London February 16 1999
Train your mind to fight depression
You can liberate yourself by learning to live with your feelings. Anjana Ahuja discovers an unusual therapy
Three years ago Geoffrey Thompson swallowed 90 painkillers with a pint of milk, then lay down in a park to die. It was his second attempt to escape, once and for all, the continual depression that had enveloped him since adolescence and turned him into a loner. “I thought about suicide every single day,” he says. “Because I wanted it to be final, I would contemplate jumping under a train, or throwing myself off a 100ft building.”
Racked by violent stomach pains and guilt, he confessed to his overdose and recovered in hospital. Now his life is unrecognisably different. Where before he had never sustained a relationship for more than two months, he is now married and planning a family; the long-distance driving jobs and manual labour have been replaced by a fledgling career as an educational author, and the itinerant, attachment-free lifestyle he once coveted has been swapped for a settled existence in Devon.
Thompson, 39, who had previously tried antidepressants (he collected them for his first suicide attempt), assertiveness courses and cognitive behaviour therapy without success, attributes his remarkable turnaround to an encounter with Dr Clive Sherlock, a consultant psychiatrist in Oxford recommended by his GP. Sherlock’s approach was, to say the least, unconventional. “I soon realised that he was advocating the opposite of what I had done before,” Thompson says. “While cognitive behaviour therapists had tried to get me to change my thoughts, Clive would say ‘Accept them. Just don’t consider them. It is not an intellectual activity, so don’t give them the time of day or do anything with them.’
“So whenever I found myself dwelling on the past or thinking about the future, I would take a sharp intake of breath, label them ‘thoughts’ and go back to what I was doing. I now respond with zero questioning, reflection or contemplation. It took a long time to get used to it, but it has cleared away a lot of the clutter. I went from thinking of myself as hopeless and awful to realising that it was a complete waste of time to think about these thoughts at all.” Sherlock, an affable, energetic man with sharp blue eyes, is currently spending a lot of time and effort trying to persuade his peers that encouraging patients to adapt to and live with one’s feelings, rather than rebuffing, ignoring or acting on them can be very liberating. He calls it Adaptation Practice. His journey of enlightenment began when he started out in psychiatry more than 20 years ago and realised that “drugs and psychotherapy were not the whole answer”.
“What happens when we feel angry or frustrated?” he asks. “We hit out, shout out or suppress them, and feel tense or uncomfortable. Perhaps we feel frightened or threatened. But saying ‘damn’ or punching the door doesn’t relieve the problem. We react in the same way again, we form habits. We are not adaptive.”
He cites an example: a patient, a fellow doctor, had come to him about an incident three months earlier. A romantic dinner in a restaurant with his wife had been ruined because of noise at a neighbouring table. The waiter declined to intervene; however, his wife did not regard the neighbouring diners as excessively disruptive. “It was his intolerance to the noise, rather than the noise itself, that was a problem,” Sherlock says. “Take the noise away and he would have found something else to be intolerant of. If we can learn to tolerate things, they cease to be a problem.”
Doesn’t this sound suspiciously like becoming a sop to all the unpleasantries that life throws at us? Sherlock rejects this wholeheartedly. “If we learn to tolerate a feeling, then something changes. It is no grinning and bearing it. It is being willing to let go of the thought ‘I must have my own way’.”
It is very different, he admits, from the usual therapeutic approach: “Medical opinion says patients must face their problems. Well, you cannot tell people who cannot swim that the best way to learn is by pushing them off a boat in the middle of the ocean.”
Adaptation Practice, which Sherlock has pioneered at his clinics in Oxford and London, is controversial because it is so different. He has yet to publish his work in the prestigious medical journals reviewed by his peers, such as The Lancet or the British Medical Journal. However, he has engaged the interest of Dr Chris John, a GP in Wales who is also involved with the training of young doctors. Concerned by the rates of depression in the medical profession, John has encouraged about 20 doctors to undergo Adaptation Practice. He says: “Doctors have a horror of being labelled ‘sick’. But they are keen on Adaptation Practice because it is a very practical therapy, and it isn’t introspective. Doctors generally don’t like being counselled.”
He thinks that Adaptation Practice is rapidly gaining credibility in medical circles partly because it has a “sound, coherent base”. He describes it as a physical fitness plan for emotions. “You wouldn’t do a 2O-mile run without taking a few runs around the block. But most of us try to avoid emotional difficulties. That is why we have such problems coping in a crisis. Adaptation Practice gives you an increased capacity for coping with mood states.”
Grateful patients are also willing to champion Adaptation Practice. Among them is Rachel Harvey, a 33-year-old social worker from Oxford, who became depressed shortly after having her first child, Jack, two years ago. Her postnatal depression coincided with stresses at work; she was also missing her family in Australia and had a problem with digestion. After two weeks of miserable days and sleepless nights, she was put on antidepressants. In an effort to come off the drugs, she began seeing Sherlock a year ago. Much of Harvey’s anxiety came from being unable to switch off. “I would think about what we were going to have for dinner, where we would be living next year or about work.” Now she concentrates on the here and now. She says: “I allow thoughts to come in on one side of my head and out the other. I can carry on with things I don’t want to do because I don’t think about them. I am coping much better with life now. Instead of my stress controlling me, I feel that I have some control back.” It required a lot of commitment, and she admits that she was worried about turning into an emotionless robot. But after following Sherlock’s advice, she thinks that her fears were misplaced: “I can still express and feel emotions, but I can address them within myself. I do not need to behave differently.”
As Harvey quickly realised, the key to Adaptation Practice is self-discipline. Sherlock believes that self-discipline over our feelings begins with self-discipline in other aspects of our lives. That is why, to start with, he recommends that patients adopt a timetable for the day. His motto for this regime is “Just do it” (he finds it rather amusing that the sports company Nike has the same slogan, and claims that he thought of it first).
“Get up at the same time each day, no matter how you feel. Don’t rationalise it, don’t give yourself a treat for doing it and don’t think about all the household chores you can do before you go to work. Simply get up.” This, he says, is designed to counteract the philosophy by which most of us live — how we feel controls what we do.
His next piece of advice is to not procrastinate. Deal with telephone calls, letters and tasks when you get them. He phrases it more elegantly: “Make an effort to respond to whatever calls us.” That way, he says, things that preoccupy us and stress us out gradually turn into normal everyday activities.
Another recommendation is to pay complete attention to whatever we are doing. Sherlock says: “We spend well over 50 percent of our lives thinking about something other than what we are doing. For example, when you eat, don’t have the television or radio on. Just taste the food.”
Lastly, he says, work with your feelings: “When you get a feeling, don’t tense up against it. Don’t suppress it, express it or distract from it. Say ‘yes’ to it in your head and simply feel it for a few seconds. That’s all that’s necessary.”
Sherlock is not overly concerned that Adaptation Practice is still outside the mainstream; what matters is that he can help people to deal effectively with their depression, anxiety, panic attacks or even obsessive compulsive disorder. “What has struck me over the years is how well people take to Adaptation Practice,” he says quietly. “In 20 years I have never had such positive and grateful feedback. I find that very moving.”
Geoffrey Thompson says: “My thoughts used to take over and drag me down. I was living in my head. Now I am not dwelling in the past or considering the future. I am living ‘for the here and now, for this moment in this place in space and time.”
Copyright © 1999 The Times Newspapers London UK
The text of this article is reprinted here with kind permission of The Times Newspapers, London.
Only the names of the two Ap students are not their proper names.