When clients tell me they feel depressed, I’m rarely surprised. We’re living through an era marked by collective stress and uncertainty. In the span of just two decades, we’ve witnessed the 2001 attacks on the World Trade Center and the long War on Terror; the financial collapse of 2007; the devastating 2011 tsunami and nuclear meltdown in Japan; and, of course, the global shutdown triggered by COVID-19 in 2020. Any one of these events could unsettle a person’s sense of safety. Together, these events form a backdrop of instability that affects all of us, whether or not we consciously register it. In such an environment, depression can be understood not simply as an illness but as a response—a way the psyche copes with overwhelming stress by muting feelings that might otherwise be too painful to bear.

Depth psychology has long recognized that the roots of depression often reach back to early life. A toddler or a young child who experiences something frightening, confusing, or emotionally overwhelming has limited tools for processing those feelings. Instead, in a defensive move, the child’s psyche may repress the experience, burying the emotions in order to survive psychologically. This same mechanism can carry into adulthood. Depression becomes the visible sign of feelings that were once too difficult to experience and have remained sealed away.

Alice Miller’s classic work, The Drama of the Gifted Child, first published in English in 1981*, powerfully illustrates this connection. Miller writes that depression appears in nearly all patients, “either in the form of a manifest illness or in distinct phases of depressive moods.” These phases, she explains, serve different functions—one of the most important being a signaling function. Depression signals that something within us is calling for attention: a buried emotion, a forgotten wound, a part of the self that has been pushed aside for too long.

One of the most common sources of these buried feelings is the early suppression of essential needs. Chief among these needs is the drive to individuate—to be one’s authentic self. Yet in most families, even loving ones, certain feelings or behaviors are welcomed while others are discouraged. A child quickly learns which parts of themselves earn approval and which provoke disappointment or withdrawal. Over time, the child may come to shape their identity around pleasing the parent, often without realizing it. This people-pleasing mode can persist well into adulthood, eventually leading to a deadening of the self. When authenticity is chronically stifled, depression often becomes the psyche’s way of expressing what the person themselves cannot: something essential is being suppressed.

Depression can also arise from the sheer accumulation of strong feelings that have no avenue for expression. Anger, grief, fear, longing—if these emotions are repeatedly judged as unacceptable or unsafe, the psyche may lock them away. But repression is not a permanent solution. Hidden feelings gather weight over time, sometimes flooding the barriers meant to contain them. Depression is sometimes the first sign that those barriers are starting to strain.

Healing begins when the link between current depression and past repression becomes visible. By gently uncovering the buried experiences and allowing the long-held emotions to be felt, the protective function of depression is no longer needed. The energy once spent on keeping feelings out can flow back into living fully, creatively, and authentically.

Seen this way, depression is not merely a diagnosis. It is a messenger. It invites us to slow down, look inward, and reclaim the parts of ourselves that were silenced long ago. When we meet it with curiosity rather than judgment, depression can become not the end of vitality, but the beginning of a return to emotional wholeness.

*Alice Miller: The Drama of the Gifted Child: The Search for the True Self. Basic Books ©1997.

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Finally finishing a project that had been in the works for more than 10 years (granted, on again off again) produced a very strange sensation of accomplishment and wonder. I wondered how I ever finished it. Year after year I would say, this is the year I finish Father Figures. Another year went by. And another. Writing partners, setting goals for myself, rewards, and reinforcements, they all came and went. What never left was my commitment to the project and what it could mean to my clients and to gay and queer men around the world.

Like a good psychotherapist, I began to look at the process itself, the constant delaying and precluding the work I needed to do. The effects of going through this roller coaster of promises to myself broken again and again contributed to an overall undermining of self-esteem. Finally, I remembered that it is in keeping one’s word to oneself that self-esteem starts to grow. So, I turned my project into an orderly bunch of doable baby steps, assuring myself that I only had to do that one small thing in the time allotted and I could congratulate myself for having kept my word.

