Dealing with Depression: Why ‘Get Over It’ Doesn’t Work

Storm clouds gathering over waterIn the face of our depressed moods, friends, loved ones, and even our therapists may say things like, “Stop doing that to yourself!” or “Get over it!” We may even say to ourselves, “Why can’t I just get over it?” These forms of “psychotherapy” usually come from a loving place but often turn out to be ineffective. But why? Why is it that we can stop ourselves from doing certain things (touching a hot stove, for instance), but when it comes to the low energy, hopelessness, helplessness, and self-attacking thoughts of depression, we can’t “just get over it”?

When ‘Get Over It’ Does Work

Believe it or not, as a therapist I spend a fair chunk of my day using a form of “Stop It!” therapy, often with success. When a person is (1) in conscious control of a behavior, (2) no longer wants to do it, and (3) wants my help to stop, challenge (Abbass, 2015) or response-prevention interventions can be quite effective.

“Get over it!” is a form of challenge or response prevention—it says, “Stop doing the thing that hurts you!” When you look at it that way, you can see the loving core of the comment. When someone asks me for help with a pattern they know is self-defeating, such as stubbornness or detachment, but they intentionally continue to do it, challenging them with a “don’t” intervention is one of the most compassionate, helpful things I can do.

When ‘Get Over It’ Doesn’t Work

When someone has conscious control over a behavior, “get over it”-type interventions can help, but my clinical work looks much different when the self-defeating pattern is unintended or unconscious, habitual, or automatic. Decades of clinical research in intensive short-term dynamic psychotherapy (e.g., Abbass, 2015) have shown that a portion of those experiencing depression have symptoms driven by an unconscious emotional process—a process that, at least at the start of therapy, occurs automatically and is entirely beyond their control.

In ISTDP, we call this process “repression” or “instant repression”—the process by which mixed emotions toward another person are instantaneously and unintentionally shunted back against the self, either in the form of depression or somatic symptoms (this is a slightly different definition of repression than in psychoanalysis).

Often, people who experience repression-driven problems never recognize they were mad at someone else; instead, they are instantly overcome by a process of self-blame and self-torture that leaves them feeling fatigued and hopeless. At no point did they decide to do this. Before therapy, this is just how their brains are wired; they automatically say, “When I feel anger toward someone I love, I protect them by pointing it back at myself.” Considering the people we love most are the most likely to irritate us, this is a potentially dangerous state of affairs.

Saying ‘Get Over It’ to Someone with Repression

So what happens when we say “get over it” to someone with depression that is driven by unconscious repression? Here, the “get over it” confronts the depressed mind with an impossible task: (1) gain conscious control of an unconscious process that is currently operating out of your awareness, or (2) do a thing you simply can’t do (yet).

When people, especially people we love, challenge us to do something that is impossible, it triggers anger, and in the depressed mind where instant repression is still active, that anger will deflect right back onto the self. Instead of lovingly reducing the person’s symptom burden, then, the “get over it” would actually make symptoms worse by activating anger that will be sucked back in via repression.

When people, especially people we love, challenge us to do something that is impossible, it triggers anger, and in the depressed mind where instant repression is still active, that anger will deflect right back onto the self.

‘Get Over It’ and Psychotherapies for Depression

Some therapies encourage us to challenge, question, or detach from our depressive thoughts and moods. Other therapies encourage us to get up and do something even when we have no energy. Sometimes, for some people, these approaches produce positive benefits.

My concern, however, is that for folks who have depression caused by unconscious repression processes, questioning their thoughts implies, “Don’t think that,” and encouraging different behaviors implies, “Don’t be like that.” These both sound a lot like saying “get over it” to someone who is not in conscious, intentional control of the symptom; asking them to do something different when they literally cannot. This could trigger anger toward the therapist that will get shunted into repression and lead to worsened therapy outcomes. No one wants that.

How ISTDP Can Be Useful

ISTDP is an ideal therapy for building the capacity to become consciously aware and tolerant of the mixed emotions that usually get deflected back on the self in repression-driven depression and somatization. When working with people with depression in ISTDP, the therapist is in a largely supportive mode, helping people self-reflect on and feel the feelings that were previously getting automatically and unintentionally converted into depression or somatic symptoms. This builds affect tolerance—the ability to feel feelings while still being able to think clearly and channel them in a satisfying way.

This process helps people with repression because, rather than telling them what not to do or what they should do, it gives them another option—it helps them become more comfortable with their emotional reactions so they can then decide how to channel their emotions. In ISTDP, what people wind up “getting over” is the destructive way their mind would unconsciously bury mixed emotions. Once they can think clearly while being in touch with their emotions, rather than being unconsciously overwhelmed by those emotions, they can then make wise, authentic decisions about what to do.

Reference:

Abbass, A. (2015). Reaching through resistance: Advanced psychotherapy techniques. Kansas City, MO: Seven Leaves Press.

© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Maury Joseph, PsyD, therapist in Washington, District of Columbia

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • Josh

    December 8th, 2015 at 9:55 AM

    Why is Repression depression /somatization triggered?? (Great article, btw). I think I have a phobic reaction to potential interpersonal conflict that triggers repression.

