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Depression
What’s Your Secret Sauce?
Identify the underlying beliefs that trigger negative thoughts.
Posted May 25, 2019
Sigmund Freud started with the premise that locked away in the unconscious mind were deep-seated psychological conflicts involving nasty impulses of an aggressive or sexual nature. The mechanism of mind called ego, charged with seeing to it that the person’s behavior conformed to social expectations, kept these threatening impulses buried in the unconscious mind or diverted them by using defense mechanisms so that their true nature was deflected or disguised.
Unraveling these conflicts involved a form of mental detective work that Freud called psychoanalysis, which relied on finding clues in the person’s dreams, slips of the tongue, and occasional meaningful utterances the person would make while spending months or years on the couch in analysis, just saying anything that came to mind. The secret sauce in this process was insight into the nature of these underlying conflicts so that mental energies would no longer be needed to keep them tightly under wraps and far away from the conscious self.
Cognitive-behavioral therapy (CBT) also has its secret sauce, the contents of which comprise deep-seated beliefs, called core beliefs or underlying assumptions, which lie at the root of distorted, negative thinking. Gone are beliefs that primitive sexual and aggressive urges are kept at bay by the forces of repression. To the cognitive-behavioral therapist, what lies beneath are maladaptive ways of thinking that typically arise from negative emotional experiences in childhood.
The principal architect of this approach, psychiatrist Aaron Beck, proposed that proneness toward depression comprises a tripartite set of underlying negative beliefs about the self (“I’m no good”), the world at large (“The world sucks”) and the future (“Nothing will ever work out for me”). Scratch the surface of anxiety, and you're apt to find underlying core beliefs involving exaggerated perceptions of threat (“The world is an unsafe place, and bad things are going to happen”) and lack of self-efficacy (“This is too much for me to handle”).
Children raised in secure and loving family environments are likely to develop a secure sense of self and hopefulness about the future. For them, disappointments are bumps in the road. But children growing up in an unsupportive or fractured family environment may develop a set of core beliefs reflecting a darker viewer of the self and the world, characterized by a shaky or negative self-concept and beliefs that other people are untrustworthy, or even malicious. Later in life, disappointments are filtered through these core beliefs, becoming crushing blows while rejections become piercing wounds.
Core beliefs tied to depression typically involve themes of worthlessness, helplessness, self-blame, and hopelessness. Believing at your core that you are deeply flawed, a failure, or a loser justifies taking a backseat to life, expecting that nothing you try and nothing you do will change your life for the better.
Drilling Down to the Core
Core beliefs are not easily changed, especially when they have been drilled into the mind since childhood. Successes are negated as flukes or explained away as sheer luck, and accomplishments are dismissed or minimized, while disappointments are magnified in importance. Molehills become towering mountains that seem like obstacles too overwhelming to overcome. Thinking the worst and fixing blame on oneself become knee-jerk reactions to negative events. The person may think, “What’s the use? I should just accept being a loser,” leading to the conclusion that misery is destiny.
Core beliefs give rise to negative automatic thoughts (negative thoughts that seem to pop into your head). As a CBT therapist, I help patients capture their automatic thoughts and use them as a guide to uncover their underlying negative beliefs. Thinking, “It’s my fault,” whenever something negative occurs—regardless of the facts at hand—is greased by a set of underlying core beliefs. Once we identify this secret sauce, we work to rewrite the recipe by substituting more adaptive ways of thinking.
Perhaps you view the world as a cold and barren place, where people are unforgiving of even the slightest flaw or defect in your character or performance. Taking a dim view of the world, you avoid taking chances to prevent anticipated failure or rejection. Your worldview may comprise a set of core beliefs like these:
- "Other people are just waiting to seize upon my mistakes.”
- “Whatever I try is bound to be criticized by others.”
- “I couldn't stand being criticized again.”
By accepting the absolute validity of these beliefs, the only safe recourse is to stay on the sidelines of life and avoid any choices you make that might expose yourself to criticism and failure.
