Depression may follow a distressing event (for instance, a divorce, the death of a loved one) or it may seem to arise without apparent cause. For some, these are episodic events with a clear beginning and end. But this isn’t always the case. Some live amidst an ongoing battle, doing their best to stay one step ahead of emotional darkness.   

Meet Karl (and his fall into depression)

Karl was “reeling” from being passed over for a major promotion at work. He knew the competition was fierce but he also knew that he would have been perfect for the position. He had the credentials, experience and the right attitude. It was exactly what he needed, and, he reasoned, what the company needed too. But instead, someone he knew peripherally, someone with less seniority and experience, was chosen.Depression therapy

At first, Karl was dumbfounded. He wondered: Was there a mistake? Why wasn’t I considered? Did the other person know someone? His confusion, however, quickly gave way to anger and feelings of being mistreated. He took comfort in telling himself, “It’s their loss, and sooner or later, they’re going to realize it!”

But as the weeks passed, Karl’s anger (and feelings of humiliation for what he perceived as “failing in front of his colleagues”) gave way to lethargy. A deep sadness blanketed him. He felt emotionally heavy, and even when he wasn’t thinking about work, he couldn’t escape the feeling that something was off in his world. An emotional shadow attached itself to him. At home he sulked around the house despite his wife’s encouragement to get out and occupy himself.

Karl had always taken pride in his ability to problem-solve and successfully complete challenging work projects. So he took a big emotional hit when he began to doubt himself. Cracks of insecurity started to appear in his foundation of confidence. 

Ultimately, it was his self-doubt that turned his sadness and frustration in being passed over for the job promotion into a major depressive episode.

The shape of depression

By the time Karl called to set up our first session, his emotional struggles were at their peak. Two months had passed since not getting the promotion. He appeared haggard, like someone who had been put through the paces of life over the course of years instead of months.

His emotional struggles pointed to major depression (learn more about the signs and symptoms of depression). He was becoming unrecognizable to himself and his family. Lost were the exuberance and confidence that defined him. Exercise gave way to physical inertia. He snapped at those he loved and then felt terrible for being unkind. His worldview was becoming increasingly pessimistic — he became infected with a “why bother?” attitude.

This wasn’t the first time that Karl experienced disappointment. In fact, he had faced considerable hardship throughout his life and had adjusted to these slings and arrows. This time was different, however. He wasn’t bouncing back.

The hidden emotional Achilles’ heel

We imbue the events of our life with meaning. And it is this idiosyncratic meaning that gives shape to our experiences and reactions. If we want to understand why we are reacting a certain way, if we want to make sense of why we are struggling to accept or adjust to something that has occurred in our lives, we must work to unearth the particular meaning(s) that we attribute to these events.

Karl and I worked together for about eight months. His symptoms of depression slowly lifted as he gained clarity about his reactions and as he processed his feelings. It was obvious to him that he felt like a failure. But why couldn’t he shake this feeling? He had a string of career successes that could have easily put this disappointment into its proper perspective, and yet, his disappointment steamrolled him.

Why did he emotionally fall so hard?

Enter the critical father

Karl’s father was long deceased. But despite his physical absence, Karl’s father remained a powerful inner presence during his depressive episode, shaping Karl’s emotional life. Karl had little awareness of this internal struggle.

Karl reported that his relationship with his father was a challenging one, even from an early age, with the boy feeling he could never please the man. If Karl received a “B” in a class, the first words out of his father’s mouth were, “Why wasn’t it an A?” His father’s approval was elusive — despite Karl’s efforts, he felt trapped in mediocrity.

Karl had long given up on having a loving relationship with his father. He rarely thought about him. It had been ten years since his father died, so Karl was convinced that the answer to his emotional crisis had nothing to do with his past.

It was in Karl’s dreams that his father’s presence took center stage.   

Karl described the following dream:

“I’m a kid playing on a little league baseball team. I’ve been sitting on the bench for most of the game when the coach finally calls my name to pinch-hit. It’s a pivotal moment in the game and a lot rests on me proving myself.

