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How does depression look like?

A 40-year-old client reports a poor mood, and says she experienced depression in the past. She told me about it when she first arrived. Now, at our fourth session, she does not speak, pushes back when I make an attempt at a conversation, sits squatting and tells me she is depressed. The room is silent. It is not easy for me, as a therapist, to be there. I decide to take out the therapeutic cards and ask her to choose one that best describes her 'depression'; a card that when she looks at it she can say: "what I see here reminds me of my depression". To my surprise, she chooses 3 cards, while asking me if it's permitted. I, of course, tell her it is ok. The first card shows a horse with appearing scars, "this is me", she says. I wait for her to elaborate. "My depression is like scars".

We start conversing, while looking at the card. At one point I ask her where is the horse located and she answers that he is on his way back to the stable. "Describe the stable", I say. She describes the stable as herself. A 40 year-old women, an accountant, successful in her profession. She adds that the image of the horse with the scars keeps coming back to her. Using her words, we talk about the cyclicality and how her depression comes and goes. The session ends. The following meeting, she shares with me that this week she sent her "scared horse" to a trip in the meadow, "I was trying to let him go free".

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