What values do you have about the role of religion or spirituality in your life? What values do you have related to your physical health and emotional well-being? What does it mean to value self-care? Is this something you value? Why or why not? Psychoanalysis is a deep-exploration therapy whose beginnings originated with Sigmund Freud. It is the most intensive of all psychotherapies, requiring a passion and commitment to attending sessions four to five times a week. In this treatment, you and your analyst will peel away depressive symptoms to find their subconscious and conscious origins. Psychoanalysis is a long process, so it's not a first-line choice for acute depression intervention. It's also not generally a choice for children. Psychoanalysis can be a meaningful experience for adults who have stabilized their depression and want to work on understanding the subtleties and intricacies of their life. Psychoanalytic psychotherapy is a less intensive form of psychoanalysis. Though it retains the vibrancy and depth of psychoanalysis, psychoanalytic psychotherapy is shorter in its duration. In this treatment, you and your analyst meet two to three times a week to explore inner thoughts, personal struggles, and how you deal with crucial aspects of your life. Through interpretation and the study-ing of your defense mechanisms, you and your analyst will bring meaning to past and recurring events that keep you stuck. The reduction of depressive symptoms comes not only from learning about your personality, unresolved conflicts, and desires, but also from the changes you make in how you live your life as a result of your self-discovery. Unlike psychoanalysis, psychoanalytic psychotherapy is a viable treatment for children and teens. Psychodynamic therapy, also known as "insight-oriented therapy," is the least intensive of the psychoanalytic therapies. Psychodynamic therapy focuses on motivation, meaning, and the understanding of relationships in one's life. The immediate goals of psychodynamic psychotherapy are to label feelings and learn new behaviors by creating corrective emotional experiences.

In this treatment, a therapist meets with you once a week to work on these issues. The goal here is not only to reduce depressive symptoms but also to understand the underlying issues that might be contributing to your illness. Psychotherapy integration is not restricted to following a single school of theory and/or practice when treating mental illness. Psychotherapy integration believes that all types of psychotherapy share curative factors. Some of the approaches include technical eclecticism (in which one uses techniques from many different psychotherapy schools but is not concerned with following any particular theory) and assimilative integration (in which a therapist relies on one major school of psychology, but borrows from others). Most therapists who practice within a psychotherapy integration framework are willing to be flexible in their training to find what works best for their patients. The story of Angulimala shows us that sometimes people can appear very cruel and wicked, yet we must realize they are not that way by nature. Circumstances in their lives make them act in unwholesome ways. In Angulimala's case, he became a murderer because of his devotion to his teacher. For every one of us, not just violent criminals, there are countless causes and conditions--both wholesome and unwholesome--that make us act as we do. No matter where I go in the world, in any direction, may I greet people with happiness, peace, and friendliness. May I be protected in all directions from greed, anger, aversion, hatred, jealousy, and fear. When we cultivate loving friendliness in ourselves, we learn to see that others have this kind, gentle nature--however well hidden it might be. Sometimes we have The Buddha told the story of a monk who finds a filthy piece of cloth on the road. The rag is so nasty, at first the monk does not even want to touch it. He kicks it with his foot to knock off some of the dirt. Disgusted, he gingerly picks it up with two fingers, holding it away from himself with contempt. Yet even as the monk does this, he sees potential in that scrap of dirty cloth, and takes it home and washes it--over and over and over. Eventually, the wash water runs clean, and from underneath the filth and grime, a useful piece of material is revealed. The monk sees that he can, if he collects enough pieces, he could, perhaps, make this rag into part of a robe.

Likewise, because of a person's nasty words, that person may seem totally worthless; it may be impossible to see that person's potential for loving friendliness. But this is where the practice of Skillful Effort comes in. Underneath such a person's rough exterior, you may find the warm, radiant jewel that is the person's true nature. According to the Centers for Disease Control (CDC), for every one thousand people, approximately eight to nine hundred antibiotics are dispensed. At this rate--and our consumption of these drugs in the United States is shrinking compared to developing nations--it's not surprising that at least two million people annually suffer infections from antibiotic-resistant strains of bacteria. You might argue that antibiotics are critical to health care and resistance is an unfortunate side effect, and you would be right . The problem is that the CDC has also determined that nearly 50 percent of antibiotic use in US hospitals is unnecessary or inappropriate. This means we are unnecessarily creating a massive potential for disease outbreaks and a declining effectiveness of antibiotic treatment. Why? Because as we overuse and misuse antibiotics, certain diseases become resistant to the drugs, thus causing a proliferation of those specific diseases. The politics of antibiotic use and overuse aside, the fact remains that with so many people taking antibiotics, we're looking at the biggest cause of upset to the gut microbiome. It's part of the reason I said earlier that almost all Americans suffer from gut imbalance to some degree. While we may be healing certain illnesses through antibiotic use, we are also undoubtedly setting the stage for more to arise. Think of how an antibiotic works: you ingest this substance, and it goes after infection-causing bacteria like a bloodhound, then eliminates them from your system. The problem is that many antibiotics, especially broad-spectrum treatments, are more like bloodhounds with crop dusters. They hunt down those "bad" bacteria all right, but when it comes to elimination, they indiscriminately take out a lot of good bacteria as well. The most aggressive antibiotics can damage your system so thoroughly that some good strains of bacteria can't even grow back--sometimes not for years, and sometimes not at all, without being intentionally reintroduced. Perhaps you already know it's fairly common for a person taking a round of antibiotics to develop a yeast infection afterward. What's happening is that the antibiotic has killed off so many good bacteria, Candida strains (yeast) thrive and take over. Their reproduction is out of control.

