Relationships

One of the bitter ironies of depression is that depressed people crave connection with other people, while the nature of the disease makes it impossible for them to connect.

People with depression can be very difficult to live with. We need a great deal from others, but we are embarrassed and confused by our needs, so we don't convey them well. Some of our troubles with other people come from our faulty emotional, behavioral, and cognitive habits, but a great deal of it comes from our own needs and our unrealistic expectations of others.

Part of the reason why depressed people can have unrealistic expectations for others is that they never state their needs directly. Instead they keep secret wishes locked up inside themselves. If we can take the risk of being good communicators, we can say what we want of others. They may not be able to give this to us, but they are less likely to abandon us.

People with depression can be very sensitive to the feelings of others. They have great empathic skills-as if they have radar for what others are thinking or feeling. They have permeable boundaries to their selves. Unfortunately, their radar is not reliable at all because what they want and need from others distorts their perception. They tend to overuse the defenses of projection (attributing one's own feelings to others) and introjection (taking in the feelings of others and making them part of the self), which means that feelings in a relationship become a confused, contagious mess.

People with depression seem to react more to rejection, loss, or abandonment than other people do. It is as if they are thin-skinned, very aware of subtle cues of approval or disapproval from those around them, thrown for a loop by little signs of disapproval that might be shrugged off or argued about by another person. A term used to describe this quality is rejection sensitivity. People who are excessively rejection-sensitive might seem different from each other superficially, ranging from the self-preoccupied hysteric to the withdrawn introvert but all would suffer from depressive symptoms when they feel rejected.

Researchers who developed the concept of rejection sensitivity were mostly interested in psychopharmacology, and it seems as if the effects of Prozac, and some of the newer antidepressants support their ideas. Prozac seems to make people less easily derailed by setbacks and rejection. They are still aware of these events, but it seems as if the medication helps them gain greater objectivity. For example, a woman who was always upset by her husband's teasing now sees it as his way of expressing affection. Another person tries for a promotion she had avoided before because she now knows the world won't fall apart if she doesn't get it.

Depression is both caused by and a cause of poorly functioning relationships. We may be born more sensitive to rejection than the next person, but it's possible to learn how to control this sensitivity and make relationships work better by learning how to communicate more effectively.

Metacommunication

What's wrong with these conversations?

SHE: What time is the concert?
HE: You have to be ready by 7:30

SHE: How many people are coming to dinner?
HE: Don't worry, there's plenty of food.

HE: Are you just about finished?
SHE: Do you want dinner now?

Regardless of how the questioner identifies the feelings that these responses get, the questioner now has a choice. He or she can act based on these feelings or can express them verbally. While a person may have the impulse to pick up and throw the nearest object when they are spoken to this way, they are better off saying it verbally. For example, they could say something like "I feel like you're overprotecting me. You're assuming you know what I want, but you're wrong. Please just answer the question directly." This is a form of metacommunication, or talking about how we talk.

The content of a conversation is what we talk about; the process is how we conduct the talking. Content is lyrics, process is music. Which is it that most directly speaks to feelings? Process, like music, goes directly to our soul, while content must be analyzed intellectually. If we feel listened to and respected, we can take a rebuff. If we feel dismissed or patronized, even if we get our way, we're likely to be dissatisfied.

Shifting the focus of the conversation from content to process can be a very effective way of resolving communication problems. When a wife asks her husband what he wants for dinner, and he says he doesn't care, what he is often missing is that she's asking for a little companionship, a little mutual ownership of a decision. If he says, "Chicken sounds good," but says it with a "Don't interrupt me" attitude, he is still dismissing her, even though he has answered her question. She will then feel diminished. What she can do is say, "Don't ignore me like that," or "It wouldn't hurt you to take your nose out of your book for a minute"-shifting from content to process, letting the husband know that he has been rude, and letting him know that she just needs a reasonable amount of his attention.

Ambiguous Communication

It seems natural to expect that those close to us understand us perfectly. But it is a wish that adults must abandon.  One of the points that marriage counselors usually make is that expecting the spouse to read one's mind is just unfair and silly. If you don't communicate it, you can't blame your partner for not understanding it.

