The Psychology of Healing and Treatment: 4 Ways We Can All Recover from Depression

“How do I heal?” is possibly the biggest question people ask after experiencing a setback. And I get it. Two months ago, I was diagnosed with depression, and, since then, I’ve begun my own journey of treatment and recovery.

But I believe there is no single right answer when it comes to mental and emotional healing. Healing is non-linear and multi-dimensional. Everyone heals at a different pace and in different ways. 

In her book Notes on Heartbreak, Annie Lord (a writer for British Vogue) confides in her friend, Diyora, about still being upset over a break-up. Diyora argues:

“Progress isn’t linear, though. If you plotted it onto a graph, it wouldn’t be this straight line up towards happiness. It would wiggle backwards, then forwards, up and down. You might feel worse in a month from now than you did a few weeks after it happened. But that doesn’t mean you’re not healing,” (pg. 358).

Diyora’s response is valid. First, we shouldn’t put pressure on ourselves to be at any stage of healing that we’re not already at. Second, healing isn’t always measured by feeling. There are multiple ways we see evidence of it. 

With that being said, there are psychological fundamentals of treatment that we can use to gain wisdom and help us. 

Side-note: I am not a qualified professional. I am simply a psychology student writing about what I love, and presenting research that has helped me. 

In this article, I want to offer you 4 ways to conceptualise healing and treatment, using recovery from depression as an example.

1. 5P’s Model

The 5P’s is a tool often used by clinical psychologists when conducting a psychological formulation of a client. 

If we were to represent the 5P’s graphically, we could draw a circle intersected by multiple lines surrounding it. The circle would represent the presenting problem while the surrounding lines would represent the various factors of the problem.  

The factors of a problem include the causes, consisting of predisposing factors (genetic or historic influences), precipitating factors (immediate triggers), and perpetuating factors (the thoughts or behaviours that maintain the problem).

Using the example of depression, the graph would look like this:

However, the factors of a problem also include the things that prevent or reduce the problem, called protective factors. These could include the people we have in our lives (our support networks) or the hobbies and activities that bring us enjoyment, purpose, or meaning. 

Protective factors are forces for change. In this model, healing happens when we build more and more protective factors, till the factors causing the problem are outweighed by the protective factors. This might involve participating in new activities, re-engaging in old hobbies, or strengthening existing friendships. 

2. Te Whare Tapa Whā Model

In 1984, Sir Mason Durie created a Māori framework for mental health and wellbeing called Te Whare Tapa Whā. Māori are the indigenous population of New Zealand. The framework conceptualises Hauora (well-being) as the four walls of a house or a whare (Māori meeting place): Taha Tinana (Physical), Taha Hinengaro (Mental), Taha Whanau (Social) and Taha Wairua (Spiritual). 

The main feature of this model is holistic wellbeing, which poses various dimensions of health. As in the 5P’s model, it posits that a problem has multiple factors. If one wall falls, the whole house is weakened. In the same way, if we are lacking in one aspect of wellbeing, our entire wellbeing is compromised. 

Depression is a psychological disorder that affects all aspects of wellbeing. It consists of low mood or loss of pleasure, affecting sleep and eating, causing isolation and irritability, and resulting in feelings of hopelessness or suicidal ideation.

Healing occurs when we optimize our wellbeing by strengthening these four walls. In my previous article, I listed eating a balanced diet, exercising, and getting enough sleep as examples of physically health-enhancing activities, but these activities also enhance our mental, social, and spiritual health.

Spiritual health is where you find purpose and meaning. It can come from prayer, mindfulness, creativity, or connecting with nature.

3. Stepped Care Approach

The Black Dog Institute determines the ideal treatment for an individual with depression by which step they’re on, depending on the severity of their symptoms. Those on Step 1, with mild depression, may find it most helpful to focus on self-help, through changing lifestyle factors and utilising alternative therapies. Those on Step 2, with moderate depression, may find it most helpful to engage in psychotherapy (or talk therapy) as well as health-enhancing lifestyle factors, and so on. 

The stepped care approach is similar to the Actions, Choices, Alternatives Model of treatment for major depressive disorder, which asserts lifestyle interventions and psychotherapy as a necessary action, medication as an optional choice, and physical therapies as an alternative last resort. 

In this approach, healing is “step-by-step,” utilising treatment until we no longer need it, ultimately descending the stairs. 

4. Recovery Approach

However, Health Direct defines recovery not as remaining well without treatment but as the improvement of life more holistically. “Recovery from mental illness is not the same as a cure. Recovery means being able to create and live a meaningful life and contribute to your community, with or without mental health issues.”

Their approach is in the realm of positive psychology, which is a field of psychology that shifts the focus from the pathological to the functional, from the harmful to the health-enhancing. 

Generally, the severity of depressive symptoms can be graphed as a likert scale, from severe (or happening frequently) on one end to none (not happening at all) on the other.

In the recovery approach, healing is to surround yourself with protective, health-enhancing factors, which may include clinical treatment. It doesn’t matter where you are on the scale — what matters is the trajectory you are heading in. 

How Do I Heal?

In Letters to Young People, psychiatrist Glen Colquhoun addresses each of his poems to one of his patients.

My favourite poem is The Far Paddock, in which he writes, “sometimes there is nothing to do but keep on going; that’s all the medicine there is to it.”

He compares healing to small, daily tasks: getting out of bed, getting dressed, and doing the dishes. “Hatred is a pile of dirty dishes, stacked like a city, all angle and filth, grubby towered and demanding. At some point we run the water, squirt the soap, pick up a cloth and begin.”

He describes mowing the lawns “in circles” — but it’s still lawn-mowing, and it’s still momentous. “Don’t underestimate the strength it takes to stand still, appear in your day each day,” he writes, promising, “one day you’ll arrive in yourself… and feel at home without ever knowing you’d left.” 

Healing isn’t linear, and it isn’t immediate. Sometimes we go in circles. Sometimes it’s messy. However we conceptualise healing, there is always strength in continuing — simply picking up a cloth and starting to scrub, completing the daily tasks we know we should do to make our lives a home.