中華心理衛生協會

Purpose: This study examines the subjective experience of depressive rumination, to descript an experiential structure of this phenomenon. Methods: A total of 5 patients (1 male, 4 female) diagnosed with a major depressive disorder and referred by a psychiatrist participated in this study. They all had the experience of thinking repetitively when feeling depressed. All completed the Beck Depression Inventory-II (BDI-II) and were interviewed by the researcher 1-2 times, for about 1.5 hours each time. Interviews were transcribed verbatim. Phenomenological analysis was used to analyze the text. Results: Our results indicated a general structure of perceived experience: ＂Daily life-Patient’s life-Suffering life＂. People with depression and disability experience themselves as existentially apart from their daily life. They experience a ＂suffering life＂ through: (1) a sense of disability and lack of control, and (2) comparing their suffering to daily life/other people’s lives. When people are suffering, they want to go back to daily life, to have life be as good as before. However, the process of ＂being good＂ is hard and full of frustration. Participants criticized themselves for living a suffering life. When they asked for medical service, they rejected the label of ＂patient＂, which to them means they would live a ＂patient’s life.＂ When people can’t return to a normal daily life, they feel conflict. They remain in a suffering state that is nameless. The experience of depressive rumination is the effort to make sense of this nameless suffering. However, this effort to make sense of things may cause them to live with much more distress and experience secondary suffering. After that, people make sense of their secondary suffering again. This creates the circle of depressive rumination and suffering. Conclusions: This article indicates that the effort to ＂make sense of my suffering＂ may explain the reason depressive rumination and suffering are sustained. Psychotherapists should help depressive patients explore their suffering and find a more adaptive way of making sense of their situation.