CBT Role-Play - Depressive Symptoms and Lack of Motivation

Elizabeth how you doing today I'm all right I think it's been common since the last time in that it's about the same I'm still feeling pretty down I mean I just feel really stuck and not happy and I just don't know why okay so there's a few things going on there you said you feeling stuck not happy and some sound like you look confused as to what's going on what's causing it you have any suspicions about what might because of it I mean I've been feeling like really isolated lately you know because I'm a stay-at-home mom it's hard there's not a lot of people you know right at my fingertips to to spend my time with you know obviously my family but um so I guess you know I kind of I had some friends in the neighborhood but like our friendships just kind of fizzled out and I ever since then it's just like I don't really feel like doing much I just kind of feel like what's the point and let my husband take care of a lot of stuff you know I used to you know shop for the groceries all the time and make sure the house is always stocked and make dinner every night and get the kids ready for school in the morning and I still do that stuff but a lot of times you know I let it slide sometimes I won't make dinner or whatever and when I do do it I just feel like I'm forcing myself to do it the passion is gone and how long have you been your state housewife right how long have you been the housewife um for a long time I have two boys they're eight and ten and I've been staying home since my first one was born so ten years and you know it's it's been really rewarding for me I'm not really interested in going back to work or anything like that because I know people always say you're you know you're feeling unfulfilled like you should go back to work but it's not it you know I felt happy with it for so long I don't think that it's being home I think it's something inside of me something's changed so for a long time you were satisfied being a housewife you enjoyed that life or found satisfaction my life and somewhere along the line something changed in you and I you're not happy with it so what it represents in terms of activities like caring for your children and shopping no that's what changed yeah well I guess you know my youngest is eight so he's only been in school for a couple of years so I guess like it's not super recent but recently he I finally have no children in the home so it's more it's more time to myself and I kind of filled that gap a little bit with other things like I did Cub Scouts with the boys for a while and um like I said I had some friends around the neighborhood so that kind of like filled that time but now that stuff it's just not really happening anymore so now I kind of feel like it's not it's not boredom you know it's not like I don't have enough to do it's like I don't want to do anything but then at the same time I feel frustrated because there's nothing to do all right Cyr you're frustrated with your situation maybe with yourself a little bit yeah I think a lot more with myself because I know that I would feel better if I you know maybe found more friends or found something to do with my time but I don't want to at the same time so I'm frustrated with myself because I kind of know what would help but then I don't really have the like the volition to do it you're not motivated yeah I'm not have you received any feedback for other people about this meaning has a mouse noticed that you're down yeah I mean obviously my husband has noticed because he has to get the boys ready in the morning he's really supportive I know he can tell that I'm not feeling the same but you know he works and then he has to come home and pick up my slack so he is getting frustrated which I understand and you know my mom has said to me that you know she thinks I'm not doing as much and so it kind of hurts it feels like everybody's trying to tell me I'm lazy and that I'm not doing enough and it's always that like feeling you know like nobody really understands how much work that goes into being a mother but then at the same time now that I'm doing less and less I feel like they're alright you know I am lazy I'm not doing anything they used to word lazy no no not that I can remember you know I think my mom said like you're not doing as much as you used to and I kind of took offense to that even though it's kind of true it's like I don't know it hurt okay I was painful for you what about what your husband said puts you desire you know I think at first we didn't really acknowledge it it was like you know I took a break here he picked up the slack and it was fine but now that it's been more and more he's kind of getting frustrated and you know he's been asking me about how I feel and why I'm not doing as much but at the same time like even though he knows that I'm not motivated it's still frustrating because I it's my responsibility so I think he's you know he's been saying like I need you to to do more around the house pretty much is what he said I need you to do more what was your response to that and I said I need you to do more I started crying because I know he's right and that's what I tell myself every day I need to do more but I don't have the motivation to do it and so I'm so frustrated with myself and you know I know that he needs that from me and I don't know why I'm not motivated to do it okay so you're frustrated for feeling down yeah and you're frustrated for lacking motivation and just as little as a few years ago you didn't feel with this fight at all yeah yeah I actually think you know I've been feeling this way more like in the past like six months or something like that like I it was hard for me when my youngest son went to school but more in like the natural way than it is hard um but this is something else this is more consuming it's you know like the difficulty of him going away to school almost was motivating like it was hard but at the same time it was freeing because I had other opportunities to do stuff this is just like stunting okay so many shift gears a little bit can you tell me about your role a recent day that it's kind of typical what you're telling me now being not motivated down sure um on Wednesday I was having a really hard time getting out of bed so my husband just got the kids ready in the morning and I felt really bad about that so I just stayed in bed for a couple more hours probably until