Case 2 – depressed

Case study 2 – Depression in marriage originating in family of origin issues

Ed had reached the limit of his endurance from being criticised by Dena and their ongoing power struggle. He withdrew deeply into himself and had begun planning suicide. Dena had done everything she knew to reach him but discovery of his plan on the day she was about to walk out, was from way out of left field. They had both come from troubled families and for both this was a second marriage. They had no previous counselling or therapy and were such capable people that they only need me to provide them with a strong, emotionally safe and secure base from which to unravel the issues and develop creative solutions.

Ed was a builder living with his family in the unfinished dream home he was building outside of Lismore, NSW.

He had agreed to do anything to fix his marriage following a walkout by Dena. That included seeing a ‘head shrinker’, something you would normally have had to drag him to – ‘worse than the doc’s finger up my A-hole’, he said.

She had said, ‘I give up! It’s over’, whilst calmly packing some clothes, the business laptop and walking out of the house, passing the sheds and the piles of building materials and the unfinished wood fired bath house she had longed for.

She got into the Ute and made to drive off.

This followed many previous attempts of her ‘trying to get through to him’, as she put it. He called it hammering him into the ground.

Ed was rattled. This time she had got through to him. Finally out in the car, they lit a cigarette and sat down to really talk. Real and gutsy talk, not a shouting match like usual. Talk on the edge. ‘Why does it have to get this bad before we finally open our hearts again’, she wondered.

He told her that for months he had been thinking about hanging himself in the garage of their unfinished beach house at Brunswick Heads.

This was totally out of left field for her. Shocked, speechless for a moment, she felt simultaneously responsible and disgusted with his revelation.

Torn between empathy and outrage, she couldn’t stop the explosion of: ‘where the kids would find you on the weekend, you f… b…?!!!!!!!’ as she slammed her hand onto his chest.

Ed was suffering from clinical depression, and neither knew it though both knew of depression. The media coverage and the giant Beyond Blue bill boards on the Pacific Highway from Grafton to Tweed Heads had not escaped them. Applying it to themselves had.

He came to our first session ‘asked’ by Dena, he said with a wry smile. He was unwilling to take a seat for the first five minutes, suspended between fight, flight and freeze. He was a big teddy bear of a guy who looked so vulnerable and exposed in my office. It must have felt to him like he was about to be stripped naked.

He eventually settled and warmed to me, and described the truly ghastly childhoods that he and Dena had endured, and then the wild young adulthoods that led them into their own troubles before they met.

He talked so freely that Dena was doing double takes all the time. She kept repeating ‘I don’t believe what he’s saying’, ‘why haven’t you said all this before’.

At that point I knew he was the withdrawer and she was the pursuer in the demon dance. These were two great people who had become stuck in a chronic disconnect pattern of pursuer and withdrawer, fuser and isolator. Then I felt hope.

It seemed to me that they had acted out the damage of their parents’ legacy. Both had critical fathers – nothing was ever good enough. Dena was a daddy’s girl and so his criticism was deeply wounding. As an adult she was hypervigilant of being invalidated in word or deed. She had no idea she had become just like her father.

Ed’s father had used the strap for punishment – brutally. As an adult Ed was a bit emotionally numb. He had become addicted to hating himself – it was like taking a deep draw on a cigarette, weirdly satsifying and damaging at the same time. He had a monkey on his shoulder telling him he was stupid.

They each reinforced the other’s deepest fears – of being invalidated and of being found stupid.

Over time they had done an incredible job mending the mess of their lives, creating a business and managing a family of seven kids – two and three from previous marriages and two babes of their own.

They were successful, intelligent, articulate, fiercely independent and aware – contradicting the myths about people who seek help from shrinks.

Yet incredible to me, neither had sought help during or after the breakdowns of previous relationships nor in forming this one. They used the ‘go it alone’ strategy and were proud of it.

Ed was initially defined as ‘having the problem’. However, when I worked with them together, they each owned up to having known for some time that they were in trouble as a couple and within themselves but neither would fess up. Fear and shame again.

Automatically we deny our inside view of hurt or broken, and focus instead on the more compelling scene of the damage we do and is done to our lives and our relationships. We end up dominated by fear – mostly the girls – and shame – mostly the boys.

That’s like a hidden, inner-relationship power struggle we have with ourselves.

It requires great courage and honesty to expose the vulnerable and tender parts of ourselves. That is ‘the paradox of how we become more whole by acknowledging our parts.’

These guys had that courage in spades but they needed a safe place and a method to explore tenderness together.

From reading my web site, Dena had understood that couple’s therapy was one of the most effective treatments for depression and better than medication:

The research project has affirmed our perception of the complex interweaving of contexts – social, political, economic, cultural, gender, class, individual – interactions that shape the experience labelled as depression. During the second year, without any treatment, the depressed individuals who had taken part in couple therapy remained less depressed than those who had taken antidepressant drugs. London Depression Intervention Trial. More from the UK on this bio psychosocial jigsaw.

Dena feared isolation and pursued him to talk. Ed hated conflict, feeling ashamed when it broke out and so withdrew. The demon dance ran the show. The pattern was the problem. The pattern is almost always the problem.

Just like the boy girl differences at birth, the physiological differences reinforced their disconnection – he managing shame by averting his eyes and she managing fear of isolation by pursuing closeness.

Frankly, all I did was provide a wise, calm voice in the storm, with unrelenting empathy and validation. I helped them build a safe harbour that brought out the best in them. They did the rest. That was no small thing I know, but it is both the simple and uncommon gift of a good therapy. How to choose a therapist with those skills.