A Depressed Teen: (Part 2) Jusuf
Updated: Nov 22, 2019
Robert Davies © 2018
As stated in Part 1, Mr. Jenkins knew that he must respect Jusuf, his client, and if Jusuf is choosing to think in a certain manner, Mr. Jenkins will follow him down that path. At some point, both Jusuf and Mr. Jenkins can determine how true those thoughts are in the light of any cognitive distortions that might be found, mistakes in thinking, twisted thoughts. Consequently, Mr. Jenkins continued to go as far as Jusuf would go before examining the path taken.
“Okay, write that down,” said Mr. Jenkins.
I MIGHT LOSE MY APARTMENT
“Jusuf, if that were true, what is the worst thing that could happen then and how true would that be for you?
“I would have to live in a cardboard box.”
"Okay, write that down, Jusuf."
“I WOULD HAVE TO LIVE IN A BIG CARDBOARD BOX”
“Jusuf, where might you live in a cardboard box?”
“I was thinking maybe behind a big 24 hour restaurant where I can get food out of the garbage.”
“I understand. If that were true, what is the worst thing that could happen then and how true would that be for you?
“ Mr. Jenkins, that would be the end. I’d just sit there and get food when I could when they would throw stuff out. I could use their washroom. Yes, that’d be it.”
“Okay, write that down.
I WOULD LIVE BEHIND A 24 HOUR RESTAURANT WHERE I CAN GET FOOD OUT OF THE GARBAGE AND WHERE I CAN USE THEIR WASHROOM. 100% TRUE
“Anything else to add.”
“No, that is pretty well it.”
“Okay, Jusuf, let’s read the entire thing out loud, you go ahead.”
Jusuf read the entire list out loud. Then Mr. Jenkins repeated the list slowly and pausing to take in the significance of each statement.
I WOULD FEEL DEPRESSED. 100% TRUE
THEN I WOULD FIND IT HARD TO STUDY. 100% TRUE
AFTER THAT, I WOULDN’T GET VERY GOOD MARKS. 100% TRUE
CONSEQUENTLY, I WOULDN’T GET GOOD ENOUGH MARKS IN GRADE 12 TO GO ON TO UNIVERSITY OR COLLEGE. 100 % TRUE
THAT WOULD MEAN THAT I WOULDN’T BE ABLE TO GET A GOOD JOB. 100% TRUE
THEN I WOULDN’T BE ABLE TO EARN A GOOD SALARY
THIS WOULD MEAN I WOULDN’T BE ABLE TO GET MARRIED.
THEN I MIGHT NOT BE ABLE TO KEEP MY JOB. 100% TRUE
WHICH WOULD MEAN I MIGHT LOSE MY APARTMENT
THEN I WOULD HAVE TO LIVE IN A BIG CARDBOARD BOX
FINALLY, I WOULD LIVE IN A CARDBOARD BOX BEHIND A 24 HOUR RESTAURANT WHERE I CAN GET FOOD OUT OF THE GARBAGE AND WHERE I CAN USE THEIR WASHROOM. 100% TRUE
“Well, Jusuf, that is something. I mean I feel pretty sad just thinking about it. I can imagine you must be feeling pretty sad, too and probably anxious and maybe angry at the state of your future. Am I reading you correctly? Please tell me.” “Yes, that’s right.”
Here, Mr. Jenkins let out a big sigh and mirroring Jusuf’s sad thoughts, echoing what Jusuf’s plight was.
“I don’t know what to say," said Bob-the-Counsellor (Mr. Jenkins) . It looks like you might be on track. I am sorry I failed you. I was hoping I could turn things around. It looks like you have your future wrapped up, given how depressed you are feeling about being in Canada and not being successful in your new school.”
Then Mr. Jenkins leaned back with a caring but resigned look on his face.
