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Cheer up, you miserable git

How's this for a truly ingenious form of CBT - just tell your depressed patient to act happy. Works every time, reckons Copperfield

How's this for a truly ingenious form of CBT - just tell your depressed patient to act happy. Works every time, reckons Copperfield

Recently, I had a Eureka moment. I was reading an article and came across a paragraph that was such a revelation I leapt out of my bath and ran naked through the streets. Okay, I didn't do that. I cut it out and put it in my folder to show my appraiser. Okay, I didn't do that either (because I don't have such a folder, and because I'm not a sad bastard). But I did let out an impressed expletive.

To explain. With some depressed/ anxious/stressed/obsessive-compulsive/ (insert your favourite psychiatric diagnosis here) patients, every therapeutic approach I can think of (exercise, an SSRI and, er… that's it) proves futile. Which is when I find myself recommending CBT. Because it works for everything, doesn't it? Besides, the waiting list is indefinite, so it gets the patient off my back.

But then I hear the patient say: 'What exactly is CBT, doctor?' Hmm. Well, there's the cognition bit, which is, erm, about how you think, and then there's the behavioural bit, which involves, umm, the way you behave. And it's a therapy, so it makes you better. Simple. By this point we're staring at each other and the only thing the patient truly understands is that I'm clueless.

That's why I was reading this article about CBT. And there, among all the usual meaningless psychobabble, was a piece of rock-hard, cast-iron advice. It was so wise, yet so obvious, I had to implement it immediately.

This is what it said. 'In depressed patients, one useful technique is to suggest they act as though they aren't depressed.'

I know what you're thinking. Something along the lines of 'that's complete and utter bollocks'. But bear with me.

Self-fulfilling prophecy

After all, depressed patients think negatively, withdraw from social contact, stop going to work and ditch all their interests. So their illness becomes a self-fulfilling prophecy: social isolation with lonely hours filled watching crap daytime TV is not a recipe for recovery.

Whereas patients who act like they've just won the lottery will inevitably infect themselves with their own fake positivity until they start to feel better. In other words, acting happy makes you happy because it makes you do things that cause happiness. Plus everyone will reinforce your state of elation by commenting how bright you seem. Assuming they don't stick you on lithium.

Fantastic, isn't it? To break through the vicious cycle of despair, you simply invert cause and effect. We can now, in essence, tell the average depressive: 'Stop acting like a miserable git.' Because that's CBT.

Either this is just common sense dressed up as psychotherapy or it's the greatest gift to primary care since the Hob Nob.

Whatever, I'm hooked. I've been using the technique constantly since. Tired? Pretend you're full of energy. Dizzy? Act stable. Overweight? Make like a slim person.

It's possible I could take this too far, of course. I'll let you know how my man with a burst aortic aneurysm gets on. 'Act like you're not leaking,' I suggested. Though I'm not sure he heard me.


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