How to do psychological first-aid on a desert island

You’ve probably never had it THIS bad. Nearly killed in a shipwreck, stranded alone on an island, no hope of rescue. The temptation to give in to despair must have been nearly overwhelming. Many would have become immobilized, maybe even considered taking a long, cold walk back into the ocean to end it all.

message in a bottle

But Robinson Crusoe didn’t. And the reason he didn’t, the psychological “first aid” that he rendered unto himself, still stands nearly 300 years later as perhaps one of the simplest, yet best example of what would later be called “cognitive behavior therapy.”

How Crusoe did it

Here’s the key passage* from Daniel Defoe’s 1719 classic:

I now began to consider seriously my condition, and the circumstances I was reduced to; and I drew up the state of my affairs in writing, not so much to leave them to any that were to come after me—for I was likely to have but few heirs—as to deliver my thoughts from daily poring over them, and afflicting my mind; and as my reason began now to master my despondency, I began to comfort myself as well as I could, and to set the good against the evil, that I might have something to distinguish my case from worse; and I stated very impartially, like debtor and creditor, the comforts I enjoyed against the miseries I suffered, thus:—

At that, Crusoe write down a list of negatives in one column, and responses in the other:

             _Evil_.                             _Good_.
I am cast upon a horrible,          But I am alive; and not drowned,
desolate island, void of all hope   as all my ship’s company were.
of recovery.

I am singled out and separated,     But I am singled out, too, from
as it were, from all the world,     all the ship’s crew, to be spared
to be miserable.                    from death; and He that
                                    miraculously saved me from death
                                    can deliver me from this
                                    condition.

I am divided from mankind—a         But I am not starved, and
solitaire; one banished from        perishing on a barren place,
human society.                      affording no sustenance.

I have no clothes to cover me.      But I am in a hot climate, where,
                                    if I had clothes, I could hardly
                                    wear them.

I am without any defence, or        But I am cast on an island where
means to resist any violence of     I see no wild beasts to hurt me,
man or beast.                       as I saw on the coast of Africa;
                                    and what if I had been
                                    shipwrecked there?

I have no soul to speak to or       But God wonderfully sent the ship
relieve me.                         in near enough to the shore, that
                                    I have got out as many necessary
                                    things as will either supply my
                                    wants or enable me to supply
                                    myself, even as long as I live.

His conclusion from the exercise:

Upon the whole, here was an undoubted testimony that there was scarce any condition in the world so miserable but there was something negative or something positive to be thankful for in it; and let this stand as a direction from the experience of the most miserable of all conditions in this world: that we may always find in it something to comfort ourselves from, and to set, in the description of good and evil, on the credit side of the account.

Useful lessons from a shipwrecked man

Reading the above passage, there are a few really good examples of effective self-treatment for depression or despair.  You can probably see how effective this exercise might have been in reducing some of the despair and fear he was feeling.

Here are a few of the most notable things Crusoe does:

1. Writes his concerns down

First, Crusoe makes the point that it’s better to not let your concerns just rattle around loose in your head:

“I drew up the state of my affairs in writing…to deliver my thoughts from daily poring over them, and afflicting my mind.”

Continuously “poring over”,  ruminating about your worries, overthinking things, is a sure way to go crazy — at every turn, these things will pop up and nag at you.

“Free range terrors,” left to run amok in your mind, are the most damaging. Tweet this

You’ll often see this key principle of writing things down happening if and when you talk to a therapist. Forget your troubles for a second and just watch how they work, and how this works for you:

Generally, they start jotting down the sixteen things you rattle off that are bothering you. And at the end of their high-priced session, they look up over their spectacles, smile, and in that kindly and wise seeming way, say, “so… it seems to me that your main worries are…” and they glance down at their pad, and like a genius, they read back to you the three or four main “worry clumps” that pretty much summarize your last hour’s worth of fretting and whining. Then they sit back, let that soak in, and send you a bill.

It seems too simple. But odds are, you’ll feel like your head is a bit clearer, things seem less chaotic, just for having had your concerns summarized back to you. This kind of summary lets us get a bit of psychological distance from things, and that seems to help.

Like Crusoe, stuck on an island that has no managed care clinic nearby, you can jot down your worries and fears yourself, pick out the main “themes,” and get about $150 dollars’ worth of therapeutic help from that simple step. (Plus, write down one more in the “Good” column: you will have saved $150.) Writing your concerns down tends to give you a bit of psychological “distance” from them. Seeing  beasts on the ground from helicopter height, instead of down on the ground where the big scary rhino is breathing in your face, you tend to feel a bit more able to think clearly about things.

2. Examines his thoughts and asks critical questions

The second thing Crusoe does, is to start coming up with responses to his fears. This is almost exactly the same process that later became the hallmark of “Rational Emotive Therapy” founder Albert Ellis, and still later, the “Cognitive Therapy” of Aaron Beck.

It’s not a hard thing to master. Having written his worst fears down, Crusoe then has a bit of psychological “breathing room” in which he can think logically about these concerns. He is then able to think of a specific, focused responses to each concern, a sort of “on the other hand” response.

It’s important to notice that this is not a vague, overly general “always look on the bright side of life” cure. He is not just staring up at the blue sky and whispering “everything is peachy keen today!” Because that would not work. It would not deal with the very real, and very specific, raging fears and concerns that are tormenting him.

Rather, he gets each individual concern down on paper. He then comes up with a SPECIFIC “on the other hand” kind of response to each concern.

The standard Cognitive Therapy way to work with such a list would involve taking  each concern on your list, and asking yourself a few simple questions:

– Is this concern valid? How do I know? (Could I be misinterpreting the evidence? Am I being selective in what I am paying attention to, filtering out the good news and only paying attention to the scary clues? Was that scary bump a burglar, or just the cat…again?)

