I went out to a talk last Friday night, by Nancy McWilliams. She had been in NZ for the College of Psychiatrists annual conference and came to Sydney for a few days either side of the main event.
The chance to see her was something I couldn't pass up. And it was worth going. She was interesting, thoughtful and I could understand most of what she was talking about.
In general, she talked about Affect (emotion) Theory and psychotherapy.
A couple of interesting ideas she talked about...
She divided people with depression into 2 subsets, those whose primary need is for healthy attachment and those who focus on negative self-evaluation (I am bad/not-good-enough). The 2 groups respond differently to particular treatments. The first group are responsive to, (and vulnerable to), the therapeutic relationship. The second group are often perfectionistic in their expectations of themselves, and are less responsive to the relationship with the therapist. Instead they may respond to challenge to their ideas of being bad, expressed at the right time.
She told a funny story of a perfectionistic, depressed man she was treating, who started improving after she said to him " I'm not disputing that you're and a**hole, I'm just pointing out you're no worse than the rest of us miserable suckers."
It made me think of how easily we sink into this type of thinking - that we are no good, and that we are worse than other people. We forget one of the freeing things about our human sinfulness... that all humans share in it. Not that being sinful frees us, rather that sinfulness and failure being universal means we are freed from self-absorption. Focus on ourselves as uniquely sinful is just as self-obsessed as thinking we are special because we don't sin.
Secondly, she talked about some research she had done into altruistic people. She studied people who were involved in altruistic, serving endeavours and discovered among them a high degree of perfectionism, too. Most of them did not, however, get depressed and she theorised that by living out their principles of serving others, these people were satisfying their own high self-expectations to the point where they did not become discouraged or feel like a failure.