Psychotherapy is still alive and well, but increasingly we have moved to a biological paradigm of depression in which sufferers are encouraged to try antidepressants, mood stabilizers, nutritional therapy with whole foods and supplements, Ketamine infusions, and Transcranial Magnetic Stimulation. Many psychotherapies used for clients with severe depression are highly structured one-size fits all approaches. I was a philosophy major in college who was very attracted to and immersed in existentialism. Now that I am a psychotherapist, I use it with some of my clients and I have seen it help. My approach is to inquire how much or how little my clients have enjoyed their collegiate, graduate, and post-graduate studies and their careers. I then inquire as to how much or how little my clients had control over the choices that led down their particular educational and career path. There seems to be a directly proportionate relationship to lack of meaningful choice and onset of severe depression. Clients who were unduly influenced by their parents to pursue admission to particular schools and careers are much more likely to feel weak, inadequate, and powerless than those who made their own decisions. Once clients see the relationship and take control of lives through choiceful decision-making their depression begins to abate. Why are some people more subject to being strongly influenced by their parents in making key, life-altering decisions? My observation is that these particular clients were survivors of attachment wounds who live with an insecure attachment style. These clients hunger for parental approbation and approval and are less concerned with how they personally measure the value of the schools and careers they chose to please their parents. Even in adulthood it is never too late to kick start the processes of self-differentiation, boundary setting, and the development of authenticity. To make this work I also teach clients to develop self-compassion and to change their attachment figure from mom, dad or both, to their own wise Self who has their best interests at heart.
