The Sad Feelings

The session began with Denise describing the “sad feelings” she was having. The therapist al- most immediately started to elicit Denise’s au- tomatic thoughts during these periods.

THERAPIST: What kind of thoughts go through your mind when you’ve had these sad feel- ings this past week?

DENISE: Well, I guess I’m thinking what’s the point of all this. My life is over. It’s just not the same. I have thoughts like, “What am I going to do? Sometimes I feel mad at him, you know, my husband. How could he leave me? . . . Isn’t that terrible of me? What’s wrong with me? How can I be mad at him? He didn’t want to die a horrible death. I should have done more. I should have made him go to the doctor when he first started getting headaches. . . . Oh, what’s the use?

THERAPIST: It sounds like you are feeling quite bad right now. Is that right?

DENISE: Yes.

THERAPIST: Keep telling me what’s going through your mind right now?

DENISE: I can’t change anything. It’s over. I don’t know. . . . It all seems so bleak and hopeless. What do I have to look forward to . . . sickness and then death?

THERAPIST: So one of the thoughts is that you can’t change things, and that it’s not going to get any better?

DENISE: Yes.

THERAPIST: And sometimes you believe that completely?

DENISE: Yeah, I believe it, sometimes.

THERAPIST: Right now do you believe it?

DENISE: I believe it—yes.

THERAPIST: Right now you believe that you can’t change things and it’s not going to get better?

DENISE: Well, there is a glimmer of hope, but it’s mostly . . .

THERAPIST: Is there anything that you kind of look forward to in terms of your own life from here on?

DENISE: Well, what I look forward to . . . I en- joy seeing my kids, but they are so busy right now. My son is a lawyer and my daughter is in medical school. So, they are very busy. They don’t have time to spend with me.

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