“When I stand in the batter’s box I notice there was no pitcher or other players in the field. It felt really weird but almost normal that nobody was there. And then I hear the umpire behind me shout, ‘Strike one, strike two, strike three; batter, you’ve just struck out!’

“I felt so confused and small. Helpless. There were no pitches thrown, but I didn’t question it. I stood frozen in place. And then a deep fear came over me, a fear I never felt before, when I finally realized that the voice of the umpire was my father’s voice. I wanted to turn around to look at him, to finally tell him how unfair this all was, but I couldn’t. I just couldn’t. I forgot what happened after that.”

As he shared his dream, tears accumulated in Karl’s eyes. We’d spend the next few months exploring how the memory of his disapproving father was resurrected in the form of Karl’s debilitating self-doubt.

Standing up to the harsh, internal oppressor

Some might argue that depression is a natural reaction to the self-hatred that exists in us. An anger that targets the self for its reign of terror. At a conscious level it’s easy to deny that any such feeling exists. “Why would I hate myself? I don’t feel angry at myself, I’m mad about [X or Y]…” 

Psychoanalytically informed therapists have long noted the connection between anger and depression. (See “Anger and Depression” by Fredric N. Busch for a review of the role of anger in depression.)

Karl’s depression would give way to the voice of anger. But it wasn’t his voice. It was the voice of a disapproving father that kept Karl frozen in helplessness.

This was Karl’s emotional Achilles heel. The wounds caused by his father. Wounds that propelled Karl to accumulate success after success in order to keep from falling into the vortex of self-doubt and self-loathing.

Underneath his drivenness was a deep-seated sense of not being enough in the eyes of the man that meant the most to Karl. But making this connection in our therapy work wasn’t enough to lift him from the weight of depression. Karl would have to find his own voice — a voice that would allow him to stand up to the inner presence of his critical father. Not surprisingly, this was the most difficult work in the therapy.

When we stand up to those we care deeply about — even when this is done only in the mind — powerful feelings of guilt can arise. We can feel disloyal and move into greater self-loathing. We believe we are betraying those we love. We make excuses for them. We minimize the relevance of their actions and our pain. We let them off the hook for “not knowing any better.” This is a very different dynamic than forgiveness. True forgiveness grants us permission for our pain-anger so that we can let go of these feelings when we’re ready.

Karl would vacillate between acknowledging the anger he felt for his father with making excuses for his father’s actions. Over time, however, he became aware of how these excuses short-circuited his ability to untangle the feelings that contributed to his depression.

Moving past anger into peace

Working through anger was an important part of Karl’s healing journey. But it’s important to note that allowing himself to be angry (turning the anger that was self-directed toward his father) wasn’t the endpoint of his healing. Too many of us become stuck in anger. For some, this is as debilitating as being depressed.

At the end of our time together, Karl made the conscious choice not to forgive his father. It was essential that this felt like a choice, that Karl was empowered to direct how this internal relationship with his father played itself out.

While we can idealize forgiveness as the highest level of healing of emotional wounds caused by others, Karl was clear he didn’t need or want that for himself. When he thought about his father in particular ways, intense anger would emerge.

Why did he need to hold onto this feeling?

In this anger, Karl felt powerful and justified. It became his shield, a way of protecting the helpless child that existed within him — the part of him that longed for but never received his father’s approval.

This was an important shift for Karl. And it allowed him to experience his reaction to not getting promoted in a more balanced way.

But none of this would have been possible unless Karl had discovered the internal voice of his father. A voice that powerfully shaped Karl’s experiences whenever he fell short of achieving something important. Karl labeled his unconscious desire to win his father’s approval as his “emotional Achilles’ heel.”

At the end of our work together Karl wondered if everyone had their own emotional Achilles’ heel. A particular vulnerable spot that we carry forward into our lives. One that can remain dormant for long stretches until some event awakens it.

This is a good question for all of us to ask ourselves when we start to slip into feeling depressed. It’s easy to automatically assume that a particular situation is what’s unilaterally causing the depression. Karl’s example teaches us that it can be more complex than that.

Until next time,

Dr. Rich Nicastro

Richard Nicastro, Ph.D. is a licensed psychologist in Georgetown, Texas.  

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