A couple of readers have asked me to comment on whether it’s possible or advisable to try to act as a ‘therapist’ for your depressed partner. This idea came out of responses to one of the posts on relationships that has attracted the most attention on this blog: How Can You Communicate After Your Depressed Partner Leaves?
The word ‘therapist’ has to go in quotes because a non-depressed partner cannot and should not try to do what a professional therapist does. The more I learn about psychotherapy and the range of skills and training it takes to be good at it, the more respect I have for anyone who can fill this difficult professional role.
Quite apart from the specialized knowledge and clinical experience required, a partner has such enormous emotional involvement in a relationship that every word, intonation, gesture and silence is interpreted in the light of deep needs for connection. Depression threatens the bond that has existed in the past so every discussion, in a sense, is about the relationship more than it is about one person’s depression.
Present as Partner or Therapist
A professional therapist can be present with a client in a completely different way. Without the personal and intimate history of a relationship, the therapist brings concern and compassion but also detachment and a set of skills that are essential for helping a depressed person confront and cope with difficulties. The relationship of helper to client focuses on the need of one person to end suffering.
The therapeutic relationship is a testing ground for bringing out difficulties and finding ways to handle them. It can serve that purpose because it is not an intimate partnership. The therapist is constantly reminding the client of the boundaries that keep the focus on the need to deal with the client’s problems.
The differences may seem obvious, but we all talk informally about the sort of ‘therapy’ that can happen between intimate partners. Sometimes, the word refers to the healing discussion of feelings that are so sensitive that they can only be brought up when both partners feel especially open and trusting.
Sometimes, the word means the opposite of intimacy. A partner might come across as lecturing or applying pop psychology that isn’t really responsive to the depressed person’s needs. Or the non-depressed partner might resent being cast in the role of therapist when that means listening to a one-sided unburdening or venting.
The problem with both of these situations is that they are about one-way communication. It’s like being read to from a script, not talking together as partners who are present and responsive to each other’s needs.
Depression’s Filter on Relationships
I think a depressed person has needs that are very hard for a partner to meet because they aren’t about relationship. They come out of a narrowed perception of yourself and your partner.
Depression provokes a kind of soul panic. You feel a threat to your very being, but you’re not sure what the threat is. You don’t know how to deal with it so there’s a tendency to pull back, hunker down, withdraw. A survival instinct comes into play.
It becomes very hard to listen to other people. You sense the need of an intimate partner for loving reassurance. You hear their words intended to comfort or help. Yet most of what comes across is like an emotional demand that you simply can’t tolerate.
It can feel claustrophobic. You’re hurting too much inside, feeling too nervous about losing control of your own life to be able to listen to your partner’s needs. So it’s easy to tune out what they say or angrily reject it. There are times when I’ve been like that, and there was no talking to me.
Changing Expectations of Support
I think your expectations of your partner vary depending on your level of self-awareness and experience in dealing with depression.
Early on, when I had a poor understanding of what I was going through, I could blame everything on my partner, but these days I recognize the signs of depression right away. as does my wife. We both prepare for dealing with it. We’ve learned a lot about how to be thoughtful with each other during those times.
To the extent that we can participate in a two-way exchange, the relationship is holding up under the pressure.
Some commenters have used the word “therapy” to refer to quiet listening coupled with a deep understanding of the suffering that depression entails. The partner would be able to feel a lot of empathy and offer gentle encouragement that could help the depressed person get through a hard time.
I think most undepressed partners can manage that sort of responsive listening from time to time, especially if periods of depression are relatively short and not too severe. Knowing more about depression also helps. Understanding the illness makes it easier to react to its symptoms in a partner in a more detached way, without feeling you’re to blame or that the relationship is at fault.
Helping for the Long Term
When I think of depression that lasts for months and years, however, I can’t imagine any partner setting aside their needs to be the purely responsive listener all the time. It’s not possible, and a depressed person shouldn’t expect a partner to put life on hold for the duration. This isn’t an either/or problem. Sometimes, partners will be responsive and helpful, sometimes hurt and isolated from each other, sometimes struggling to connect and just survive.
‘Therapy’ doesn’t seem to fit the way partners can relate to each other when one of them is in the midst of depression. It seems to set up the wrong expectation. For the depressed partner, expecting your mate to help guide you through depression is a very limited way of thinking about your own treatment.
Your partner can be a knowledgeable, loving and supportive helper in a program of recovery, but the primary source of change is within the depressed person. I guess I’m sensitive about this because I spent so many years expecting therapists, doctors and, to some extent, my wife to bring me out of depression. That was a long delusion that got me nowhere.
Sure, partners nurse and care for each other when they’re ill, but when depression is a life condition, both partners have to prepare themselves for long-term changes in the relationship as they deal with the illness. Expecting one partner to act as therapist for the other seems like the wrong idea.
What do you think?