From: lady@uhunix.uhcc.Hawaii.Edu (Lee Lady)
Subject: Re: Exercise vs Psychotherapy
Followup-To: sci.psychology
Summary: No, it's not just a matter of distraction. 
Keywords: exercise   psychotherapy
Organization: University of Hawaii (Mathematics Dept)
Date: Mon, 16 Nov 1992 02:45:10 GMT

In article <97646@netnews.upenn.edu> zorrilla@cattell.psych.upenn.edu (Eric Zorrilla) writes:
>
>cholic as the jargon goes) symptoms.  In other words, we see vegetative, 
>biological symptoms in depressions that appear to be psychologically-mediated
>and reactive to a stressor - it's not just a broken brain.  So, while there
>may be appropriate subtypes of depression, talking about one type as being
>psychological and another one as being biologically caused, misses the mark.
>
>Another general point that should me made is that the mode of a successful
>treatment does not necessarily tell you anything about the level
>of analysis one should use in describing the cause (i.e., etiology) of the
>disorder.  It is a logical fallacy to do otherwise.  We are biological
>creatures and we should be quite surprised if some pharmacological intervention
>couldn't be devised that had some symptom-suppressive effects regardless of
>what the causes of the symptoms were in the firstplace.  Perhaps the most
>obvious example of this is taking aspirin to treat a tension headache.

Yes, cause-effect questions of this sort are very difficult.  I would
like to suggest that the association of certain cognitive patterns with
depression should also not necessarily be interpreted causatively.  In
my own case, anyway, it seems to me that the cause-effect may go the
other way.  I find that when I get depressed, I tend to say things to
myself using a lot of "universal quantifiers" -- phrases like "always,"
"never,"  "all my life."  I also get caught up in a lot of negative
beliefs -- things like "My life has been a waste" or "I've let myself
turn into a mediocrity."  But when I'm not depressed, I don't have those
thought patterns.  And it seems to me that, for me at least, what's
happening is that depression influences my cognitive patterns, causes me
to think in certain ways.  Rather than the converse.  

In NLP, identifying a subject's beliefs and changing the ones which cause
problems is an important approach.  But, at least for myself, I'm not
sure it makes sense to say that *I* have a particular belief.  I
experience myself as having many different modes and the beliefs I have
in one of these modes may not be present in another mode.  A belief such
as "I'm just letting my life waste away" is just not going to be present
when, for instance, I'm standing in front of a classroom in my Professor
Lady persona.  

What is certainly true, though, is that using cognitive therapy (or NLP)
to change cognitive patterns does help deal with the depression.
And knowing that is probably more important than trying to resolve the
chicken-or-egg issue.  

>In article <1992Nov14.024005.9127@news.Hawaii.Edu> lady@uhunix.uhcc.Hawaii.Edu 
        (Lee Lady) writes:
>>In my opinion (for what it's worth), exercise can have a physiological
>>effect which is very beneficial in temporarily alleviating this sort
>>of depression.
>
>I don't think I would differ with this, but (as you recognize):
>
>1)	It's tough to get depressed people to do ANYTHING

I think this is the most fundamental problem in dealing with depression.
I was up against this a lot when I was doing suicide prevention
counseling.  

>2)	What would be the long-term consequences of this?  Certainly open to
>debate.  If it's kept up enough, we might get some significant change in
>the neuroendocrine and autonomic nervous systems and, consequently, some
>mild change in symptomalogy.  It's unclear, though, what effect exercise
>would have on the processes that are juicing these systems up in the
>first place (whatever they may be)

It is certainly unclear.  Where you say "open to debate" I would rather
say "open to investigation."  I believe that it's worth doing such an
investigation.  

>>I have found that at those times when I am prone to
>>sinking into total apathy, simply getting out of the house and getting
>>involved in any kind of activity will help keep me from going into
>>complete stagnation.  I find that it does in fact help give me a more
>>clear mindset.  
>
>>I have also found that at times when I get very upset about some
>>emotional thing and my mindset is definitely not clear,  using what many
>>people call the "left side" of my brain is extremely helpful.
>
>The two things you describe (under the rubric of cognitive therapy), sound
>a bit like distraction and, to a lesser degree, the recognition of automatic
>thoughts.  Cognitively or behaviorally distracting oneself seems like
>an adequate temporary intervention for distress.  It's not very satisfying
>as a permanent fix for some rather obvious reasons.

I repeat that I think there are different kinds of depression.  Many more
different kinds than just two.  While I was going through my NLP training
a fellow student who was a gestalt therapist taught me how to stop
frequently going into very deep, melancholic, almost suicidal depression.
("Very frequently" meaning usually several times a month.)  Basically
what I learned from him was to acknowledge my anger and give myself
permission to be angry, even when the situation I was angry about was
ultimately my own fault.  

