A Season of Hope in the Midst of Darkness

One of my favorite mental disorders to treat is depression. That may sound odd, but when I can see a client come out of the fog of depression and start seeing the world in a new light, it is deeply gratifying for the client and me. A lot of research has been done on depression and much progress has been made in successfully treating it, but depression remains a leading cause of suicide. Even if a depressed person does not complete suicide, he or she will have an unhappy and unfulfilled life if depression persists.

I have discovered that hope is the one emotion that generates motivation and the will to live. When all hope is gone, treatment becomes extremely difficult. Research has shown that the primary emotion for suicide is the sense of hopelessness. It is more than just a mood; it is a belief that nothing will ever get better. As a therapist, no matter how hard I may try, I cannot instill desire, motivation or a sense of hope. I may cite all the reasons that a person has to live and point out the harm that a suicidal person would do to his or her family and friends in the event of suicide, it does little good if the person cannot feel any hope for the future. No matter what I may suggest, the retort is usually, "none of that matters; there is no hope."

But there is hope. Regardless of whether a person is religious, hope is the catalyst for change. Things may be dark and gloomy now with no apparent way out, but if there is hope for a better future a life can be changed. Even a flicker of light in the midst of darkness can be used to instill a sense of hope. I often use this analogy when treating depression: Imagine that you are in a dark room with no windows or lights and the room is pitch black. However, the room has a door which opens both ways, from inside or outside. A person comes along and slightly opens the door so there is a flicker of light. The person inside the room may yell, "close the door," or may say "please leave it open just a crack." I have found in therapy if I knock on the door and ask, "May I open the door just a crack?" and the person says yes I know there is hope. If the person tells me to close the door, I will close the door and ask if I may come back later. If the answer is no, I still come back later. Oftentimes, the second time the answer is "yes, you may open the door a crack." I also remind the client the door opens from the inside too when I knock.

This is the season of hope. Spring is the season of rebirth. It is the transition from long, dark, cold dreary days to sunshine, warmth and regeneration. Good Friday connotes death and darkness. Easter represents the conquest of death and despair. This is analogous to what happens in therapy. No matter how bleak the situation is for a client, I have learned that if I can open the door just a crack and help my client realize that there is still light in the world, I know that there is hope for my client.

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