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'Sad is how I am!' Treating Dysthymia in Children and Adults

Section 23
Adults Who Don't Have Time - Children, Unimportance, and Depression

Question 23 |
Test | Table of Contents

Kurt Hahn observed that contemporary youth were suffering from the “misery of unimportance.” In earlier times they were indispensable for the survival of the family unit. Working in the fields and shops beside their elders, they built a life and a nation. Experiences in extended families and cohesive neighborhoods made cooperation an everyday occurrence. The young and the elderly helped one another, and large families offered abundant opportunities to give and receive love.

Today, all of this sounds like a fantasy island. Now cousins are just photographs in an album, and grandma is a three-minute transcontinental call. Our homes are fitted with security devices, and our yards are cordoned off with fences to protect ourselves from our neighbors. A school in California secures funds for a concrete wall around its playground to protect children from stray bullets fired by warring gangs in the housing project across the street; nobody mentions that most of the occupants of the project are also children, since that is on the other side of the wall.

While youth long for a feeling of importance, adults persist in infantilizing them. The typical approach to the cries of boredom from youth is to build them a new playground or teen-town where they are told to go and play some more. Today, little is asked of young people except that they be consumers. A vast industry serves youth with schooling, entertainment and goods of all kinds, but there are limited opportunities for the young themselves to produce goods and service for others.

Various national commissions have recently recommended that young people become involved in community service activities. This is a promising idea, but it raises the question of the amount of time youth are presently allocating for volunteer work. A study by the Search Institute asked 10,000 young adolescents the following question: “Think about the helpful things you have done in the last month -- for which you did not get paid, but which you did because you wanted to be kind to someone else.” Three-quarters spent less than two hours helping others in the previous month; this includes a third of the young people in the study who said they had done nothing at all. A quarter were involved three or more hours during the previous month. One might conclude from this that volunteer work is not presently a major force in the development of responsibility in contemporary youth.

Deprived of opportunities for a genuine productivity, lured into consumptive roles, young people come to believe that their lives make little difference to the world. Those who feel the most powerless develop distorted ways of thinking which psychologists label as “external locus of control” or “lack of personal efficacy.” They feel like helpless pawns following somebody else’s script rather than authors who can write the drama of their own destiny. They believe they are but victims of fate or the whims of powerful others.

Perhaps the most damaging proof of the child’s unimportance is the shrinking amount of attention from adults who “don’t have time.” Steven Charleston, a Native American professor, discusses this tyranny of time in Western culture. We have been fooled into believing time is real; it isn’t, of course. It is an invention of the human mind for describing change and motion. Not until very recently have humans ever tried to govern their life activity by numbers generated by a tiny machine. The great cycle of seasons and of the day, the natural development of growth, these were time. The rest is only as real as we want it to be. And as demanding.

Charleston says we can see the tyranny of time in our lives by listening to how many idioms we have invented to describe something that doesn’t exist: We make time, save time, spend time, waste time, borrow time, budget time, invest time, manage time, until in exhaustion we call time out. In contrast to time, relationships are real. They exist in the intimate spaces of our lives, when we narrow the distance between ourselves and others. Family, friendship, community -- these are the bonds of reality.

Today these bonds are being torn apart by the hands of Western time. We have a new idiom for that, a new “time word” to mask the continued destruction of love in our society: it is called “quality” time. Now not only are we quantifying time, we are qualifying it. We are willing into existence the illusion that love can be measured by seconds or minutes; that “human relationships can be made warm in the microwave of quick encounters.”

We cannot care for children in convenient time; we can’t learn from our elders in convenient time; we can’t maintain marriages in convenient time. The result of adjusting our lives to the fiction of time will inevitably be empty adults, lonely elders, and neglected children

“Let’s Get Organized” Method
The following organization technique can help your client, whether an adult or a child, feel less harried and overwhelmed in general. As you know, dysthymic clients can be so wrapped up in negative emotion that they feel overwhelmed and frozen into an action. The following seven steps can assist you in treating your clients who are frozen into inactivity.

1. Plan: Have your client write down what they have to do each day. This shortens the time spent mentally reviewing their obligations. It also helps reduce anxiety over possibly forgetting an important task and alerts them to the possibility that their expectations for one day are not realistic.