“Yes, it is too bad things didn’t work out. I really feel terrible. I really feel for you, Yusuf. If you think of anything else you can come and see me anytime. Remember that. Anytime! You are important to me. I only wish I could turn things around, but it seems that everything is so inevitable. There is no turning back. Here is your hallway pass, Jusuf. You know where I am if you need me.”
Jusuf thanked Mr. Jenkins and left.
Mr Jenkins was thinking to himself, “I think I will see Jusuf again very soon. I purposely left Jusuf stewing with his thoughts. Now that his thoughts, no matter what shape there were in, were out in the open and not spinning in his head. They had been written down. Now, Jusuf will have a better chance to hear himself. Once he hears himself. I am sure that Jusuf won’t like what he is hearing. Then any remaining resistance to doing something about his depression, should, I hope, melt away."
Bob-the-counsellor was using Paradoxical Agenda Setting, where he tries to mirror any resistance felt by the client. The aim is to get the client to fight back against these thoughts. In reality, the client is attacking himself with any reasons he might be reluctant to giving his all to change.
The very next morning Jusuf was knocking at Mr. Jenkins’ door.
“Good morning, Mr. Jenkins, I just came to say that I don’t need you anymore.”
“That is good news,” smiled Mr. Jenkins.
“Can you take a minute to tell me about it. It sure would help me to know how you figured things out. I can use your knowledge to help other students. Please have a seat.”
“So, what happened to make things different.”
“Well, Mr. Jenkins, I have some friends now.” “You have some friends now? That is great. What happened? How did you do it so quickly? I am proud of you!”
“Well, there was a guy at his locker which is pretty close to mine and I said ‘Hello’”.
“So, you said hello. What did he say?”
“Well, he said hello, too.”
“Let me get that. You said ‘Hello’ and then he said ‘Hello’ back to you. Wow!"
Mr. Jenkins was emphasizing the positive.
“Well, then he said ‘What’s up?”
“I said ‘Not too much’. What about you?”
“Let me catch that again. First, you said ‘Hi’ and he said ‘Hi’. Then he said, ‘What’s up?” and you said “Not too much’.
“Well, I can’t exactly remember but we got talking about video games and then we met after school. I met his friends there. And well, I don’t feel terrible anymore. I'm doing fine.”
“Well, I am really happy for you and proud that you went out and looked after yourself by inviting some people into your life. Congrats!”
“Thank you, Mr. Jenkins. I’d better get to class.”
The bell had just rung.
“Sure thing. But can you do me a favour. You know that thing we worked on. I have just one more step to do. I know you don’t need it, but it would really help me with my counseling other students. It is a new technique that I have been practising . I need to know if the next step might be helpful to you even though you are feeling great. Can you drop by tomorrow or today?”
“Sure, Mr. Jenkins. I don’t mind helping!”
“Okay, see you tomorrow.”
Mr. Jenkins practices TEAM CBT as developed and taught by David Burns MD. He knows that the ‘B’ in CBT is behaviour and Jusuf had changed his behaviour. Nevertheless, it is important to do the cognitive part, the ‘C’. It is because ‘Our thoughts cause our emotions and our emotions determine our behaviour. We can start with the end, the behaviour change, but we must go back to the thoughts. It is the change in thoughts by finding the cognitive distortions that will give the client the tools to keep depression at bay. It allows the therapist to do an inoculation against the return of the depression, which will come back at some point. But it will not last if the client uses the same tools he used to rid himself of the negative emotions in the first place.
See Yusuf Part 3 for the final episode.
Most people like stories, and therapy is all about stories. Telling stories about powerful techniques used in TEAM CBT therapy demystify this therapy one story at a time.
Yet, confidentiality is a cornerstone of all counselling. Without confidentiality, clients wouldn’t feel safe going to therapy to divulge the most painful areas of their lives. To safeguard clients while illustrating TEAM CBT techniques, confidentiality is kept by either having the client’s consent or by distorting the facts, making the client unrecognizable .