The party line is cognitive behavioral therapy combined medication will do a whole lot of good for people with mental illness.  I’m sure it works for some people but not me.  A large part of that reason is I’m bipolar (cue sound of career being destroyed) and a dirty little secret of any mental illness worse than depression is they often can’t give you the most effective depression medications because it will trigger psychotic episodes.  Add to that the fact that a lot of the things therapists say make no sense to me at all.  Some follow below.

You have innate worth. Yes, in a paid helping professional’s office you have innate worth, but once you walk out their door things are different.  You can lay claim to self-worth but nothing will come of it unless others recognize this claim as legitimate.  What exacerbates self-worth issues is the disparity between claimed and effective self-worth.  You may think you’re worth something because your mom and your therapist think you’re so great but in the world where what car you drive and how you look are what matters your claims of self-worth won’t be recognized.  Then there is this cognitive dissonance because you have been primed to think you are entitled to self-worth.  This is a result of two systems, the helping professional’s and the real world’s, both working the exact opposite of each other.

You need to compartmentalize.  This is a curious thing to say as one of the symptoms of someone with a mental illness is the inability to do so.  If the underlying depression and OCD is not effectively treated (which it isn’t with me) than this is a useless thing to say.  People with mental illness are generally self-absorbed and take things personally so training them to be otherwise is difficult if not impossible.  Take rejection for an example—the rejection should not be taken personally, it just represents the sentiment of the rejector at that particular time.  Just taken as a single event ignoring everything else one could take this view.  But in the aggregate, once you compare the amount you are being rejected by that particular person verses how much others are, things get different.  Add to this the fact that culture has gotten nastier and personal attacks are more common and you see it’s hard enough for mentally healthy people to compartmentalize not to mention those with mental illness.

Go out of your comfort zone. Once again for this advice to be helpful depression and OCD have to be way under control.  If you dare go out of your comfort zone and things turn out not OK or bad you will be reminded of it constantly for a time proportional to the amount of discomfort the risk took.  For example if you tried asking a girl you liked out and things went bad you will be reminded of it constantly—the more you liked her the longer you’ll be reminded of it.  Therapists will tell you the reward of going out of your comfort zone is worth the risk but for people with depression and OCD the risk is a lot greater and more immediate.