Depression-A simplified view

What is Depression?

According to cognitive principle matrix theory "depression is feeling hopeless and having hopeless thoughts, generating enough fear to try to force the body into withdrawal mode"

Note: The term "withdrawal" is based on Dr. Stephen Porge's polyvagal theory.

It is a conflict between the three brains. The head and the heart brain are saying "life must end, withdraw now." The gut brain and nervous system are saying "this is not an external threat trying to kill me, your thinking must end."

How does depression occur?

The cognitive principle matrix is based on Maslow's "hierarchy of needs". Depression occurs when one or more of those needs aren't being meet and the person "predicts" [based on predictive mind theory] that those needs won't be meet in the future. This produces a level of fear that cannot be tolerated.

How does the mind and heart create a "hopeless" view of needs being meet?

  • Rumination causes "false memories" to be created in the subconscious mind which eventually lead to a feeling of hopelessness in certain circumstances. The subconscious mind has no logic and will accept anything that the conscious mind ruminates over. The process is similar to learned helplessness.
  • The subconscious mind predicts outcomes based on information received. If the conscious comparative mind visualizes and beliefs that "my needs are not being meet" then the subconscious mind will start making predictions about that. The end result of prediction and rumination is a negative-comparative-predictive-loop which is common to all types of depression.

Once the spirit brain experiences no motivation in "self" hopelessness is present.

The depressed person has an overly negative comparative mind, particularly related to past concerns, that is "if only's. " But they also have an overly negative predictive mind, related to future outcomes, that is, "what if's"

Polyvagal theory and depression

The following diagram is a simplification of Stephen Porges' polyvagal theory

Depression occurs when the:

  • Head brain gives up on achieving the "need"
  • The heart brain turns off "social engagement"
  • The head and the heart convince the Gut brain to turn off the fight and flight response and push for withdrawal.
  • The nervous system pushes back saying "This is not a life threatening situation"
  • While the nervous system is strong enough, then "fight" and "flight" will engage, but these will be dysfunctional based on the person's backup personality type.

Why is depression a complex mental disorder?

Depression is a complex topic because the above process is carried with each individual having their own thoughts, feelings and behaviors based on their genetics, their family history, their personal experiences and their personality type.

In order to understand and treat depression at an individual level it is better to assess depression as a "temporary personality disorder" using the CPM's simplified personality disorder model with some minor variations.

Personality Disorders-A simplified view according to CPM

The purpose of proposing a simplified view is that the method goes straight to the treatment plan, rather than looking at behavioural symptoms for diagnosis to assign a label.

According to the cognitive principle matrix we start with a normal or healthy personality, but also with a backup personality when put under stress.

The healthy personality is based on the following traits:

  • A balanced sense of self and others [spiritual brain based on Trust, Respect & Acceptance]
  • A balanced sense of thinking, where automatic thoughts [head brain], match core beliefs [gut brain], based on logic, positive thinking, common sense and intuition.
  • Healthy impulse control [gut brain]
  • Healthy balance in emotions [heart brain]
  • A healthy personality integrates all of the above to a whole sense of self.

However, the healthy personality in each person varies based on the amount of stress they can handle before a back up personality arises. There are four types of back up personalities, namely:

1.    Overly controlling [strongest emotions are fear plus anger, equals rage]

2.    Overly responsible [strongest emotions are fear plus anxiousness, equals panic]

2.A Overly responsible- false positive [strongest emotions are fantasy, greed and self-centeredness]

3.    Overly avoidant [strongest emotions are fear plus confusion, equal hopelessness]

4.    Withdrawal [Strongest emotions are fear plus paranoid fear, equals shutdown]

With a personality disorder, the back up personality becomes the dominant personality and all or most of the 5 healthy traits become unhealthy.

However, with depression, the back up personality is dominant only while in the depressed state.

Note:

1.    Withdrawal is never a backup personality by itself, however, it can be present with the first three backup personalities.

2.    Overly responsible-false positive back up style is an escape from the overly controlling negative back up, because the person can’t handle the negative emotions.

Based on the simplified model then there are five types of depression to treat based on each back up personality type, but they will all display the following symptoms:

  • Black & white thinking about need/needs not being meet.
  • Take and make things personal rather that about behavioral
  • Display high levels of negative predictive thinking.
  • More pessimistic than optimistic about their needs being meet.
  • Display physical symptoms such as sleep difficulties, etc.

A. Overly controlling type & withdrawal [low levels]

  • Can be optimistic or pessimistic personality, but mainly the latter.
  • Thinking is too rigid [1A.], based on "I am right or entitled" and "They are wrong or working against me and I am not going to get my needs meet." They make things personal and take things personally, but not by blaming themselves.
  • Overly on emotion[2B], often going into a rage, demanding that their needs be meet. Under on emotion [2A] when in a depressed state.
  • Over on impulse control [3B], being too demanding and lack of self control. Can be under on impulse control [3A] and move towards avoidance, then withdrawal under extreme stress.
  • Over on self [4A], being self-centered and entitled, but also Too others [4B], demanding that others meet his/her needs.

