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Depression and the Elusiveness of Pleasure

Allan Schwartz, LCSW, Ph.D.

Depression and The Elusiveness of PleasureLast week I posted a blog about flattery and its effects titled "Special Strokes." The blog can be found on this site at the following URL:

http://www.mentalhelp.net/poc/view_index.php?idx=119&d=1&w=5&e=35071

One of our readers promptly commented about the article. Her comment is titled "Not Convinced" and is as follows:

Well, I can see the sense in this.  However, does it depend on the mental state of the recipient of the flattery?

For example: during many years of depression, no matter how sincerely given a compliment was, I would not believe it.  In fact I'd assume the person saying it was being sarcastic, and my self-esteem would sink even lower.

If it was REALLY obvious that the flattery was false and over the top, the negative impact on me was even worse as I'd feel that I was being ridiculed."

In my opinion this is a very perceptive comment that reveals much about the nature of depression as well as how such things as compliments and flattery may be received by a person in the midst of depression.

First, it is common place for someone who is depressed to suffer from low self esteem and to react to any flattering comments with suspicion. I suppose this represents a variation on one of Groucho Marx' famous quotes, "Any club that would admit me as a member ain't worth joining."

I can remember times, especially as a new and inexperienced therapist when I wanted to reassure a very depressed patient by telling them I thought highly of them. It is not just that my flattery was rejected but my abilities and skills as a professional came under severe scrutiny. After all, "If I knew what I was doing, how could I ever compliment such a terrible patient," is a variation on the theme of how they would react. As the person who wrote the comment above points out, "if I was sincere, I was not to be believed, even if I knew what I was doing."

However, there is another part of her comment that needs consideration for what it reveals. The original posting, "Special Strokes," has to do with flattery being used to manipulate people. In the parlance of behavioral psychology we do not talk about manipulating people but of using positive reinforcements to attain your goals. In other words, the article has only in part to do with the use of flattery to influence our behavior. The other part has to do with any individual using it to influence others.

The woman who posted the comment failed to see that she might be able to achieve certain goals by positively reinforcing others in an effort to attain her goals.

I am making a point of this because depression is frequently likened to feeling helpless and, therefore hopeless. Those who are depressed frequently complain about their conviction that they are utterly without any power to alter the events in their lives. Yet, here is one way of changing that.

An example of this is something an acquaintance of mine talked about many years ago. He was a High School teacher who often complained about the unfriendly nature of faculty at the school. This particular school ranked very high in terms of academic standards with most of its graduates being accepted to the top colleges and universities in the nation. The faculty was older, mature and very proud of its achievements. He was a young teacher who had not yet established himself. He would greet others in the corridors with a "Hello" and was usually ignored, according to his report.

He tried an experiment using what he learned from behavioral psychology. Under the principle that positive reinforcements shape behavior, he made up his mind to go out of his way to greet every staff member with a vocal "Hi" and with a broad and happy smile," whether they had previously ignored him or not. This he was determined to do regardless of how long it would take to be greeted in turn.

Indeed, it took several weeks but, after that period of time, virtually every faculty member was greeting him with energy and enthusiasm.

This new teacher could have gotten depressed under the mistaken thought that "No one likes me in this school." Instead of allowing that to happen he decided to take action and conduct this experiment. I want to point out that the greetings he started to get went beyond a simple greeting all the way to brief discussions as everyone proceeded to follow their daily schedule.

Research:

An study was completed at The University of Wisconsin-Madison. Forty six subjects were selected and divided into two groups. One group was made up of people with no history of depression and the experimental group were all very depressed. fMRI brain pictures were taken to study the impact of viewing pleasing images  on the brain. All forty six subjects showed activation of the same part of the brain that controls emotions, particularly pleasurable feelings. However, the people in the depressed group were not able to sustain those pleasurable feelings as revealed in the fMRI's while all of those in the normal group showed continued high brain activation for more than fifteen minutes.

What this means is that depressed people are able to experience pleasure. However, they are not able to sustain pleasure for any significant amount of time.

Implications for Psychotherapy and Self Help

Cognitive Behavioral Therapy has focused on helping the client identify and modify those "automatic thoughts" that are unrealistic but very depressing. Now, in light of this research, it is believed that it will be equally important for clients and therapist to focus on those positive, pleasurable thoughts and learn how to keep them longer than five minutes or less.

When depressed it is easy for anyone of us to say something like, "I'm a total failure." In reality, every individual has enjoyed successful and happy moments in their lives. We need to focus our attention on those instead of devaluing ourselves when depressed.

Your comments, questions and experiences are welcome and encouraged.

Allan N. Schwartz, PhD