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Paul Midden, Ph.D.,
Clinical Director,
Saint Louis Consultation Center
Maintaining health & wellness in a vowed, apostolic
life of service.
Recognizing distress/depression.
How therapy/counseling can help with these things.
Taking care of oneself.
No one chooses an emotional or psychological
No one joins religious life to be unhappy.
Balance in life is an ongoing goal.
There are obvious tensions in a life of service
between caring for others and caring for self.
Our self care is our personal responsibility.
Maintaining health, wellness in
apostolic life
We are happy when
we are relatively stress-free,
we enjoy ourselves,
we relate to others with a sense of ease and pleasure;
we pursue our goals and responsibilities in a comfortable
Our life is in balance among the physical, intellectual,
emotional, social, and spiritual aspects.
Tensions & risks. . .
 Man for others versus self-care
 Hero ideal
 Compassion fatigue
 Self-care versus self-absorption
More tensions, risks. . .
 The allure of narcissism
 The allure of avoidance
 Sexual tension
 The dilemma of formation
Recognizing distress/depression
What is it?
A multi-system disturbance of emotional
regulation which negatively impacts one's
outlook, body, and spirit and which compromises
a person’s ability to function effectively.
A few things to consider
 It is an affliction; it is not a choice.
 It affects those so disposed for lots of complicated reasons.
 It can be triggered in many ways, some complicated and some
By sunshine deprivation
By reactions to interpersonal tensions or any of the other
tensions noted above.
By grief
By circumstances that trigger memories of earlier abuse.
By trauma, either recent or historic
Types of depression
Major Depression
Dysthymic Disorder
Bipolar Disorder I & II
Reactive depression (Adjustment disorder)
Major Depression
 Depressed mood*
 Markedly diminished interest in things that are ordinarily
Fatigue or loss of energy
Feelings of worthlessness, guilt.
Impaired concentration, indecisiveness
Insomnia or hypersomnia
Psychomotor retardation or a agitation (slowed down or restless)
Recurring thoughts of death or suicide.
Significant weight gain or loss (+/- 5% body weight/month)
Must have loss of interest or depressed mood among symptoms
most every day for two weeks
Dysthymic Disorder
Poor appetite or overeating;
Insomnia or hypersomnia
Low energy or fatigue
Low self esteem
Poor concentration
Difficulty making decisions.
Feelings of hopelessness.
Bipolar I Disorder, manic phase
 Mood Changes:
 A long period of feeling "high," or an overly happy or
outgoing mood
 Extremely irritable mood, agitation, feeling "jumpy" or
Bipolar I Disorder, manic phase
Behavioral Changes
Talking very fast, jumping from one idea to
another, having racing thoughts
Being easily distracted
Increasing goal-directed activities, such as taking
on new projects
Being restless
Sleeping little
Having an unrealistic belief in one's abilities
Behaving impulsively and taking part in a lot of
pleasurable, high-risk behaviors, such as spending
sprees, impulsive sex, and impulsive activities.
Bipolar I Disorder, depressed phase
 Mood Changes
 A long period of feeling worried or empty
 Loss of interest in activities once enjoyed.
Bipolar I Disorder, depressed phase
 Behavioral Changes
 Feeling tired or "slowed down"
 Having problems concentrating, remembering, and
making decisions
 Being restless or irritable
 Changing eating, sleeping, or other habits
 Thinking of death or suicide, or attempting suicide
Reactive depression
a.k.a.Adjustment Disorder
 The development of emotional or behavioral
symptoms in response to an identifiable stressor(s)
occurring within 3 months of the onset of the
 These symptoms or behaviors are clinically significant
as evidenced by either of the following:
(1) marked distress that is in excess of what would be
expected from exposure to the stressor
(2) significant impairment in social or occupational
(academic) functioning
How Therapy Can Help
Therapy provides a safe place where a person can talk
about anything, including their most serious and private
personal difficulties, and expect to be understood,
attended to, and cared for.
What therapy does
 Provides a forum outside the internal dialogue.
 Provides a place to check out one's thinking, get to the
root of emotions, and practice new skills.
 Provides a way of receiving feedback that is not
What therapy does not do.
It does not change your experience or your history.
It does not take away your feelings, including whatever
anger or resentment you might have.
It does not turn you into someone else, or a more perfect
version of yourself.
Therapy is about change
 In your behavior
 In the ways you think about things
 In the way you deal with your emotional life
 In the way you deal with your relationships
Shedler’s List
 Helping a person work out his feelings
 Exploring attempts to avoid distressing thoughts and
 Identification of recurring themes and patterns
 Discussion of past experience (developmental focus).
Shedler’s List, cont’d
 Focus on interpersonal relations
 Focus on the therapy relationship
 Exploration of fantasy life
 1) a sense of personal autonomy/centeredness
 2) awareness of personal, interpersonal needs and
 3) awareness of sexuality: orientation, attraction
profile, vulnerabilities
 4) emotional/interpersonal skills
Self-care, cont’d
 5) social support network, or relationships,
relationships, relationships
 6) clarity about one's vocation/life path
Key concepts
 Integrity
 Being who you say you are.
 Self-awareness
 Knowing the self that you are
 Mindfulness
 Paying attention to the self that you are.