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INTEGRATING CBT & HYPNOSIS

6. The client is encouraged to play a happy mental tape. 7. The client is conditioned to a positive cue-word. The First Aid for Depression can be used with or without hypnotic induction. The First Aid technique was utilized with Case 2 (Rita) in order to help her deal with the upset caused by her husband. Rita has a history of recurrent major depressive disorder. She was overly preoccupied with negative self-schemas. The author therefore decided to introduce CBT to her in the second session. She had four sessions of CBT and was showing very good response to the treatment. However, three days prior to her next session, Rita made an urgent appointment to see the author as she was very upset. She came to the session very depressed and tearful. She explained that her husband had treated her very unfairly the previous day, which had induced her deep depression. Her husband was leaving town on a business trip on the previous day and asked Rita to give him a ride to the airport. Rita indicated that she was feeling depressed and that she did not feel confident to drive to the airport, which is about 30 kilometers from her house. He became very angry and accused her of being lazy and avoiding her responsibilities on the pretense that she was depressed. The author reassured her that he was glad that she made an appointment to see him quickly and that he would try to help her out. After allowing her to ventilate her distress and feelings of hurt, the author stated:
I can understand how you feel. Reactive depression is a mammalian response, it is a defense mechanism. When a monkey is fighting, when he feels defeated, he adopts a tucking reflex, his head goes down, his shoulder droops and he tucks in. This tucking reflex or depressive posture is adopted to indicate to the dominant monkey that he is defeated so that the dominant monkey does not hurt him. We humans do the same when we are subjugated by a dominant person. By adopting the tucking reflex or depressive posture we are saying to the dominant person to leave us alone, we have had enough. But the problem with the depressive posture is that sometimes we find it difficult to come out of it. Reasoning does not help because we feel we have valid reasons to be upset. I am going to show you how to do something biological to get out of the depressive posture. Would you close your eyes and imagine yourself standing in front of Buckingham Palace, noticing the guard on duty. Observe that he is standing up very straight, his head is up, his shoulders