like 10:30 then I got up you know and made myself something to eat and then I thought you know I should probably go to the store because we're almost out of milk and you know and I think the boys need shampoo but I just I just sat down and I just sat there and I think i sat for I don't even know how long um the boys came home from school it was like you know 3:30 and I hadn't even gotten up and so then I said okay the boys are home I should probably get started on dinner soon because my husband will be home soon and I found I found something in the fridge to make and I made dinner and you know after that everybody you know just sat down we just watch TV and I just sat there until it was time to go to bed all right this is you so this was recently right what would the ideal diet look like take that same day and do you wish you could have done I wish that I would wake up and you know I want to wake up um when it was time for the kids to get ready to school to go to school you know I could make sure that everything that they had everything they needed I could pack their lunches and get the boys dressed and you know check thing you did any permission slip sign that kind of thing send them out the door and then I would see if we needed anything from the store I probably do a little bit of cleaning around the house I used to like have like a list of chores that like I would do different things on different days and different days of the month and stuff so like bedding would get washed one day in the week and that kind of thing so I would probably like follow that list nowadays I just you know if it gets done it gets done and usually my husband helps me with some of the stuff and it you know I do the bathrooms one day a week that probably gets done like once a month now but um I would do that so do the cleaning if we if I needed to go to the store we do that I'd get ready for the voice to come home I probably make him a snack and and figure out what was going to be for dinner I would go ahead and do that and then probably you know sometimes we we would watch TV after my husband got home after dinner or I would figure out something for us to do we could play a board game or all watch a movie as a family or something like that and but that would be after the kids did their homework and everything like that and then after we spent some time together I'd put him to bed all right so it's a fairly wide discrepancy to where you are in terms of behavior right and where you want to be all right so let me ask you a very specific question about one of the first things in the day he would mention that what it was time to get up all right you didn't so you were awake and aware of it but you went back to sleep Uhuru and of course your husband got up and he took care of things right how did you feel allowing that to happen because clearly that's not what you wanted to happen how did you feel about that oversleeping it's just like you know the alarm goes off and I know it's time to get up and my husband's getting out of bed and I just look at the clock and I think what's the point and you know it's just this instant feeling of I can't even describe it like pointlessness of getting up and so I go back to sleep but I feel worse for doing it you know like it's a catch-22 like if I don't want to wake up I just don't want to but then when I go back to sleep I feel bad I feel guilty okay so I'm not getting up at a time you wanted you feel guilty and but you also mentioned something that you thought which was I'm not mistaken you said what's the point can you expand on that it just it's just like you know when I'm sleeping I don't realize how sad I am and I don't realize how hard it is to function when I'm sleeping I'm not aware of that and as soon as I wake up I am and so I just have this feeling of like what's the point of getting up and experiencing these feelings when I could go back to sleep and not have to what's the point getting up when sleeping pana Bay yes yeah okay but then when you when you do get up you feel sad and guilty about having overslept yeah yeah definitely definitely so really functionally what you're doing is you're delaying experiencing the pain and then in terms of how it affects your relationships your family you're not getting your kids off to school your husband's getting little frustrated and all you've really bought yourself is a couple extra hours sleep and then you know presumably without without paying because you're sleeping but you're not really escaping it so that makes sense yeah before when you felt more satisfaction and purpose did you get up and help the kids off to school yeah it was so easy I was just like you know I would wake up and and I would be like okay it's time to get up and get out of bed and get ready to go I mean you know sometimes if um if I was a little bit tired it would be a little bit hard but you know it's not you know as a stay-at-home mom I usually get enough sleep for the most part now that the kids are older and everything so it's not usually too hard to get up and I would I would you know it would be another good day you know I would be glad to get up and take care of the things that I needed to take care of and I felt accomplished so maybe what's going on here I never knew it could help remember you know over the last few sessions we talked about cognitive behavioral therapy and different techniques that I'll be using and different things we're talking about sometimes with behavior the behavior that's useful which in this case I'm assuming we can agree is the getting up one-time behavior that's useful has to come first even if the feeling doesn't match right so sleeping those extra I presume you a couple hours delays you from feeling sad it causes other problems if you were to get up one time you might still feel sad right because that's why you're over sleeping you're sleeping longer to avoid that but the functional part of being a housewife as you identify would be completed so maybe some of those feelings of sadness and guilt would over time a bait because functionally speaking or completing the tasks that you want what's tough about that is it in the moment it's easy for me to say the snap right but in the moment like for instance when you have to get how about tomorrow you're going to be facing that same challenge which is I can get up now and feel depressed or I can wait and feel depressed later so in that moment it's hard