Depression Squared: Baby Steps
How does playing with a dog or cutting weeds in a garden help those who are seriously ill?
It makes sense that Talking Therapy works — by talking out problems and perspectives until they can be fully understood and cease to give pain.
But I can’t give a full explanation for the focus on particular hobbies as therapies, except to say that either they also succeed in delivering treatment, or else they function like the Emperor’s New Clothes at some of the best psychiatric treatment centres around.
Being active and focused as part of a group clears the head in ways that self-directed tasks to fill in time do not. It does not cure, but like many other treatments for viruses and serious illnesses, it helps ease the pain along the way and buy a little more time of feeling human.
It is somehow immensely soothing to be set to work. When feeling useless as a whole, it feels better for a part at least to be able to start and complete something and to see in incontrovertible terms that you have made a difference. Potting plants, pruning geraniums, cutting herbs, clearing waste ground in the hospital patients’ garden all allow for that, with the advantages of fresh air and even sunshine. Gardening as therapy just includes a short round up at the end of the carrying out of allotted tasks, to express that satisfaction with a task well done.
Animal therapy works very differently, through a combination of soothing touch and the ability to command a (highly trained) animal to obey you. It would be wrong to underestimate how much that can mean when you feel no one listens and you are powerless against yourself. Having a rabbit or a dog to stroke can ease the stress of yet another day. Putting it through its paces whether that means taking the animal for a walk, getting it to jump through a hoop or fetch something brings conviction that not everything has been lost, that some communication remains possible, and at least one thing can work out positively.
I have written previously about Art Therapy and the magic that seems to offer. But craft therapies go well beyond formal art sessions. Repetitive things which keep the fingers busy are popular in Occupational Therapy workrooms — like crocheting or knitting — even if the work produced is routinely unraveled, or the vague scarf just keeps growing longer and longer.
Biblio-therapy makes friends of the printed page, encouraging patients to attack books with energy and no constraints, to create work out of them and around them that over time forms a visual history of emotions and actions.
Music Therapy once again offers autonomy within a group setting, encouraging patients to listen or actively to participate in music making through drums and percussion.
Drama Therapy uses games and simulations to allow for the acting out of other selves as a way, at least for its duration, to shed constraints and see through to the real beings hiding inside.
Sport and exercise fit into another category, since all the research demonstrates that physical activity can have a significant effect on mental health. It can tilt the chemical balance in patients’ favour, setting the endorphins flowing as confidently as other forms of medication. The form of exercise doesn’t matter — though mostly it tends to be yoga, pilates, aerobics or some combination of the three. What matters is the distraction and opportunity to feel briefly in command of the body, rather than commanded by it.
In part, all these hobbies help to fill the days and the empty time within them. When engaged in some sort of active framework it is difficult to allow thoughts to run freely, and that is a good thing. I would like to think that they do more from that, that baby step by baby step, they work behind the scenes to help deliver a cure. Much as I and others prefer that, I have little direct evidence.
It is undoubtedly the case that you need to be in a certain frame of mind to engage with the therapy on offer, you have to want to try to fill the time and to become healthy once again. I have seen little real evidence either in myself or others that people get better quicker through participating in these therapeutic activities. But I do see that people improve for a halo period of time around their direct involvement. They step out of the space, and the load on their shoulders is lighter, some of the clouds in their vision lift a little and they confront the world more directly. It may be that none of the pastimes lasts outside of the treatment setting. But that is not a failure. They are offered and continue to be an important part of the overall programme because over time their possibilities of distraction can equate to a means of escape.
And as we try to haul ourselves out of the depths of Depression towards an uncertain waterline, any kind of a ladder is in short supply.