But now I still sometimes (but much less frequently) find myself sinking
into apathy or caught up in a defeatist state of mind, or a hopeless
feeling of being trapped.  Of course it would be great if I could find
a way of making sure this would never happen, but in the absence of
that what I need are good techniques to get myself out of it when it
does.  Physical activity, even at a fairly low level, seems to help to
some extent, as does putting myself into a different environment --
things like going to a shopping mall on a day when I would normally be
in my office.

On thing I've become quite aware of is that there's a somewhat literal
change in perspective in different mental states.  When I get caught up
in feeling trapped, my vision will have a quite narrow focus and I'm
seeing only what's directly in front of me.  Then I'll be walking down
the street and suddenly my perspective will open up, become panoramic --
I'll see the whole horizon.  (I'm using these visual terms very
literally, not metaphorically.)  And at that same moment, I will have a
sense of the heaviness that's been weighing me down suddenly dissipating.
Unfortunately, I can't always make this happen deliberately.  

In any case, going back to what you said, 

>thoughts.  Cognitively or behaviorally distracting oneself seems like
>an adequate temporary intervention for distress.  It's not very satisfying
>as a permanent fix for some rather obvious reasons.

The sort of temporary intervention I described meets my own needs
reasonably well, but would presumably be less useful for the sort of
person who wakes up almost every morning feeling depressed.

>>I have also found that at times when I get very upset about some
>>emotional thing and my mindset is definitely not clear,  using what many
>>people call the "left side" of my brain is extremely helpful.
>
>The two things you describe (under the rubric of cognitive therapy), sound
>a bit like distraction and, to a lesser degree, the recognition of automatic
>thoughts.  Cognitively or behaviorally distracting oneself seems like
>an adequate temporary intervention for distress.  It's not very satisfying
>as a permanent fix for some rather obvious reasons.

I think that to describe "getting out of the house and getting involved
in any kind of activity" merely as distraction is to miss the point.  In
my experience, the word *activity* here is very important.  Watching
television or reading a book will usually not be effective.  I think it
has to do more with putting one's brain into a different mode.  

You see the choice as between depression being biochemical or -- for want
of a better word -- psychological.  I think this is a false dichotomy,
and that there are many more categories than these two.  

What we do know is that affect is controlled by the brain, and that it's
in the realm of the autonomic nervous system so that it takes quite a bit
of skill for a person to have any conscious control over it.  We also
know that many emotions are associated with a change in the hormonal
balance throughout the body.  And that this in turn can cause changes in
cognition, perception, and motor abilities.  (For instance an adreneline
surge will enable muscles to perform more powerfully.)  

I don't know how to discuss this more coherently, but I just want to say
that when we talk about the physiological aspect of emotion there's a lot
more involved than just neurotransmitters.  And I think that when the
brain is called upon to organize some purposeful activity, that changes the
balance of the whole system.  

And of course a really high level of physical activity will result in
the production of endorphins, which will certainly have an effect on
one's mental state.  The subject will feel good physically and is
likely to translate that good feeling by saying "I feel good about
myself."  And a psychologist might interpret that by saying that
exercise increases self-esteem.

>>I have also found that at times when I get very upset about some
>>emotional thing and my mindset is definitely not clear,  using what many
>>people call the "left side" of my brain is extremely helpful.
>
>Your second strategy, where, when you recognize that you're in a highly
>charged emotional state and to engage your mind processes in a more logical,
>passionless framework of thinking is similar in many ways to the cognitive
>model's strategy of recgonizing when one is highly emotional, taking a
>step back to isolate the automatic thoughts which produced that affective
>state and logically breaking those thoughts down to see if they are distorting
>reality.

Well, yeah, that is certainly the net result.  But "taking a step back"
is easy to say, but not so easy to learn.  The point I wanted to make is
that for me (and a couple of my friends) using the so-called "left side"
of my brain seems to be highly effective in facilitating the "stepping
back process."  Again, I believe that this is not just a matter of
distraction.  I think logical thinking puts the brain into a different
mode and perhaps changes the availability of neurotransmitters.

Now I realize that I'm not a psychologist and am speaking on the basis of
experience with a single, rather atypical subject -- myself -- but I
strongly believe that this is a very important discovery and I hope that
I can encourage some clinical psychologists to investigate it further. 

--
It is a poor sort of skepticism which merely delights in challenging
those claims which conflict with one's own belief system.  
                                                          --Bogus quote 
lady@uhunix.uhcc.hawaii.edu         lady@uhunix.bitnet
Newsgroups: sci.psychology,soc.women,soc.men,sci.anthropology