Intervention Program for Depression
Depression disorder
Depression is a mental disorder that cause disturbance in thought, body, and mood. The affected individual continuously feels sad, disappointed, hopeless, lonely, guilty, and is always in a situation of self-doubt. The degree and duration of depression varies among individuals depending on the nature of the cause, ability of an individual to deal with the situation and availability of corrective mechanisms. For this reason, some people are seen to feel more deeply depressed than others, while other people experience prolonged feelings which might exist for several months. Victims of depression disorder present with changes in perceptions, changes in attitudes and behaviors, and physical complaints, some of which might result into suicidal feelings (Foley, Neale and Kendler, 2001).
The causes of depression can be described based on evolutionary theory. Based on this theory, it is assumed that depression disorder results from the influence of diverse environmental conditions to which an individual was exposed at one time in life. In other words, depression results from unsuccessful psychological correction that one tends to go through while faced with adverse situations within the environment. Factors linked to personality and stress, are believed to be the main causes of depression. Ways through which stress can result into depression in adult life include growing up in uncaring family, exposure to abusive conditions during childhood, break-up of closes relationships, loss of parents, or feelings of shame. Personality feelings such as shyness, high levels of anxiety, and self-criticism can cause depression in adult life especially if they occurred during childhood (Foley, Neale and Kendler, 2001).
Since depression is believed to result from previous exposure to adverse environmental situations, an intervention program known as compassion focused therapy can be used to bring back normalcy to the affected individuals. The main aim of compassion focused therapy is to create healing environments to patients by helping them to develop feelings of warmth, appreciation and kindness towards themselves despite the adverse situations that they had gone through in the past (Brune et al., 2012).
The theoretical basis and duration of compassion focused therapy
Compassion focused therapy is a mental intervention strategy that seeks to teach people to develop feelings of compassion towards themselves and others, in order to eliminate aggressive behaviors (Gilbert, 2009). This therapy is applied with a conception that the types of behaviors developed by an individual at a certain point in time are as a result of some previous unpleasant experiences. When conditions that are completely opposite to the initial situations are made to prevail, such people can be made to develop positive psychological thoughts. Compassion focused theory concept is derived from attachment theory that was described by Bowlby in 1969. In his book, Bowlby claims that, the strength of attachment between an infant and the mother significantly determines the child’s psychological perception during adulthood. The child might feel depressed when this attachment is lacking. However, feelings of happiness and self-esteem can result from creation of maternal attachment, of situations that resemble presence of the mother.
Compassion, which involves empathy, is one of the major elements of compassion focused therapy. The depressed patient is taught to be able to understand personal feelings, as well as those of others (Gilbert, 2009). This intervention program encourages the affected individuals to believe that feelings of anger, anxiety, self-criticism, and sadness are natural experiences that occur as a result of brain development. It is therefore not the fault of humans that such feelings exist. Patients of depression are assisted to explore how early experiences of abuse and life threatening situations may relate to the ongoing fears of rejection, safety strategies such as submissive behaviors, and un-deliberate consequences such as mental health problem (Gilbert, 2009).
When people feel self-critical and intimidated with strong bodily perceptions, they can learn to slow their anger and focus on compassionate imaginations such as becoming empathetic and viewing others talking to them with empathy. For instance, people who view themselves as failures and less important may be helped to think more positive thoughts. Under compassion focused therapy, patients are helped to practice exercises that enhance detection of self-criticism and to develop compassionate thoughts that show kindness, supportiveness, and encouragements emotional attachments. As they develop these positive thoughts, they are taught how to notice how such thoughts contribute to psychological healing (Brune et al., 2012).
Depression is majorly attributed to feelings of self-criticism and shame. The affected individuals might not come of such feelings easily without any professional assistance. According to Gilbert (2009), affected individuals can be taught to register and respond with a sense of well-being and calming to being cared for. In other words, people who are self-critical can be made to develop feelings of attachment for the creation of reassurance thoughts. Compassion focused therapy trains people to work with their experiences by integrating recovery-oriented perceptions of safeness, compassion and inner warmth (Brune et al., 2012).
Gibert (2009) emphasizes that compassion focused therapy acts best as an intervention mechanism in people with low shame and self-criticism. Since the degree of psychological effects varies among individuals, the compassion focused therapy can take different durations among depression patients. Some people demonstrate positive change within a few sessions or hours, others take to it within days, while certain individuals who show resistance to positive feelings might take weeks to recover from the mental problem.
How compassion focused therapy is based on evolutionary psychology
Compassion focused therapy assists a patient undergoing depression to develop positive feelings towards past negative experiences. This intervention is based on evolutionary psychology in the sense that, it recognizes that feelings of depression result from adverse environmental conditions to which that an individual was exposed sometimes during childhood. In that respect, it is therefore possible to eliminate the mental disorder by making the affected person to views the helpful sides of the past experiences. According to Buss (2012), evolutionary psychology assumes that human minds consist of information-processing mechanisms that are integrated in the nervous system. These mechanisms are shaped from those that existed in the ancestors by the process of natural selection. Most of these mechanisms are responsible for behavioral developments that aim at solving specific adaptive problems such as cooperation.
