I want to dive into what is central to many of our depressed patients lives which is difficulty with motivation and commitment to change. When you think about it, people with mood disorders suffer from depressed mood, feeling sad, feeling hopeless, feeling helpless, feeling worthless, feeling like life is not worth living. So to get them to get inspired to kind of make significant change in the face of that psychological heaviness and pain is an incredible challenge for us as clinicians. So we have to think about first leaning in with a fair bit of validation of the pain that they're dealing with so they feel understood and that we recognize the depth and the severity of their pain.
And then try to find some moments where we can highlight reasons for living, life worth living goals, things that in the past they kind of were inspired to do or there's still some thread even in the present moment of things that they would kind of want to work toward. Because these need to be first identified, then highlighted, then amplified, and kept in the forefront of their minds. And in the DBT skills, we talk about mindfulness being effective and doing what works. We need to continue to come back to the patients and have them recognize I don't feel like moving, I don't feel like working on my application for a new job, and I know I've already talked with you, therapist, about what's important to me long term and how do we cut the cord between I don't feel like doing this and here are my goals that I still need to work toward in order to kind of change my life for the better.
So needless to say, you're gonna need to not only identify a goal, life worth living goal, and then ask are they committed to working on it. And hopefully in the first or second session, they will say yes. You may need to push through a little bit of resistance, I'm not sure, I don't know if it's gonna work and kind of instill some hope or what we call beginner's mind, let's see. We don't know, I don't know, you don't know, we don't have a crystal ball, but kind of keeping an open mind to the possibility that it can actually have an impact and that they might be able to give it a college try to see what what happens from it.
But as you can imagine, just because you have some commitment to kind of work on this on session one or two, by session four, five or six, that commitment may wane and they're like, oh, I don't know if I can do it. It's not changing fast enough, it's not working, and they fall into the hopelessness pool. And I think you as a clinician need to acknowledge that it is a big mountain for them to climb, it does take a lot of work, but it also takes a fair bit of persistence and perseverance and that you are going to walk arm and arm with them through this process to help them get there and recognize even incremental progress to positively reinforce and say, look at that, I like how you did that. Really catch them quote unquote being good and being skillful and being effective.
That to me from a behavioral standpoint will shape their behavior toward their longer term goal. And we're gonna acknowledge baby steps, recognize it, validate this is hard, and positively reinforce those steps as we go.