I don't relate well to "themes" in therapy. I don't mean to be critical; I just speak for myself. A theme to me is a cognitive symbol, and it is a complex representation that stands for something more real, something that moves with life, feels gritty, smells sweet, or tastes bitter. A theme is a fiction, and it often forms the third point in a triangulation of contact between therapist and client. It's as if they collude with one another to talk about the theme rather than to actually meet one another in the moment. Themes may lend themselves to cognitive manipulations, but they don't facilitate dialogue. Depressed people can be helped by focusing on the way they think and by challenging automatic thoughts, but that has to take place within the context of the therapeutic relationship, which gets us back to such things as contact and the immediate experience of being "with" another person. That's not a representation or a symbol. It has a lot to do with the pre-conceptual flow of one's experience - ie, with phenomenology.