To be able to function normally, these mechanisms must be trained to work in content-specific ways (Buss, 2012). The compassion focused mechanism therefore aims at training the psychological mechanism of depression patients, in order to enable them to clear negative thoughts that were developed early in life, thereby allowing them to adapt to past experiences (Brune et al., 2012). Compassion focused therapy is an effective program for solving evolutionary psychology disorders such depression because it helps the human brain to focus on and retrieve only the most important information that can be used to solve adaptive problems.
Delivery and content of compassion focused therapy
Compassion focused therapy is a psychotherapy intervention program that is effective in managing depression disorder. This intervention program is classified as psychotherapy because it aims at helping the depression patients to comprehend the causes of their prevailing conditions and to motivate them by helping them to inculcate corrective behaviors. In addition, it is based on the systematic use of close relationship between the professional therapist and the affected patient to produce change in behavior, thinking and feelings. The program employs techniques that contribute to therapeutic efficacy, which mainly rely on quality interpersonal relationship. This means that effective communication must be carried out between the therapist and the patient for the creation of quality interpersonal relationship (Brune et al., 2012).
Compassion focused therapy is also a psychotherapy because it is rendered for clinical problems such as depression disorder. Therefore, the psychotherapist has little opportunity to identify those they help as patients. The therapist must also apply knowledgeable psychological theories to formulate and guide the intervention in order to obtain good results. Generally, as a psychotherapy intervention, compassion focuses therapy is intends to create change in the patient seeking help in order to solve the presenting psychological problem presented by the individual (Gilbert, 2009).
The best person to deliver the compassion focused therapy to patients with depression disorder is the clinical psychotherapist. This is important because the psychotherapist is believed to have expertise in psychiatry and can make helpful psychiatric diagnosis. In addition, the psychotherapist has adequate knowledge about different forms of mental disorders and how they present. This way, he or she can initiate the best intervention practices that can bring about change. An effective psychotherapist that can deliver compassion focused intervention program to depression patients must be able to show feelings of genuineness, inner warmth and empathy. This will determine how fast the therapist can help initiate a positive change the suffering patient (Gilbert, 2009).
How compassion focused therapy relates to evolutionary psychology
Compassion is a skill than one can be trained to develop, and practicing compassion frequently can influence a person’s neurophysiologic process with time. In compassionate mind training, the patient’s mind is trained to develop specific activities that are designed to develop compassionate traits and skills, especially those that influence adaptation of affect regulation. It can be explained that compassion focused therapy has some relationship with evolutionary psychology because this intervention adopts the philosophy that human understanding of neuro-physiological and psychological processes is continuously evolving at a rapid rate, and people are now focusing on bio-psychological science of psychotherapy (Gilbert, 2009).
It is believed that compassion-focused therapy is related to evolutionary theory in a number of ways. First, the therapy focuses in bringing change to individuals with previous experiences that have resulted into feelings of shame and self-criticism. People who experience great effects from such situations can have difficulty in developing positive change. In addition, they find it difficult to be kind to themselves, feel compassionate, and to develop a feeling of self-worth (Gilbert, 2009). Second, it has been known for quite a long time that problems of self-criticism and shame have evolutionary histories of bullying, anxiety, family neglect, high expressed emotions in the family, and many others (Buss, 2012). People exposed to early experiences of such types can become extremely sensitive to threats of criticism or rejection.
However, such people can be helped through the application of compassion-focused therapy. Third, many psychologists have recognized that working with self-criticism and shame requires a therapeutic guidance on the affected individuals to enable them focus on memories of such early experiences. This is the basis of compassion focused therapy. By focusing on such memories, these people are trained to accept them and begin developing positive thoughts towards such unpleasant past experiences.
Fourth, people with mental disorders can be taught to engage with the behavioral and the cognitive tasks of a therapeutic intervention, and become skilled at generating alternative thoughts and behaviors for their ingrained negative thought and beliefs. A key element of compassion focused therapy is therefore related to the evolutionary psychology, and mainly observes that individuals with high levels of criticism and shame can find it difficult to recover from feelings of depression. Consequently, they experience difficulties in generating feelings of safeness, warmth, contentment, and compassion in their relationship with themselves and others (Gilbert, 2009).
Conclusion
The best intervention programme that can be used to treat depression is compassion focused therapy. In compassion focuses therapy, the patient is taught how to understand the previous experiences and to develop feelings of inner warmth, safeness, and compassion towards them. Compassion focused intervention is delivered by a psychotherapist, and the healing process depends on the degree of impact generated by the past negative experiences.
References
Brune, M., Belsky, J., Fabrega, H., Feierman, J. R., Gilbert, P., Glantz,K., Polimeni, J., Price, J.S., Sanjuan, J., Sullivan, R., Troisi, A., & Wilson, D. R. (2012). The Crisis of Psychiatry- Insights and Prospects from Evolutionary Theory. World Psychiatry, 11(1): 55-57.
Bowlby J., (1969). Attachment and Loss: Volume 1 Attachment. New York: Basic Book.
Buss, D. (2012). Evolutionary Psychology: The New Science of the Mind. United States of America: Pearson Education Inc.
Gilbert P. (2009). Introducing Compassion-focused Therapy. Advancements in Psychiatric Treatment, 15:199–208.
Foley, D., Neale, M. & Kendler, K. (2001). Genetic and Environmental Risk Factors for Depression Assessed By Subject-Rated Symptom Check List versus Structural Clinical Interview. Psychological Medicine, 31: 1413-1423.
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