: feeling that you can talk about anything with the therapist. That includes anything about the therapist and the therapy relationship. The whole idea of transference—where patients unconsciously project onto the therapist their ideas and feelings about significant people in their lives—is an important part of what we discuss. In Olivia's case, transference has been especially helpful in dealing with her mother issues. She could see me in something of a maternal role that was very different from what she's used to. And experiencing acceptance from me has allowed her to accept herself more, thereby reducing her depression, which I believe was fueled by a pervasive drive to succeed at all costs.

Olivia: I used to think it was the therapist's job to give you answers. But what Peggy does is help me come to my own answers. She asks me what I think. And at first, it was almost like: What does it matter what I think? What does my mom think? What does my boss think? What does my husband think? Therapy has focused on how I need to live my life based on what I think is important. Because otherwise I'm just going to be chasing my tail trying to please others—which I may or may not be able to accomplish. I don't want that anymore. I want to try to feel happy with my efforts and not be such a perfectionist. I still struggle with that, but Peggy says, "Olivia, you're too hard on yourself…. Olivia, why isn't that enough?" And when I don't have a good answer, I realize that I've got to let it go.

Peggy: Without awareness, no behavior change is going to happen. Awareness—being able to think about and struggle with your behavior—is just essential.

Olivia: I wonder if women sometimes start therapy because of problems in a relationship with someone else, only to find that the therapy turns into something so much more. For me, it became a relationship with myself, a chance to get to know myself better and figure out what's important to me. As a woman, you're always making sure that the needs of others are being met. You have all these demands placed on you. But in therapy there are no demands other than trying to get to know yourself better.

Peggy: Olivia has had a growing realization that while her competitiveness has served her well in many areas, it has also prevented her from enjoying a lot about her life. If you're so focused on winning or doing things perfectly, you miss a lot. Now she has less of a drive to do things perfectly, and more of a deep satisfaction at juggling the roles of mother, wife, and career person.

Olivia: More than anything, I think I was struggling with the question, Is this all there is to life? And I think what I've found out through therapy is, yes, and that's okay. That's kind of my mantra from Peggy: "That's okay." It's wonderful to be happy with life. And to finally feel like that's enough.

*Names and some identifying details have been changed.

Three Women, Three Problems, Three Therapies continues…

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