In mental health, the technique you use doesn’t matter. Gestalt, Kleinian, cognitive-behavioral. What really makes the difference is how you view the symptom. That’s where psychiatry splits in two. Either you see the symptom as a deficit that needs to be eliminated, or you understand it as a defense. If you see it as a problem to remove, treatment aims to get rid of it. The patient takes a passive role and the intervention is usually pharmacological. Delusions, crying, or withdrawal are suppressed. But the cost is often high. The person loses energy, motivation, and strength to sustain themselves. It’s not depression itself. It’s being left empty after others decide what is “excess” in you.

If the professional sees the symptom as a defense, the approach changes. That distress is your way of surviving. It’s the resource you have to handle the anxiety. The first step is to respect it. Ask why you need it, what function it serves in your life. It’s not about celebrating it, but understanding it. Until you have another way, that defense is your support. The clinical work is to accompany you until you can build something different. Here the patient is not passive. They participate. They are recognized as someone trying to protect themselves, not as someone failing. And from that perspective, the treatment also changes.