2. Prioritize: Help your client understand the importance of this step by having them picture the chaos that would result in a hospital emergency room if all the patients were assumed to be equally in need of immediate attention. Not only would the staff be in a state of panic, but while they were hurrying to care for those with minor problems, the patients with more serious difficulties would expire. The idea of equal importance obviously does not make sense in an emergency room, and it does not make sense in their life either. Instead of the client treating all their responsibilities as if they were urgent and equal to one another, have them prioritize the items on their “to do” list. Each time they have to make a decision about how to use their time, let their preset priorities be their guide.

3. Delegate: Help them identify any items on their daily schedule or “to do” list that other people could do or help them do. They need to give up the unproductive notion that to have something done right they must do it themselves. Also, stress to them that requesting assistance is not a sign of weakness, and that they should go ahead and ask for the help they need. Also, suggest to them that they can save additional time by allowing the people whose help they’ve requested to do as they’ve asked without hovering over them, checking up on them, or going back to improve upon the job when it is finished.

4. Stop assuming unwanted responsibility, especially other people’s: For example, if their co-workers want to take up a collection and send flowers to their recuperating supervisor, they need to understand that they do not have to be the one to do it. Another example, if their daughters want to go to the mall, they do not have to drive them both ways or at all. If such nonessential activities are adding more drudgery and no satisfaction to your client’s life, tell them to stop doing them. Doing this will take even more pressure off and cut down on feelings of resentment if they stop doing things for other people that they are perfectly capable of doing themselves or that your client does not have to do such as picking up their children’s dirty socks from the floor, getting their husband’s shirts from the laundry, taking a co-worker’s calls when he is out of the office.

5. Combine or condense activities whenever possible: Suggest to your client that they pay bills while watching TV, or have their son do his homework in the kitchen so that they can help him while they cook dinner. Shop for groceries twice a week instead of three, help them learn how to organize errands so that they do the least amount of driving. These are just a few ways to combine or condense tasks and obligations in order for your client to save time and feel more in control of their life.

6. Reduce the amount of time spent “lost in thought”: As you know, the tendency for those suffering from depression to get lost in thought means it will take them longer to complete a task. Mentally drifting off into space is a difficult habit to break, but having your client purchase a watch with an alarm or an inexpensive kitchen timer may help. If they set the timer/alarm to go off after a specific amount of time or at fifteen-minute intervals, it will interrupt any trances they may have fallen into and get them back on track.

7. Respect your inner time clock: Your client probably knows from experience whether or not they are a morning person or that they seem to run out of steam at four in the afternoon and get a second wind by five-thirty or six. You can help them use this self-knowledge to their advantage and get more done in less time if they schedule complex or tiring tasks for the times when they have the most energy.

Adapted from Reclaiming Youth At Risk: Our Hope for the Future. Brendtro, Larry K., Brokenleg, Martin, and Van Bockern, Steve. National Educational Service: Bloomington, IN. 1990.

"Personal Reflection" Journaling Activity #3
The preceding section was about Adult's Who Don't Have Time. Write three case study examples regarding how you might use the content of this section of the Manual or the "Positive Reinforcement" section of the audio tape in your practice.

Update
Time Trade-Off Health State Utility Values for Depression:
A Systematic Review and Meta-Analysis

Balázs, P. G., Erdősi, D., Zemplényi, A., & Brodszky, V. (2023). Time trade-off health state utility values for depression: a systematic review and meta-analysis. Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 32(4), 923–937.

Peer-Reviewed Journal Article References:
Fernández-Theoduloz, G., Paz, V., Nicolaisen-Sobesky, E., Pérez, A., Buunk, A. P., Cabana, Á., & Gradin, V. B. (2019). Social avoidance in depression: A study using a social decision-making task. Journal of Abnormal Psychology, 128(3), 234–244.

Geschwind, N., Bosgraaf, E., Bannink, F., & Peeters, F. (2020). Positivity pays off: Clients’ perspectives on positive compared with traditional cognitive behavioral therapy for depression. Psychotherapy, 57(3), 366–378.

Schaerer, M., Schweinsberg, M., & Swaab, R. I. (2018). Imaginary alternatives: The effects of mental simulation on powerless negotiators. Journal of Personality and Social Psychology, 115(1), 96–117.

QUESTION 23
What is the most damaging proof of a child's unimportance? To select and enter your answer go to
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