Inertia and Shame

I often notice myself avoiding eye contact with Dr. X. Almost every appointment I begin by explaining how I am feeling and what has taken place the past week. During this time I always look away, staring at the corner of the door, or the books on his shelf; looking anywhere else but at the person I am talking with. During this time I almost always feel ashamed of myself. Ashamed for not getting better, ashamed of the way I act, ashamed for not doing the things I know I need to do to get better; like exercise, eat better, and spend more time with other people.

Usually about half way through my session I begin to feel less anxious and my gaze moves towards Dr. X's face. Yesterday this never happened. I spent almost my whole appointment staring at the bookshelf. I recognize this is a problem. My avoidance of eye contact is a reflection of my fears of being rejected by Dr. X., my low self esteem, and how much guilt and shame I carry inside me.

The last two sessions I have noticed that my chair has been positioned so it is directly facing Dr. X. If I sat in the chair as it was I would have a hard time avoiding Dr. X. Both times I have repositioned my chair so it faces away from Dr. X. I never thought he might have positioned the chair facing him on purpose until last night. Now that I think about it I think he intentionally positioned the chair so, when I sat down, I would have no choice, but to face him.

I have thought about this before. Part of why I move the chair is because I feel like I am too close to him (proximity wise) when facing him. I need more space. This feeling happened when I first began seeing him in another office. I began thinking he was moving closer and closer to me to test the veracity of my claim that I felt uncomfortable when others got to close to me. Now that I know him I do not think he was doing that. I believe he simply became more comfortable with me over time. I do however think he repositioned my chair the last few weeks. The chair was too sharply angled towards him.

This post is not to fault him for that, but to help myself participate in his scheme. I think it is unhealthy for me to avoid eye contact with him. I believe my doing this only serves to reinforce the feelings of shame and guilt I have about my increased inertia. My feeling this shame and guilt is like my buying into the scorn others heap on me about my not trying hard enough, not doing what I need to do to get better. This shame about who I am when severely depressed ignores such depressive symptoms as the severe inertia and amotivation that encompasses me when I am depressed and even the fact that the shame itself is a symptom.

I am going to address this in my next session. I have a difficult time challenging my avoidance of eye contact when I am in the moment. It is only afterwards that I regret missing the opportunity to address it. I will ask Dr. X. to help me take a behavioural approach to this problem, to help me redirect my gaze towards him when I speak; especially when I speak of things I feel bad about.

I believe if I can look at him while I tell him the things I feel ashamed about it may help dissipate those feelings of shame and guilt. I also believe by looking at him while talking I am asserting my self esteem and acknowledging that it is my illness, and not some lack of character on my part, that keeps me from becoming well. I am hoping a behavioural approach to this situation will reduce the amount of self-stigmatization I feel about having treatment resistant depressive symptoms.