'The Black Dog' Course

Report on ‘The Black Dog: Making Sense of Depression’.

Summary

This was an eight week course at the Gateway Arts and Education Centre in Shrewsbury that took place between September and November 2004. It was organized by Guy Holmes and Cailzie Dunn, who both work as clinical psychologists in Shrewsbury, and fourteen people came on the course. Sessions lasted for two hours with a short break in the middle. Each week a different theoretical approach on depression was presented, and participants had an opportunity to think together about how that approach seemed to fit with their experiences, and whether it led them to any ideas about what might be helpful for them. Everyday language was used throughout and people were free to talk as much or as little as they liked. A philosophy of the course was that there is not one idea of what depression is or what underlies people’s experiences of depression, but it is worthwhile thinking about these ideas and trying to make sense of what our experiences of depression are about. Although attention to what ‘experts’ in the field of depression have said might be worthwhile, we also had a philosophy that we are all psychologists and experts regarding our own experience. From the feedback it seemed that people got a lot from being with other people who had experienced something similar, from being able to talk about their experiences and ideas about depression in a safe, supportive environment, as well as finding the theoretical content of the course interesting and relevant. People became quite friendly with one another and talked about meeting up again after the end of the course.

Structure of the course

Week One: Introductions. Participants were encouraged to say something about why they had come on the course, and what particularly interested them from a menu of topics. Initial discussions centered around the medical model of depression including questions about how can doctors be so sure a person’s depression relates to their brain biochemicals when they are unable to test or measure those chemicals in that individual; the effects of medication; and whether evolutionary explanations can give us insights into why depression is experienced so powerfully as a physical state that perhaps inhibits action, anger and assertiveness and creates powerful feelings of helplessness.

Week Two: What depression is like for me - using different techniques to stimulate ways of describing individuals’ experiences of depression (including drawing ‘depression’), and involving discussion in pairs and in the wider group.
Discussion of separation issues; lack and Lacan; and ‘Jekyll and Hyde’ feelings and how they relate to depression and ‘being yourself’.

Week Three: Life experiences that increase the chances of feeling depressed and getting stuck in states of depression.

Week Four: Depression and loneliness and depression and loss. Attachment theory and the impact of separations. Is depression something to do with the quality of relationships we have and have had? How do grief and loss relate to depression?

Week Five: Psychodynamic theory. Is depression something we experience as a defense or (unconscious) coping strategy against feeling an uncomfortable or threatening emotion, such as anger?

Week Six: Is depression something that happens when we lose or don’t have meaning in our lives?
Cognitive theory: Is the experience of depression caused or made more unbearable by negative thinking patterns?

Week Seven: Depression and power: Is depression the normal state to be in at times of our life when we have very little power to escape from difficult experiences? How can we map and increase the power we have in our lives?
Feedback: What did people get from the course?

Week Eight (‘reunion’): What have people learned during their lives that helps when we feel depressed?

“What did you get from the course?”

Participants said they got various things from coming on the course. Their feedback was largely positive and included the following comments:

“I found trust and openness within the group of people. At the first session I worried it might be just a group of depressed people depressing each other even more, but it wasn’t.”

“Initially I was nervous and talked too much, then I became very quiet because another group member pointed out that some people were not able to get a word in edgeways, then it was ok.”

“I was anxious about the group at first, and then also sometimes later.”

“It was helpful to say I didn’t like being put on the spot when asked to talk.”

“It has felt safe to talk and to not talk, to sit and be quiet.”

“It would be good if childcare was provided as this has been difficult.”

“Most people have come every week even though a lot of us find a 9.30a.m. start too early.”

“I found a release; spoke about certain things for the first time.”

“Talking with people who have had a similar experience made it easier to explain how I felt.”

“It might have been helpful to look at just one approach per session.”

“I wonder if it should be open to partners and relatives.”

“The handouts have been good.”

“I’ve talked with people in my family about things we discussed here and that has been helpful.”

“For years I took pills. I have come off some now and only take one.”

“I have been looking at other courses on offer – to help find a new meaning to life. My job used to give my life meaning and I don’t do it now.”

“I decided to join the library.”

“I made a decision to move closer to my children.”

Cailzie Dunn and Guy Holmes
December 2004