to act on the behavior did you kind of know you want to move towards I mean it sounds like you wanna get up yeah yeah I mean I want everything to be normal again and I guess I never really thought of it like that like I just thought well if I'm waking up at the right time and I'm just feeling bad then like like I said what's the point that I guess it makes sense like even if I don't feel like doing it maybe it'll make me feel better if I do do it even if it's hard because nothing's really harder than what I'm already going through well it seems like you're you're more or less making things worse right in an effort to avoid the pain that you're going to suffer anyway if you're making the pain worse and just delaying it a little bit right of what what the thought we talked before about automatic thoughts there's lots to come up car when your belief system meets these different situations occur when you have that thought that this is pointless and I'm going to expand on a thought a little and say that you know what that thoughts really getting at is I can avoid this pain if I sleep a little while longer that's a version of thought it'll make it and also I guess I thought that no it wouldn't really be that beneficial to get up okay you're also minimizing the benefit yeah so there's a couple things going on right I can avoid the pain by sipping in and there's really no point that to getting up cuz I won't do any good anyway yeah what adapter response is that self talk we talked about those things we we consciously think to ourselves could you apply in that moment when you're you know whatever time you get up in the morning when you're thinking about this and that thought comes in that it doesn't really matter if I get up anyway I mean I guess I could tell myself like I can do this like instead of you know when I say to myself what's the point instead I can say I can do this I can get out of it it'll be okay I can I'm strong enough even though it's hard to push through the pain and get up now even though I don't want to I can say I can do this okay so have you adaptive response I'm strong enough I can get through this but it will be difficult right how about the value of getting up early and seeing the kids off to school the other night thought right now is telling you that's not valuable but I think that you believe it is value yeah I mean I know it's valuable I guess what my frustration is is that I know it's valuable and it used to give me like an emotional payoff of like pride and satisfaction and now I'm not getting that anymore so I guess I need to realize that even though I'm not getting it right now if I keep trying maybe it will happen again because it did happen before what seemed logical that you have a higher probability of getting that back if you do get up then if you may guess that's true yeah don't never get the satisfaction of setting my kids off to school by never send my kids off to school let's see it was 0% chance of successful successfully moving past this with a sleeping in and you have some other probability greater than zero if you if you do I never thought about it like that that kind of makes sense yeah yeah so even though getting up early is going to be painful and going to seem like not a practical move logically you know that it has a better chance of paying off for you and I think that with these type of what you're going through is probably a depression right now what I like to talk to you further to make sure that's what's going on it seems like you and sometimes with depression just have to get one thing going your way each day right so so I'm not saying necessarily tomorrow you have to get up one time and then go make new friends and then go find social activities right you'll have to build Roma that here it's it's more like can I do this one thing can I prove to myself just what I'm saying which is I'm strong enough to get up see the kids off and have that one victory for tomorrow I didn't build on that again yeah and poor that's going to be playing those adaptive responses back right thinking those thoughts whether it's just thinking them you know in your mind you're actually thinking and saying sometimes it's helpful just to say them out loud not letting the negative thoughts take over because that's what I'm thinking like okay I can get the kids off to school but after that I'm going to start thinking you know what's the point again like what why don't I just sit down there's no point so if I can keep reminding myself that I just have to try and that I did accomplish something and then you know even though it's hard and I know that those thoughts are going to come back and then I'm going to feel bad if I don't do anything I'm not going to feel any better so you have a good handle on the adaptive responses it sounds like right and you know what you have to say have to but you know what you want to do I'll see you again in a week and there'll be five days in there between now and I see again we'll have to decide that it when I get up and see your kids off to school or not right so I want you to give that a try the adaptive responses and try to push through with that behavior now it's important to keep in mind that we have five days between now when I see you again you know five business days or school date and you may not succeed every day goodness that's okay all right sometimes the the setbacks like you could you could get up early two days in a row and then you get a setback that third day don't let that wash away those successes it's a day-by-day fight try not to think of it in terms of the week I want you to try to think of in terms of what I have to do today not worrying about the future and not worrying about you down in the past okay the only moment we really can't live in is now so try to stay present a moment recite those adaptive responses and and try to push for that just that one victory okay try that all right so work on that and continue with the homework let me get the CBT homework I've been giving you and I'll see you next week thank you Thanks

Channel: Dr. Todd Grande

Views: 278,745

Keywords: cognitive-behavioral therapy, cognitive behavioral therapy, cognitive behavior therapy, CBT, REBT, cognitive distortions, automatic thoughts, core beliefs, intermediate beliefs, adaptive responses, self-talk, homework, depression, motivation, Grande

Id: 8aDFvvjC6XM

Length: 24min 8sec (1448 seconds)

Published: Sun Jan 18 2015