Overcoming Depression is an expertly fashioned manual for clients suffering from depression, dysphoria, or sub-clinical mood disorders. Mark Gilson, founder and director of the Atlanta Center for Cognitive Therapy, and Arthur Freeman, chair of the Department of Psychology at the Philadelphia College of Osteopathic Medicine, bring their considerable expertise to bear on the treatment of depression. Both authors have made major contributions to the cognitive therapy literature in the past, and their current volume promises to give hope to clients who have had the sunlight in their lives dimmed by the heavy clouds of depression. Readers are taught that there are specific reasons for their low mood states that can be identified and changed through concerted effort.
This volume, like David Burns' Feeling Good Handbook, guides the reader through a series of self-examinations that are critical to the understanding and treatment of mood disorders. Although the clear conceptualization and the highly readable nature of the writing allow the work to be used as a stand-alone self-help manual, the authors encourage readers to seek the professional assistance of therapists. In addition to championing the use of cognitive therapy for the treatment of depression, the authors also present responsibly the merit of psychopharmacology as an adjunctive treatment. The book is replete with practical examples that clearly demonstrate the recommended treatments are simply and elegantly offered. To audit the reader's mastery of the content, brief review quizzes are presented at the end of each chapter.
The theoretical background for the volume is drawn from the cognitive therapies of Aaron T. Beck and Albert Ellis. Gilson and Freeman acknowledge the multifaceted nature of the causes of mood disorders and suggest a holistic approach to its treatment. The acronym BEAST, is used to explain the components of the approach: B is for body; E is for emotion; A is for action to be taken; S is for stressful situations; and T is for thoughts. The primary focus is placed on aspects of wellness such as nutrition and exercise (the B for body) and thinking (the T for thoughts).
The authors discuss three factors involved in creating and sustaining depression: The Cognitive Triad, cognitive distortions, and self-sabotaging schemas and assumptions. The cognitive triad refers to negative views about oneself, the world, and the future. Cognitive distortions refer to the self-defeating response sets or perceptual sieves that are not validated by others. And schemas are described as hierarchically arranged, coordinated sets of abstract ideas about self, the world, and relationships. These schemas are said to underlie and maintain one's belief system and automatic thoughts. The meaning of schemas is decidedly less distinct than the meaning of cognitive distortions or cognitive triad, but the concept seems to be used in a manner similar to the way in which Piaget used the term, to the manner in which Bandura used the concept of "rule governed behavior," and to the manner in which social psychologists use the term, attributional style. Such schemas are said to be formed in early life and can be up-dated through the process of accommodation, Piaget's concept for the learning, through experience, of new mental templates of the world. This concept of schemas appears to interface nicely with the use of unconscious dynamics by analytic therapists.
This volume should prove especially helpful to cognitive therapists in their efforts to correct the irrational beliefs and distorted perceptual processes of clients. The reading of selected portions of the volume from week to week would likely prepare the client to profit more fully from the content of therapy sessions. Clients who dutifully complete the thought monitoring exercises will greatly assist their therapists in understanding the faulty beliefs, cognitive distortions, and underlying schemas that are responsible for their depression. Moreover, it seems to me that these exercises, so appropriately prescribed for uncovering the hurtful content of the client's thinking, could be complemented by the mindfulness exercises of the consciousness disciplines and the use of awareness continuum by Gestalt therapists.
I salute Drs. Gilson and Freeman for adding another powerful tool to our repertoire of aids for clients suffering from depression, dysphoria, or undiagnosed mood disorders. I plan to own multiple copies for use in prescribing home expansion exercises for my clients.
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One of my favorite quotes from the book occurs at the end of a chapter and basically says, "Moving forward doesn't mean forgetting where you've been. It means that where you've been is not the only place you can go." I realized that I was stuck in wanting my past relationship (or one just like it) that I didn't know I could have something different.
Anyway, this is a definite for anyone who is afraid to move ahead because they "might" make the wrong decision or they "should" know the perfect answer. And if you have made a wrong choice or completely missed the mark, then this book will help you not only learn to forgive yourself, but also help you to begin taking baby steps in taking new risks and realizing that "Plan B" or C or D might be just as rewarding or maybe even better than the already failed Plan A.
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The book goes through each and every personality disorder one at a time. This made it very easy to research one specific problem without having to sift through pages and pages of irrelevant information for the task at hand.
Within each chapter Beck defines the typical automatic thoughts, or faulty reasoning, that is commonly associated with the personality disorders. He then gives broad treatment plans and goals to deal with the symptoms.
Beck is very well organized and succienct. You will walk away from even a short reading of this book feeling more confident and better equipped to deal with the disorders without the usually doubts that maybe you didnt get the whole gist of what the author was trying to say.
I felt that this was extremely well done. I also appreciate that Beck does not promise more then he can deliver and he is the first one to say that outcomes for Axis II disorders are still poor compared with Axis I.
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