This type of person is likely to have low to moderate depression, because their personality type won't except avoidance or withdrawal, but always wants to fight.

If this type presented with major depression then most likely there would be:

  • Multiply needs not being meet at a serious level
  • Low levels of awareness and or resilience.

B. Overly responsible type, with withdrawal [low-moderate levels]

  • Mainly pessimistic personality.
  • Thinking is too rigid [1A.], based on "I must try harder to get my needs meet" and "I am not good enough or they are wrong or working against me." They make things personal and take things personally, but mainly by blaming themselves. Their predictive mind is over used on working out how to get things right.
  • Overly on emotion[2B], often in a state anxiety trying to meet their needs. Under on emotion [2A] when in a depressed state.
  • Over on impulse control [3B], being too demanding on self, over using self control generating excess stress. They are often people pleasers, trying hard to get acceptance, which is normally one of their major needs from others. Also perfectionists, getting acceptance from what they do. Under on emotion [3A] when overwhelmed and moving through avoidance to withdrawal.
  • Over on self [4A], being self-centered, trying to get own needs meets. Also Over on others [4B] trying to get acceptance from them.

This type of person is likely to have low to moderate depression, because their personality type won't except avoidance or withdrawal, but always wants to fix the problem.

If this type presented with major depression then most likely there would be:

  • Multiply needs not being meet at a serious level and they are overwhelmed.
  • Low levels of awareness and or resilience.

C. Overly responsible (false positive) type & withdrawal [low levels]

  • Mainly optimistic personality.
  • Thinking is too rigid [1A.], based on "I am right or entitled" and "They are wrong or working against me and I am not going to get me needs meet." They make things personal and take things personally, but not by blaming themselves.
  • Thinking is too flexible [1B.] Need to escape the negative emotions by creating fantasies about their own achievements.
  • Overly on emotion[2B], often going into a rage, demanding that their needs be meet. Displaying grandiose emotions to attract others or manipulative emotions to get needs meet. Under on emotions [2A] when depressed.
  • Over on impulse control [3B], being too demanding and lack of self control. Under on impulse control when they give up and move to avoidance and withdrawal.
  • Over on self [4A], being self-centered and entitled, but also Too others [4B], demanding that others meet his/her needs.

This type of person is likely to have low to moderate depression, because their personality type won't except avoidance or withdrawal, but always wants to fight.

If this type presented with major depression then most likely there would be:

  • Multiply needs not being meet at a serious level and they are overly frustrated.
  • Low levels of awareness and or resilience.

D. Overly avoidant type & withdrawal [high levels]

  • Mostly pessimistic personality.
  • Thinking is too rigid [1A.], based on "I never achieve my goals" and "Life is working against me and I am not going to get my needs meet." They make things personal and take things personally, blaming themselves, others and life in general.
  • Under on emotion [2A] looking to avoid conflict and responsibility. Also when in a depressed state.
  • Under on impulse control [3A] and move quickly move towards avoidance, then withdrawal.
  • Over on self [4A], being self-centered and overly critical. Too others [4B], demanding that others meet his/her needs.

This type of person is likely to have moderate to high levels of depression, because their personality type quickly moves to avoidance or withdrawal.

E. Mixed back up personality styles.

People can have varying backup personalities in different situations, however, they normally follow a consistent pattern for each situation. eg. When their needs are not meet, a person may try and be overly responsible to fix the problem, but then get angry [overly controlling] or move to avoidance.

However, while in each backup personality type, they will tend to show the same characteristics as described in types A to D.

HOW TO COUNSEL DEPRESSION:

  1. Determine the client's need/s that are not being meet.
  2. Create hope, not necessarily that the need will be meet, but that the client "can try". This gives the client back control, because no one can stop you trying.
  3. Challenge the client's black and white thinking, but slowly and gently.
  4. Teach the client how the conscious mind and subconscious mind work. The comparative mind, the predictive mind and the affects of rumination. Provide tools to stop rumination.
  5. Teach the client how to focus on "now", not the past or the future. CPM uses the "who am I, now"-"what do I want"-"how do I get it" technique.
  6. While a client may appear calm [depressed] they are very anxious on the inside. Teach relaxation techniques to regain control. CPM uses the "Stop, find calm" technique.
  7. Teach the client about the negative affects of resentment and taking things personally. Teach the client how to forgive themselves and others.
  8. Work with the backup personality that the client presents. Work to restore a "healthy personality" as discussed above. eg. Teach assertiveness to overcome low impulse control.
  9. Teach the client how to turn on the "social engagement" vagus nerve. The most common cause of depression is related to weak attachment needs in childhood. In CPM we focus on building relationship principles of trust, respect, acceptance and commitment. The depressed person will have weaknesses in at least one of these.
  10. Set new goals to get needs meet. Ensure goals are easily achievable at the beginning.
  11. Work on the client's behavioral issues. Eg not sleeping well.

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