By Bill O'Hanlon W. W. Norton, 2014 Review by Leo Uzych, J.D., M.P.H. on Aug 19th 2014
Out of the Blue is a book about six, non-medication ways to relieve depression. The author, Bill O'Hanlon, is a psychotherapist; O'Hanlon is, as well, an inveterate writer of over thirty books. At the start of Chapter 1, O'Hanlon informs readers that he suffered a serious depression in his late teens; and that he considered suicide. Readers are informed further that the book is a medium for spelling out O'Hanlon's six strategies for relieving depression in order to make them more available to practitioners, depressed persons, and those who care for persons with depression. Each of the six strategies garners instructively informative, chapter-long attention.
The skilled writing pen of O'Hanlon applies ink to paper in stylistically plain English fashion.
A considerable number of research materials are referenced textually. Citations for textually referenced research materials, arranged alphabetically by author last name, are given in a "References and Resources" appendage attached to the far end of the text's body.
Expertly informed discourse by O'Hanlon, regarding the plethora of substantively embedded research materials, contributes materially to the book's quite considerable didactic value.
Numerous strands of therapist-client, sample dialogues, instructively germane to adjoining substantive matter, are likewise woven quite didactically into the textual tapestry.
A multitude of quotes, culled from an eclectic array of sources, contribute notably to the forming of the book's substantive composition.
Anecdotal matter, in the particular form of biographical details of O'Hanlon's life, are part of the book's composition.
O'Hanlon also recounts, anecdotally, details concerning some of his real life patients.
Although the insinuation of anecdotal data into textual crevices is very substantively animating, academically focused readers may observe cautiously that the suffusing of the book's body with anecdotal material potentially mitigates its academic vitality.
O'Hanlon's first strategy for reliving depression centers on marbling depression with non depression; and this thematic emphasis is the essence of Chapter 2. As O'Hanlon explains, in pithily encapsulated form at the chapter's start, depressed persons tend to have mostly depressing memories. And the first strategy of O'Hanlon for relieving depression involves going back and forth between depressing and non depressing experiences, marbling together different states. As the chapter unfolds, O'Hanlon, exhibiting the intellectually keen thoughtfulness that pervades the book in its entirety, discourses thoughtfully about acknowledging a depressed person's suffering, and inviting the person out of that experience (what O'Hanlon calls "Acknowledgment and Possibility"). Three techniques, in this respect, are explicated by O'Hanlon. The "inclusion" method of marbling is sighted next on O'Hanlon's intellectual radar screen; O'Hanlon focuses readers' attention on three techniques, appertaining to this method.
The strategy of undoing depression forms the substantive cynosure of Chapter 3. O'Hanlon explains, as the chapter starts, that this second depression relieving strategy involves getting depressed persons to shake things up by doing things that are not compatible with their depression. The goal is to undo depression and depressive brain grooving. In the frame of undoing depression, O'Hanlon peers with keen intellectual vision at what he views intellectually as: The Doing, The Viewing, and The Context of depression. The area of "positive psychology" also falls within the ken of O'Hanlon.
In Chapter 4, the roving intellectual eye of O'Hanlon spots a third strategy of shifting your client's (or your own) relationship with depression. This strategy, according to O'Hanlon, helps depressed persons develop a new relationship with depression and shift out of its grip. In this enframing context, O'Hanlon expounds enthrallingly on "mindfulness-based cognitive therapy". The pensive gaze of O'Hanlon ranges farther afield to the realm of shifting a relationship with depression by means of "externalizing". In contextually pertinent fashion, O'Hanlon discourses further on shifting a relationship with depression by means of self-compassion, and also by means of valuing depression. The view of O'Hanlon is that mining the richness of suffering may yield life enhancing treasures.
O'Hanlon's fourth depression relieving strategy entails challenging isolation, and restoring and strengthening connections. This strategy is the focus of Chapter 5. Seven pathways to reconnection are focused on by O'Hanlon. Two of the pathways are personal connections: connecting to the core self; and connecting to the body and the senses. Another two pathways are interpersonal connections: connection to another; and connection to a group or community. The remaining three pathways are "transpersonal" (meaning: beyond people) connections: connection through nature; connection through art; and connection to a bigger purpose and meaning or to God and the spiritual. Helping those who live with or take care of depressed persons is considered also in this chapter.
As Chapter 6 begins, O'Hanlon explains that the collapse of future mindedness is characteristic of depression. And the essence of O'Hanlon's fifth strategy for relieving depression is reconnecting a depressed person to a future with possibilities. In this regard, O'Hanlon proffers four methods. Two of the methods (described by O'Hanlon as : Problems into Preferences; and Positive Expectancy Talk) are language virus methods. A third method is encouraging a depressed person to write a letter to oneself from a post depression future. Starting therapy from a post depression perspective is the fourth method considered by O'Hanlon.
Restarting brain growth is O'Hanlon's sixth strategy; and this strategy is the subject of penultimate Chapter 7. According to O'Hanlon, one of the best ways to restart brain growth is to become physically active. The neuroatrophy/neurogenesis hypothesis of depression is examined expertly by O'Hanlon. As O'Hanlon explains, whereas exercise may help grow new brain cells, stress suppresses neurogenesis in the hippocampus. Possible ways to get depressed persons to get moving further attracts O'Hanlon's rapt attention.
In concluding Chapter 8, O'Hanlon comments on post depression thriving. O'Hanlon discusses, in this context, about: connection, compassion, and contribution. The chapter's gamut of engaging discourse extends to several possibilities for relieving depression (including: gaming, nutrition, vagus nerve stimulation, and deep brain stimulation).
In an Appendix following the last chapter, O'Hanlon comments pithily about five things a depressed person can do to lift depression.
Cautious readers may admonish that, although O'Hanlon's strategies for relieving depression are both thoughtful and potentially promising, nonetheless the need for rigorous clinical investigation of the possible clinical efficacy of O'Hanlon's strategies remains imperative.
The ideas of O'Hanlon should be of great reading interest to all persons with depression, and to their families and friends.
At a professional level, the great wealth of ideas put forth by O'Hanlon should especially be enriching, professionally, to psychotherapists as well as other mental health professionals.
Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University. His area of special professional interest is healthcare. Twitter @LeoUzych