The IPT therapist has a concept of depression that guides the treatment.
IPT is based on the idea that the symptoms of depression have many different causes. However, whatever the causes, they are usually associated with something going on in your personal life, usually with people to whom you feel close and who are important to you. It is useful to identify and learn how to deal with those personal problems and to understand their relationship to your depression.
There are at least three ways an IPT therapist will try to help you:
1. By making an accurate diagnosis and making certain that you have a depression.
2. By relieving your symptoms of depression.
3. By helping you develop better ideas and resources for dealing with whatever social and interpersonal troubles you are experiencing in relation to the development of your depression.
The IPT therapist views depression as having three parts:
1. Your Symptoms. This involves your symptoms of depression, your problems in sleeping and eating, your loss of interest and pleasure in life, your fatigue and pessimistic outlook. (These will be described later.)
2. Your Social and Interpersonal Life. This involves your ability to get along with other people in your life who are important to you: your family, your spouse, your children, your partner, your brothers and sisters, your dear friends or your work associates.
3. Your Personality. There are some enduring ways that people deal with life, that is how they express their angers and hurts, their self-esteem, whether they are shy, aggressive, inhibited or suspicious. These traits determine your unique reaction to other people. These personality patterns may even contribute to the reason for developing your depression or how you deal with it.
Many therapists begin by trying to treat a person’s personality difficulties and see personality as the underlying cause of depression. The IFF therapist does not try to treat a person’s personality and, in fact, recognizes that many behaviors which may seem enduring and life-long may be a reflection of the depression itself. That is, when you are feeling depressed, you may seem dependent, self-preoccupied and irritable; yet, when your depression lifts, many of these supposedly enduring traits also disappear.
Therefore, the main thrust of IPT is to try to understand how the symptoms came about and how they are related to your current social and personal life. The IPT therapist will look for what is currently going on in your life (the “here and now” problems) rather than problems in your childhood or past.
The idea will be to encourage you to cope with these current problems and to develop self-reliance outside of the therapeutic situation. The time limited part of the treatment precludes any major reconstruction of your personality. Many patients feel much better once their depression lifts and go on leading lives that are fulfilling and satisfying.
The goals of IPT are:
• To reduce your symptoms of depression, and improve your sleep, appetite and general outlook on life
• To help you deal better with the people and situations in your life
The IPT therapist will focus on:
• Your current problems in the “here and now”
• People who are currently important in your life
• Helping you to evaluate your current life
• Helping you to master current problems by changing how they seem, how you deal with them and developing new friendships and relationships
The IPT therapist will not:
• Interpret your dreams
• Have treatment go on indefinitely
• Delve into your early childhood
• Encourage you to free associate
• Make you feel very dependent on the treatment or therapist
In therapy you will be seen as a person in distress who is having symptoms which can be dealt with currently.
The IPT therapist will want to know:
• When your symptoms began?
• What was going on in your life when they began?
• What are the current stressors?
• Who are the current people involved in these current stressors?
• What are your disputes and disappointments?
• How are you coping with these problems?
• What are your strengths?
• Can you talk about situations that make you feel guilty, ashamed or resentful?
The IPT therapist will:
• Offer advice and give you suggestions for dealing with the problems
• Correct misinformation and suggest alternative ways of dealing with situations
• Help you develop resources on the outside The IPT therapist will not focus on;
• Why you became what you are or where you are going
• Your childhood
• Your character
• Your defenses
• Why you feel guilty, shameful or resentful
• Your fantasy life or insight into the origins of the behavior
To help develop an understanding of how your depression began and what was going on in your life that may have brought it about, you might answer the following questions:
Understanding How Your Depression Began
• What are your current problems?
• What persons are currently important to you?
• When did you start feeling depressed, sad, blue?
• What was going on in your life when you started to get depressed?
• Are there disputes in your life now?
• How are you dealing with these disputes?
• What are your current disappointments?
• How are you dealing with these disappointments?
• What situations make you feel guilty, ashamed, angry?
• What are your stresses?
• What do you see as the things that you can do well?
(extracted from) Mastering Depresion Through Interpersonal Psychotherapy, A Patient Workbook. By Myrna M. Weissman, Oxford University Press, 1995