How to Identify and Resolve Issues So You Get Better


What comes next is crucial in making your depression disappear — facing your fear. Dr. Gordon illustrates his treatment by describing “April,” a bright, talented woman who came to him in despair. Depressed over being stuck in a prestigious but oppressive job that made her miserable, she felt torn between her desire to find more fulfilling work and her fear of failure. For April — and many of his other depressed and anxious patients — Dr. Gordon suggested having a dialogue with the symptom, problem or issue (SPI) that felt most troubling to them. Acknowledging that this procedure may feel awkward and unnatural, Dr. Gordon urges trying it anyway. “It works,” he said. Sooner or later, your SPI will reveal to you the way to solve it.

Here are five steps in your dialogue with your symptom, problem or issue (SPI)…

  1. Schedule a half hour in a peaceful place where you know you won’t be interrupted.
  2. Sit quietly. Do soft belly breathing for a few minutes — in through your nose, out through your mouth. Ask yourself what SPI is most distressing to you. It could be physical pain, frustration at work or sadness about a relationship ending.
  3. Name your SPI with an initial, and use one for yourself. So, for example, fear of abandonment is “A,” and if your name is “Mary,” you are “M.” Now, begin the dialogue with “M” asking “A” why it is there… and “A” responding. Write it down as you go.
  4. Keep going, as fast as you can, with “M” asking questions and “A” responding for 10 to 15 minutes. Allow the dialogue to unfold, accepting whatever questions and answers appear, even if you don’t completely understand them.
  5. Now re-read what you’ve written and see how your SPI may have helped you understand both its causes and the solution to your symptom, problem or issue.


To illustrate how this process works, Dr. Gordon provided some examples. One was April, mentioned above, who feared leaving a job she hated. When she “talked to” her dilemma and imagined it talking back to her, it became clear that her fear stemmed from her mother’s taunts that she would fail and end up living in poverty. As she carried on the dialogue, the distress related to her overwhelming mother dissipated and her self-confidence grew. She eventually changed jobs and now has a career she loves. Another patient, a young businessman named David, suffered debilitating and undiagnosable stiffness in his neck. At Dr. Gordon’s urging, he began a dialogue with his stiff neck, becoming increasingly angry as he began to connect it with his domineering father. Without even realizing it, as he talked with his stiff neck, he began to punch the air while moving his head from side to side. He realized that these motions symbolized his struggle against his critical, authoritarian father and all the anger that he had held inside for so many years. “Hey,” David said, “maybe I ought to get a punching bag and do this every day!”

Next, Dr. Gordon helps his patients write their own very specific prescriptions — not for medications, but for self-care practices they already know or suspect will be helpful. One patient, Theresa, a seriously depressed 40-year-old single woman, prescribed soft-belly breathing for herself two to three times a day, five to 10 minutes each time. She committed to making her sporadic yoga practice regular, and reminded herself to speak daily or visit with her best friend. In addition, she prescribed for herself daily walks, Sunday church and cooking delicious, healthy food, even when she was dining alone. These prescriptions helped Theresa to overcome the helplessness and hopelessness that are hallmarks of depression. Each made a specific contribution to enhancing her biological functioning, improving her self-worth and linking her to the healing powers of faith and close human connection. David’s prescription included breathing exercises and an ongoing dialogue with his symptoms, in addition to regular anger-releasing sessions with his punching bag.


For those people taking antidepressant medication, it is important to realize you must not stop taking it abruptly — for this you must have the guidance and supervision of the prescribing physician. However, whether you are clinically depressed or just out of sorts, everyone can benefit from this method of communicating with yourself about your feelings.