At a recent case conference, Dr. Aaron Beck met with a patient suffering from depression while graduate students watched the session via live video feed in another room. The patient expressed strong dissatisfaction with his job and career direction (even though he held an objectively desirable position). At the same time, the patient was depressed, and did not presently have enough initiative or belief in himself to alter his trajectory.

During the session, after hearing about the patient’s typical week and what was bothering him most, Dr. Beck began to focus on alleviating the most pressing current problem – depression. He asked, “if your job isn’t giving you satisfaction, what else could give you satisfaction?” Dr. Beck drew a pie chart on a piece of paper and asked the patient to tell him what proportion of his life was invested in his job. The patient answered “two-thirds.”

After more questioning however, the patient said that his family was actually much more important than his job, that in terms of what he valued, his family was 80% of the circle, and 20% was his job. Nevertheless, he felt that he would not make use of his talents if he focused on just his family. He wanted a satisfying career.

Dr. Beck then asked if the individual’s talent and ability to pursue a satisfying career were more likely to flourish if he felt happy, and created the right climate to nourish his potential. The patient agreed. They then came up with the following goals: 1) Create the right climate to realize potential. 2) Work on depression, which is suppressing talent. 3) Continue to maximize the satisfaction the patient obtains from being with his family.

They outlined several concrete steps to begin working towards these goals, and Dr. Beck talked about the Give/Get balance — that what you’re putting out in terms of obligation, worrying, etc. and what you’re getting back in terms of satisfaction, happiness, etc., have to be in balance, otherwise depression can ensue.