Thursday, October 26, 2006

Three's a charm

In psychiatry, there's a set of three patterns of thought that are observed in depression known as the cognitive triad. The cognitive triad consists of the following:
  • A negative view of oneself
  • A negative interpretation of experience
  • A negative view of the future
Outside of clinical depression syndromes, I feel it adequately describes the pattern of thinking in any episode of depressed mood. Having tried to think through my own periods of moodiness and depression, I've found that the mood often exists and persists only when all three patterns of thought are present. More on this later, but first a breakdown of how the triad has occured in my own thought process.

To start, I've had a decent amount of difficulty with self-esteem, and with large groups of people social anxiety as well. When I begin to start feeling depressed, it will often start with "a negative interpretation of experience". Usually with people this manifests as an anxiety that the person or people do not care for my company, or are bored of me, or less excited about spending time with me than were I to be someone else who's company they prefer more. In the past when I worked in Residential Life it manifest as "my residents don't seem to think I'm exciting to be around", or if I'm trying to plan a social event and people don't show up, I may become down on the event and blame myself for not being desired for company. These negative experiences often lead towards the "negative view of oneself" although not always a direct thought of "i'm a failure". Oftentimes I find an end-around to essentially reach the same conclusion, which is "these people/this person must think I'm a failure, or worthless". The only difference in stating this is I am accentuating the importance I hold in what others think of me, and that is a futile source of affirmation. The last thought pattern, "a negative view of the future," occurs when I believe that the previous two thought processes are true and unchangeable, and that the negative experience will ultimately continue or pervade other aspects of my life, or that I simply cannot be any more appealing to people than I am, and fail to feel validated.

I've thought through what might occur were one of the three thought patterns were to be removed. If I remove a negative view of the future, then the mood would never persist, and any negative thoughts about myself or an experience would ultimately be forgotten. If I remove negative thoughts about myself (and this would come only through affirming my worth through God, and disregarding any concern for peoples' opinions of me), I would never blame myself for something wrong that occurs, and likely be a lot more motivated to change things. If I were to cut away the negative view of an experience (which is often where I start in the first place) I likely would not fall into the other two thought patterns.

I had a conversation with a friend the other night about this kind of thinking during times of depression. It's no secret to many people that I've really struggled with depression the last two to three months, and a lot of it falls into the above triad; a few small things started the ball rolling, and eventually it was so big that what was left was a massive amount of hopelessness, despair, and unresolved anger. Some of that is resolved, but some of it I'm not sure. I know that I haven't completely resolved or done away with the triad thinking (and I'm not sure how to permanently remove it), but its something to work on. What it will ultimately boil down to, I assume, is a willingness to trust God's sovreignty on a good many things, and a faith that I am loved by God, something I think I have a difficulty with deep down. Lastly, a faith that I am loved by people and that my circle of friends is broader than three.