Treating Depression

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specific emotional content of a stimulus can raise the threshold of the perception of that stimulus. These studies provide evidence that nonconscious processes may determine to a great extent what enters conscious awareness. Therefore, when a person is presented with a stimulus or situation, they may be upset not knowing why (since nonconscious thinking or evaluation may be involved). CBT, which relies on recognition and alteration of conscious cognition, may be ineffective here; however, hypnosis provides a tool for accessing nonconscious information. Integration of nonconscious information processing within the CDMD widens our understanding, assessment, and treatment of the depressive state. It was this realization that encouraged the author to combine hypnosis with cognitive therapy. Several techniques for dealing with nonconscious cognitive influence are described under the treatment section.

Other Factors in Depression

So far the discussion has centered on information processing in depression while no mention has been made of trigger factors (internal or external), or the role of biological variables, or the influence of early experiences that contribute to the genesis and maintenance of clinical depression. The important question still remains: what are the factors that contribute to the construction or exacerbation of the depressive reality? Schultz (1978) has suggested that undesirable life events may further contribute to the maintenance of the depressive cycle. Klinger (1975), however, points out that it is the symbolic transformation of these events that is the critical factor. He suggests that undesirable life events may serve as cues to past traumatic experiences. Depressives gradually not only become more sensitive to stimuli resembling past traumatic life-events, but their reactions may also generalize to innocuous events or situations. Such selective attending or anchoring may explain the low threshold of information processing to emotional stimuli in depressives. Through repeated and automatic anchoring, biogenic changes may occur. Schwartz (1976, 1977, 1984) has provided evidence for the development of certain neurological pathways due to conscious cognitive focusing. It is feasible that depressives through negative cognitive focusing develop depressive pathways. Individuals with anomalous developmental history (Guidano, 1987), and those who