If this all starts to sound like Project Management 101, it is. But it is so easy to forget that when your head is spinning with self-recriminations. Self-doubt: Will I ever finish it? Self-disgust: How many times have I failed to “get it done?” Self-judgment: I am a failure. My experience says that it is at that point that you find out what kind of commitment you really have to the project. Sometimes it is better to just admit that the project is not worth doing, or you are no longer interested, and move on to something else.

When a back burner project will not die and will not go away, however, you need to muster the commitment to move it up to the front burner. The front burner need only be creating a schedule and then putting it away until the time is right. For me, the best way to move a project forward, whether long-term or short, is to first and foremost, create a timeline or schedule for it, one that is broken down into various components, with days estimated for how long each step will take to complete. After that, the dates go on a calendar.

In long-term projects, you can assure yourself that the work will not be forgotten and that it will be broken down into small, doable steps when the assigned time comes. It is a slow path to accomplishment because it is stretched out over a long period, but one that will take you where you want to go. For short-term projects, the timeline/schedule allows you to budget daily hours so that you make sure there is time set aside for the here-and-now needs of the project. In both cases, it is the recognition of your own commitment to the value of the project that will assure you that, no matter at what speed, progress will be made.

David Bowman LMFT is a licensed psychotherapist based in Los Angeles, California.

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After spending some time doing psychotherapy, many of my clients have identified changes they would like to make in themselves and their lives, and we have worked together to map out goals, objectives, and even detailed plans and schedules. Often, I have become a kind of life coach at this point, helping clients create action plans and breaking their changes down into manageable steps. However, some of the most well-intentioned and highly motivated clients often run across seemingly unconnected events and circumstances that prevent them from carrying out their plans. After encountering a certain number of puzzling obstacles, we are forced to consider the possibility of self-sabotage. Are these clients either consciously or unconsciously preventing their own growth and change?

Subconscious Messages

Some of the more obvious self-sabotaging behaviors include excessive drinking and drug use, binge eating, self-injury such as cutting, or even simple procrastination. These are all ways that we can prevent ourselves from acting in our best interest. In addition, there are self-sabotaging, subconscious beliefs, which are perhaps even more profound and far-reaching, underlying scripts that play out with messages such as, “I don’t deserve to be/do/have…,” “ I’m not worthy of him/her/it …,” “I have no control over …,” “it’s my fault that …,” “ I’m too fat/thin/dumb/smart/ugly/beautiful to ….” The variety and the effects of these statements are endless. Now we must return to psychodynamic inquiry to look for clues as to why we would subconsciously act against our own best interests?

Creative Blocks

Creative types such as actors, musicians, writers, and artists often face creative blocks, a stubborn form of self-sabotage that can feel entirely beyond their control. And is it any wonder? For people who daily must display their innermost thoughts and feelings and vulnerabilities and strengths to others, the ever-present threat of personal rejection can be paralyzing or crippling. Having to face that every day can create a kind of trauma.

Freud and Resistance

Freud would call self-sabotage a form of resistance—avoidance of subjects and behaviors that are too painful or uncomfortable to accept. In fact, many of us resist improving our behaviors or attitudes or changing our lives because we are not sure of (or perhaps even afraid of) what life will be like once we’ve made that change. We get comfortable in our discomfort, and the misery we know is safer than the unknown life we cannot yet even picture. We have spent years, possibly decades, developing coping mechanisms, using avoidance techniques, even creating outside people and circumstances that will make it impossible for us to make the needed change, or make it necessary for us to stay the same.

It is important to remember that despite it having a destructive effect on life now, self-sabotage was originally developed as a defense, a way to save pain and suffering. It is the work of therapy to uncover and even honor that pain and suffering, for until we understand the very personal reason for self-sabotage, we will continue to remain at its mercy.

David Bowman LMFT is a licensed psychotherapist based in Los Angeles, California.

Photo credit: Alice Achterhof UNSPLASH