I’ve tried many methods for treating my own depression over the years but have most consistently relied on medication and psychotherapy. Most of the therapies I’ve tried, however, have not produced lasting relief from the illness. I think that’s because they often miss the emotional core of depression. Instead of taking it on directly, most therapies try to bombard it from a strategic position outside the perimeter. Mostly, they emphasize words, ideas and reason to define new ways of thinking, making decisions and taking action. If those can change, so the theories say, then emotions and moods will follow their lead. That’s the promise.
If I can retrain my thought patterns, for example, if I can decide to act rather than ruminate, if I can speak about long-suppressed feeling and memories, if I can recognize destructive patterns of behavior, if I can achieve enough detachment from my thoughts to observe what they’re doing – in other words, if I can use my conscious mind to correct these and other distortions, then I will be able to get rid of depression, or at least keep it from dominating my life.
I’ve learned a lot from these cognitively-based approaches. In fact, they’ve given me essential skills. But they rarely reached directly into the painful emotions I lived with for so long, day after day for years. When I finally felt a fundamental turn toward recovery, I couldn’t understand exactly why or how that had happened. It seemed more like a gift than the result of conscious effort.
Recently, though, researchers and therapists have tried to explain what’s been missing and why recovery can seem so mysterious. They have found that there is a network of neural connections between those parts of the brain that relate to depression and several physical systems of the body. The research shows that a big part of our emotional lives arises unconsciously – beyond our cognitive ability to control. Perhaps that’s why my own change for the better has been so hard to explain.
Among the writer’s who have explained these discoveries are Antonio Damasio (The Feeling of What Happens) and the joint work of Lewis, Amini and Lannon (A General Theory of Love). David Servan-Schreiber has focused more on the specific therapies linked to the unconscious emotional core of depression. He summarizes several forms of treatment based on this approach in his widely read The Instinct to Heal: Curing Depression, Anxiety, and Stress without Drugs and without Talk Therapy.
Servan-Schreiber is a psychiatrist who was involved in neuroscience research before developing his psychotherapy practice. After many years of working with his patients, he could see that something more than medication and talk therapy were needed. In his experience, psychotherapy that depended on language and thought to solve emotional problems often failed those who most needed help, as was also true for many who tried antidepressants. He began searching for alternatives to these mainstream treatments.
The Emotional Brain
Since his training was firmly rooted in western medicine and neuroscience, Servan-Schreiber approached alternatives with some skepticism and insistence on research that supported claims for their effectiveness. Eventually he identified several that he had seen work for his own patients and that also had solid research behind them. These are the methods he describes in The Instinct to Heal. As he explains, his experience and new evidence from neuroscience changed his whole approach to the treatment of depression, anxiety and other emotional disorders. He expresses the basis for his new approach in this way:
Inside the brain is an emotional brain … . This second brain is built differently, it has a different cellular organization, and it even has biochemical properties that are different from the rest of the neocortex, the most “evolved” part of the brain and the center of language and thought. …
The primary task of treatment is to “reprogram” the emotional brain … . To achieve this goal, it is generally more effective to use methods that act via the body and directly influence the emotional brain rather than use approaches that depend entirely on language and reason, to which the emotional brain is not as receptive.
The emotional brain contains neural mechanisms for self-healing: an “instinct to heal.” This instinct to heal encompasses the emotional brain’s innate abilities to find balance and well-being, comparable to other mechanisms of self-healing in the body, like the scarring of a wound or the elimination of an infection. Methods that act via the body tap into these mechanisms. (Instinct to Heal, 10-11)
As he also explains, though, the emotional and cognitive systems are constantly interacting. It’s not a question of relying on one or the other. Many of the treatments he describes, that focus on the brain’s emotional system, also have the effect of ending the obsessive, negative thinking characteristic of depression and inducing a more cheerful outlook by developing a sense of physical wellbeing. The feeling of harmony, he says, comes from a matching of emotional and cognitive activity. In that state, they are working together rather than in competition.
Treatments via Body and Emotional Brain
Many of the treatments Servan-Schreiber explores are familiar enough, such as the value of Omega 3 fatty acids in the diet, the importance of regular exercise, and the need to sustain loving relationships by improving the verbal communication of feelings. For each one, though, he draws together research findings that detail the neuroscience and biochemistry of their action on the emotional brain.
EMDR (Eye Movement Desensitization and Reprocessing), for example, helps the memory process traumatic events through the brain’s ability to associate physical sensations – like a taste or smell or texture – to long-forgotten events. By using the alternation of light signals, EMDR seems to help the brain mimic the sort of free associating the mind goes through during dreams. Often with surprising speed, PTSD patients, he reports, can unlock and process the violence of a past trauma that had haunted them for years.
A method called Cardiac Coherence developed directly as a result of the findings of neuroscience. These relate to the connections between parts of the autonomic nervous system, that controls basic functions like breathing and heartbeat independently of conscious thought, and areas of the brain linked to depression. As Servan-Schreiber describes the process, the sympathetic nervous system stimulates the heart, while the parasympathetic system puts a brake on that heightened activity.
Anxiety and depression distort the alternation of these influences to produce too much stimulation and keep the body in a state of stress. A key measure of this imbalance is a reduction in the variability of the heart rate – a serious problem seen in patients with failing hearts.
Cardiac Coherence relies on biofeedback. A person under high stress can learn to adjust the heart rate to a healthier pattern through the use of visualization techniques. By following a set of exercises while connected to a computer, patients see the results of their mental effort in a real time graph of the heart’s activity. The method can gradually instill an inner discipline that allows the calming effect of the process to be repeated without the use of computer software and hardware.
There are many other forms of treatment that have helped people heal themselves without the use of medication and talk therapy, or in combination with them. I’ll be devoting a series of posts to each of the most prominent approaches, mostly at the new site, Recover Life from Depression.
Have you made use of alternatives to medication and psychotherapy? Have they been helpful to you – perhaps even enough so that meds and talk therapy were no longer necessary?