  • Maury Joseph, Psy.D.

    Maury Joseph, Psy.D.

    December 8th, 2015 at 10:40 AM

    Thank you, Josh! My sense, which is supported by clinical experience, theory, and research, is that repression is designed to protect a beloved person from angry impulses that are also felt towards that person. For instance, a person has a fight with their partner, and then becomes depressed or gets a stomach ache. Repression seems to be an unconscious effort to shut the body down so that the energy and thoughts associated with anger and rage are not experienced, almost as an expression of guilt about rage towards a loved one. It is triggered in order to jam that anger out of awareness (aka, into the unconscious), and simultaneously punish the person feeling the anger: “How dare you feel anger towards someone you love! You should be punished with symptoms!” I hope that answers your question. What do you think?

  • Josh

    December 8th, 2015 at 12:06 PM

    That’s interesting. Have you encountered someone that perceived their own negative thoughts towards someone else as too strong (therefore repressed) but what they describe feeling does not seem too hulk-smashy to you? I don’t feel I’m articulating my thoughts on this succinctly…unfortunately. I have short term memory issues (TBI) and sometimes when I have a negative thought about, or feeling towards someone I love, I feel myself pushing the thought away and very soon I forget it altogether. I play out an argument that may arise out of me expressing my anger in my head, freak out internally, then bury the thought where i can’t find it. But the feeling remains and causing a guessing game to ensue, and miscommunication takes place….conflict wasn’t avoided. This unconscious defense mechanism fails to protect me. Thank u for your time and your fascinating and enlightening post. No therapist I’ve spoken with has been able to enlighten me as to what is happening and how to stop it from happening.

  • Traz

    December 8th, 2015 at 3:02 PM

    Thankyou, this was an interesting read. I have lifelong had this tendency myself. Why do some have it and others not ie the unconcious repressing of angry feekins against loved one?
    Sometimes I feel the anger and am conscious of why but other times just feel there’s something wrong with me, that I am undeserving/unlovely etc and flat.
    I grew up in a home where father switched between fun and loving to angry and distant and with consistently practical, unemotional mother who never connected on a deep level with her fout children, two being girls. She has always openly said she prefers boys and that now she is happy to have lots of grandsons, no granddaughters. I was a good daughter. Helpful and studied hard but ran away from home often between ages 6 to 8. I would pack a little bag, my mother would laugh at me and talk me I’d come back soon rather than support me and talk to help me understand my feelings. My father also hit when he was angry and frustrated. Sorry for writing so much!!

  • max

    December 8th, 2015 at 3:11 PM

    My thoughts are that anyone who just expects you to get over it has never lived with depression nor have they ever seen the pain that it cause someone in their life.
    They don’t know that there is real pain associated with depression and to tell someone to just get over it will make them feel even worse about something over which you have very little control.

  • tate

    December 9th, 2015 at 10:05 AM

    what would cause one person to respond well to get over it and for others, that is the kiss of death?

  • John

    December 11th, 2015 at 4:42 PM

    My children have said, “Why don’t you just snap out of it?” That made me feel much worse as I said the same thing to myself, but could not alter my feelings at low ebb. I am old now, but have come to realize the abuse levels from my childhood, which were quite high, were often in control rather than my conscious mind. I was also abandoned by my birth mother when I was very young. Now, my own children that I changed to be a good father for them, have abandoned me in my old age. My therapist recently said, “That is so sad.” It hurts so deeply. Don’t tell me to snap out of it.

  • Maury Joseph, Psy.D.

    Maury Joseph, Psy.D.

    December 13th, 2015 at 7:44 AM

    Thank you, Josh! The thoughts or feelings do not have to be hulk-smashy, for sure. People can have guilt over any thought, feeling, or impulse they experience as aggressive, and that guilt can lead to repression. Depending on the person’s ability to tolerate emotions, it could be that simply becoming aware of anger inside oneself is enough to trigger repression. Therapy can help build the capacity to bear these emotions.

  • Josh

    December 30th, 2016 at 5:17 AM

    Thank you! This conversation has been so helpful. :D

  • Maury Joseph, Psy.D.

    Maury Joseph, Psy.D.

    December 13th, 2015 at 7:47 AM

    Thank you for sharing, Traz. The tendency to deal with mixed feelings via repression is usually the result of adverse events in childhood, especially in attachment relationships with caregivers. The way we wind up dealing with the feelings that are triggered by our attachment trauma seems to depend on the age at which the trauma occurred, and probably has to do with the intellectual capacities that we have developed at that age. Allan Abbass writes a bit about this in his 2015 book Reaching Through Resistance.

  • Johnny M

    December 29th, 2016 at 10:41 AM

    You are absolutely correct when you say that telling someone to “just get over it” can lead to them being more angry. There are a lot of people that struggle with things like depression that are just told to get over themselves. However, that is much harder than it sounds. Do you have any other tips about finding someone to professionally help me get over depression?

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