Submissive voices dominate in depression: assimilation analysis of a helpful session

Using the assimilation model, we describe a theoretical paradox in which interpersonally assertive parts of the depressed person's personality are dominated and suppressed by parts that are interpersonally submissive and passive. We examine the relevance of this paradox to therapeutic work, focusing on a particularly helpful session (according to the therapist) from the case of Joan, a woman seen for depression in cognitive-behavioral therapy. We consider how the therapist intervened to enhance communication between the interpersonally submissive and dominant parts of Joan and discuss the implications of this process for therapy with such clients.