– Are there other ways of thinking about this that might be more helpful, or calming? (e.g., the response to “God must hate me to have stranded me” can be countered with, “Well, but he DROWNED all the other guys and kept me alive! Maybe I’m the favorite!”)

– So what? So what if this is true? What’s the worst that can happen? How, specifically, can I manage if this fear is true? What, for instance, might be the realistic, long term results of this situation? (e.g.: “I’ll just live and learn.” “Pay the fine and move on.” “I’ll make sure my next brownies aren’t burned.” “I’ll make sure my next husband isn’t such a jerk.”)

This kind of thing takes a bit of practice, and I would imagine that Defoe had to struggle a bit, tapping his head with his inky quill, to get this nifty example down on parchment. It will take you a bit of time to learn, as well. But we know from decades of psychological research in treatments such as cognitive-behavior therapy, that when you learn this technique, it practically becomes your superpower. Your mind, and your life, will thank you for learning it.

3. He gets busy

Crusoe finishes the exercise thus:

Having now brought my mind a little to relish my condition, and given over looking out to sea, to see if I could spy a ship—I say, giving over these things, I began to apply myself to arrange my way of living, and to make things as easy to me as I could.

When we are depressed and scared, we tend to be paralyzed. We may be agitated, tired, unable to get moving. Breaking out of the worried, ruminative state tends to release a great deal of physical and mental energy. Crusoe felt better and so his energy was freed up to get busy, building his island home.

Another advantage of getting going, doing things, is that you can start to deal with the “real world” situations that have been triggering all that worry. After Crusoe spends some time and effort getting his situation organized, he’s going to be in a much better position to cope with the disaster that has occurred. He may still be stuck on an island, but he will at least have managed to find safety, food, water, shelter, and protection for himself. The only way he could have done all that, was by shaking off the paralyzing depression and fear that threatened to overwhelm him.

Practice exercise

Sit down and write out three of your current concerns or worries. Do a Robinson Crusoe on them: next to each one, try to come up with a different, less catastrophic way of thinking about the situation. If it’s not easy at first, remember that you will get better at this kind of thing with practice. Devoting a bit of time to mastering this skill will change your life.

___

* Excerpt from Robinson Crusoe, a public domain book, courtesy of Project Gutenberg. You can find the whole book here.

Overthinking Depression

Women Who Think Too Much

by Susan Nolen-Hoeksema, Ph.D.

(Book review)Image

Dr. Susan Nolen-Hoeksema, who recently passed away, has left us a lasting gift in this excellent book on the causes and effective ways to treat depression.

Women Who Think Too Much explains how one major cause of depression is likely to be “overthinking.” She defined this as “getting caught in torrents of negative thoughts and emotions that overwhelm us and interfere with our functioning and well-being.” (p. 3) She describes how such thinking patterns tend to develop and gives lots of examples that will probably ring bells of recognition in many readers.

For instance, she describes how a woman who reacts to a boss’s sarcastic comment may come to spend days going over the remark, expanding her worries to include her boss’s opinion of her work, her own self-doubts about her work, and on and on… triggering more feelings of guilt, shame, and other negative emotions.

The more we overthink, the more likely we are to get depressed. click to tweet

Special risks for women

While both men and women, boys and girls, are vulnerable to this kind of psychological wound-picking, Nolen-Hoeksema highlights the ways in which women may be more prone than men to engage in depressive thinking patterns. Her chapter on “women’s unique vulnerabilities” shows how this occurs.

Stressful roles at work and in the family, lower status and pay, unequal power, sexual abuse and harassment, can all contribute to overthinking.

Managing your thinking patterns

 Most useful to many readers, she has a very clear, well-written set of strategies for breaking unhealthy thought patterns. One of her first suggestions is that one should understand how overthinking is “not your friend,” that ruminating endlessly on one’s faults and even your past history of injuries and errors, may be quite self-destructive. (This is no doubt the dark side of “navel gazing” that seems so much like “insight” when we are doing it, or even sometimes when our well-meaning counselors or therapists encourage it in less than productive ways.)

Some other suggestions she makes include:

  • Distracting yourself from overthinking, especially with positive diversions
  • Getting into healthy activities such as exercise
  • Immersing yourself in hobbies, reading, etc.
  • Avoiding unhealthy ways of distracting yourself (especially things like alcohol)

Decide to change your outlook by saying to yourself, “I have the right to choose how I look upon this situation, and I am going to exercise that right.”

Dr. Nolen-Hoeksema was a respected researcher at Stanford and Yale, trained in the “positive psychology” tradition of her teacher, Martin Seligman. Her book is essentially a readable primer in many of the cognitive-behavioral and positive psychology concepts that have been proven to be highly effective in the treatment of depression, anxiety and related conditions.

Letting your light shine

In addition to helping persons, women and men, with depression, this book can be a useful guide to simply living a better life. For instance, parents, especially parents of girls, may find it helpful in learning both to teach their kids, and to be good models for their kids, of healthy ways of thinking.

A favorite Bible quote of many psychologists should really be Matthew 5:15: “Don’t hide your light under a basket.” Whatever one’s religious beliefs, each of us needs all the encouragement we can get to remember that in a sometimes scary and guilt-producing world, “letting our inner light cut through the darkness” is good for ourselves and others. Being fully alive means, as a first step, not letting ourselves get chronically caught up in waves of self-doubt and overthinking. The late Dr. Nolen-Hoeksema’s book is a valuable source of light for use in our journeys. The book is highly recommended.