I recall a particularly poignant case of a depressed young woman whose father had abandoned the family when she was 10 years old. During the intervening 12 years, the only contact he had with her was the occasional birthday card. Yet she idolized her father, believing that had she been a better daughter, he wouldn’t have left her and her mother, and making every excuse in the book for his absences from the important milestones in her life. Her distorted core belief was that she was unworthy of love from him or anyone else, though she still yearned desperately for the love she never had. I remember her coming to a therapy session just after her birthday, beaming that she had received a birthday card from him. “See, see,” she excitedly pointed to the card, “he really does love me.” The card simply said, "Happy birthday, Dad." No expression of love, no affection, and certainly no apologies for emotional wounds he had caused.
The In's and the Un's
For people struggling with depression and low self-esteem, core beliefs often have an “un” or an “in” as a prefix, such as these:
- "I'm incompetent."
- "I'm incapable."
- "I'm unsuccessful."
- "I'm unwanted."
- "I'm unlovable."
- "I'm unattractive."
A close cousin of the "In's" and the "Un's" are the "Can'ts”:
- I can't succeed.
- I can't be happy
- I can't do anything right.
- I can't control my life.
- I can't depend on myself.
Let’s use two case examples as touchpoints.
Rita the Giver, Never Rita the Taker
In an earlier blog in this series (“Putting the Self Back in Self-Esteem”), I commented on a patient who called herself "Rita the Giver." Rita held a core belief that the only way she could receive emotional support from others was by buying their love through constantly sacrificing her own needs and wants. She saw herself as Rita the Giver, never Rita the Taker. Feeling undeserving, she was plagued by the constant fear of being rejected. Buying off her loved ones was the only way she felt she could fend off the threat of abandonment and the personal annihilation she expected would occur were she to be left alone.
Rita interpreted any sign of her daughter's growing independence as a threat to her own security. While rationally understanding she couldn't keep her daughter in a time bubble forever, preserving her as a little girl who was dependent on her mother, her underlying fear of abandonment prevented her from coming to terms with her daughter as a developing adult. Her clutching dependency exacted a terrible price. She always felt that she must "give, give, give," but no matter how much she gave, it was never enough to guarantee that her security needs would be met. The more she sacrificed her own needs, the more often she was taken advantage of by her husband and daughter, leaving her feeling angry and frustrated, and blaming herself for her perceived weaknesses. But she could never express her anger and lingering resentments out of fear of being rejected.
Fear of Going Over the Edge
Connor, a 39-year-old high school teacher, came to realize he equated "letting go" with being weak: "There was never anyone to depend upon in my family. My father left when I was about three, and my mother couldn't really handle me and my brother. She was very warm and gave me free rein, but I never felt like she was there to depend on. I grew up believing that I couldn't let myself be weak since there were no cushions or supports available to me. I always felt that if I weren't in complete control at all times, something terrible would happen that would overwhelm me. That I might go over the edge or something."
Connor learned to challenge the belief he had carried since childhood that he must be strong and in control at all times. Any weakness, especially any emotional weakness, was taken as a sign of impending doom. Connor began to challenge this belief by recognizing that while it felt uncomfortable to be anxious, he did not experience the terrible disasters he had imagined in his worst fantasies that his anxiety attacks would bring about. He was able to develop a more passive attitude toward anxiety, repeating to himself, "This may be upsetting now, but it will pass. Just let it pass through, and it will soon be over."
What’s Your Secret Sauce?
So what’s the secret sauce that lies in the recesses of your mind, striking with a viper’s sting whenever it is pricked? In this blog, we explore many of the self-damning, self-critical, and self-defeating ways of thinking that give rise to the automatic thoughts that trigger emotional states, such as anxiety, depression, anger, guilt, and worry. I believe Freud was correct that there is strength in insight, but I believe he was looking for insight in the wrong place. It’s not in the bowels of the unconscious mind we need to look, but in the ways in which the mind distorts and corrupts how we think about ourselves and our life experiences.
(c) 2019 Jeffrey S. Nevid