A common problem occurs when nonverbal and verbal messages seem to contradict each other, creating confusion. A sulking "Go ahead, leave without me, I'll see you later, I really don't mind" only confuses the hearer. Should they listen to the words (go ahead) or the music (the sulk)?

Ambiguity doesn't come only from conflict between verbal and nonverbal communication. Often our words themselves contradict each other. Sometimes we can't put our feelings into words. Sometimes we want contradictory things. Sometimes we just don't know what we want. This doesn't prevent us from getting mad at those close to us when they can't guess what would please us most. Unambiguous communication is more work than we're used to. To be clear, we must know our own mind, and then articulate our desires specifically, paying careful attention to what we say and how we say it. We have the idea that communication should be effortless, that people who are truly close should be able to almost read each other's minds. This is a dangerous belief. But careful, unambiguous communication can become almost second nature as we practice and it becomes rewarded by greater levels of intimacy and satisfaction in relationships.

Projection and Projective Identification

Two more defense mechanisms misused by depressives that contribute to communication problems are projection and projective identification. Projection means that I take my feelings, disconnect them from my conscious awareness, and attribute them to you. "You really want to fight, don't you?" People who are very thin-skinned overuse projection. They take their own bad feelings about themselves and project them onto others, seeing themselves as victims of discrimination.

Projective identification, a confusing process, ultimately occurs when, as a result of your projection, I really do want to fight. I catch the feeling you attribute to me. The projector and recipient can get bound together in a horribly complex web of feelings from which there seems to be no escape.

Like all defenses, projection and projective identification are attempts to resolve a conflict between our needs, our fears, the expectations of others, and/or the structures of reality. We need love and intimacy, but we can fear it as well. If we let someone get close, we can be hurt. We can take that fear and project it, making anyone who comes close to us seem to be nosy and controlling.

Projection and projective identification can distort reality to a destructive, uncomfortable degree. And because they are so much a part of how we communicate in relationships, and because in human interactions things happen so fast that we can easily get confused, these defenses are less subject to reflective analysis than denial, isolation, or repression. The best way of gaining control over these defenses is by working with a trusted partner in careful communication analysis.

Projection and projective identification are defenses that can be used by anyone, depressed or not. And they are especially likely to be evoked in close relationships, because intimacy, though good for us, is scary-we fear being engulfed, dominated, or controlled. People with depression are likely to take their own bad feelings about themselves and project the feelings onto the people who care about them. The depressed husband who has lost his job doesn't believe his wife really means her words of comfort and reassurance; he doubts his own worth but defends against this doubt by attributing it to her. After enough rejection, she stops trying to make him feel better and he is reinforced in his belief that she doesn't care about him.

When a person assumes that they understand you without sufficient basis in reality, the cause can be either projection or projective identification. They think they can read your mind. They become convinced that they know what you really mean, despite all your attempts at clarification. If a person keeps accusing you of really being angry at them, eventually you will really get angry at them. That's projective identification.

When I assume that you understand me, it's also a process of projection. When I get hot and bothered because I feel convinced I've made my wishes clear and you just stubbornly refuse to understand, I'm not communicating anything except by stubbornness. These irrational sensations of knowing with perfect clarity exactly what the other person is thinking are sure indications of projection. They are fueled by emotion, not logic.

What we need to do is check our assumptions. Am I understanding you? Am I making myself clear to you? The technique of repeating back what the other person has said is the place to start. It's really an exercise in developing empathy.

The tempting, easy thing to do when we're feeling misunderstood is to withdraw. This is something depressives are good at. They can be wonderfully resourceful at entertaining themselves. The feeling of being picked on, misunderstood, and isolated is an old, comfortable feeling. There is something that feels right about it. It confirms our fantasies that we are the ugly duckling, the Cinderella who is just in the wrong place at the wrong time, who can't be happy with all the mean people in the world. Withdrawal can feel self-righteous.

The hard thing to do is to hang in there and try to make the communication work. Don't assume it's the other person's fault. Listen carefully and be empathic. Maybe you're missing something important. Maybe you can at least figure out why the other person isn't understanding you.

Successful relationships don't just happen, they take work. Happiness is not a gift someone else can give you, it's not even something you can get for yourself, it just happens as a byproduct of living well. Living well usually doesn't mean taking the easy way out.

On the next page we will examine Relationships Under Stress.