The resulting infection is evidence of gut imbalance at work. This all brings us back to the act of listening - that simple yet for some reason overwhelming activity that will act as the foundation of all good conversation. Here's where things get simple (seriously!) Push away all of the thoughts that have been bugging you about the conversation. Pretend the person you're talking to hasn't had a single thought about you - this is a blank slate on which you can draw whatever picture you want. Now, honestly listen to what they have to say. A major problem many people have in conversation is getting lost on a topic. People will discuss the weather, the wellbeing of their families, their pets, local sports and recent news and then run out of topics. The well dries up and both people grow uncomfortable. Why does this happen? Because you aren't really listening to what the other person has to say. You'll be shocked by just how much information comes up in the course of regular conversation. People say things all the time that get left by the wayside. You have a thought in mind and want to say it, and therefore ignore whatever the other person has to say, plowing through and then ending the conversation as quickly as it started. Next time you feel uncomfortable in a conversation, try this instead: pay close attention to everything someone has to say. Now, instead of telling anecdotes about yourself or changing the topic to something you've had on your mind, ask questions or make comments about your partner's commentary. The idea is simple - you focus heavily on the input you're receiving and use that to frame everything you have to say. If you don't, you'll completely run out of things to say and of course become uncomfortable. With time, this technique will help you generate a much greater appreciation for the input you receive in a conversation. What do you imagine yourself following through on that would be part of your well-being recipe? After working through the questions, choose the top three values that you would like to focus on for the next 6 to 12 months.

Make sure to jot them down in your journal or on the downloadable form. This list will help you prioritize which choices to stick to your guns about in the chapters to come. When you find yourself debating "Should I do X?" or "Should I do Y?" you can ask if either is consistent with one of your top values and use that information to weigh whether or not to gently push yourself to approach the activity you value. Though it helps to intellectually know that an activity is consistent with your values, it's probably not enough motivation to change your behavior. When you also start to pay attention, in a systematic way, to how the choice to approach or avoid affects your physical or emotional state, then the decision-making process becomes a little more intuitive the next time and you can more easily understand your urges to procrastinate. If a valued activity led to a mixed bag of negative and positive emotional experiences (working out was miserable until you finished, but then you felt great), you'll probably have the urge to avoid it next time around. Anticipating this can help you plan it in a less stressful way (you always hate exercising in the morning, so you schedule it at night). Or you could schedule it in a way that facilitates showing up (you make a commitment to a gym buddy that you'll pick them up on the way and exercise together so it's more fun). If an avoidance activity wasn't so enjoyable (you flipped channels on the TV endlessly looking for something to watch instead of working out), that might help you remind yourself that collapsing on the couch isn't actually a good alternative. If the valued activity led to a positive emotional experience, you may be able to fight the urge to procrastinate in the future. Here's the rub. When you're struggling with low motivation or depression--even if you enjoyed the valued activity--your default mode is to remember that it didn't go well. You'll anticipate that doing it again in the future will be full of effort, and therefore it won't feel worth doing. The thing is, when you actually do show up, well-chosen activities tend to feel better than expected, maybe even enjoyable, relaxing, or fun. So it's vital to capture, in the moment, how you feel so your future self can remember it more accurately. You can use these documented, in-the-moment ratings to guide your decisions in the next hour, day, week, and so on. You can easily and effectively track your changing emotional experiences in everyday life using the graph in Figure 1. This encourages you to think about the different emotions you experience in terms of varying levels of arousal and valence. For me, one of the great things about training as a psychologist was the opportunity to explore different schools of theory and practice. I've had the good fortune to experience each one of these traditional therapies.