5/4/09

fore-word

This essay draws on semiotic, noetic and psychanalytic perspectives to undermine and deconstruct the psychiatric understanding of ‘depression’ as the presence of some ‘thing’ in need of 'treatment' or 'management'. In direct contrast, I present an account of depression that understands it as rooted, not in the presence of some ‘thing’ but in its absence – in a felt but still unformed awareness of a missing or lost dimension of our lives, a ‘no-thing’.

In the annals of the psychiatric literature, the word ‘depression’ is used thousands if not millions of times, as if it were some ‘thing’ in no further need of explication - and without the question ever being raised as to what this ‘thing’ called ‘depression’ essentially IS? Yet at the same time psychiatric explanations of ‘depression’ and authoritative professional guidelines to its ‘treatment’ or ‘management’ abound. Hence the significance of the simple truth made clear by the German thinker Martin Heidegger:

“All explanation presupposes a clarification of the essence of what it is that is supposed to be explained … What good is all explaining if what has to be explained remains unclear.”

what’s in a word?

If a salesman or Jehovah’s Witness comes to the door we already have an idea of how they will speak – as if reading aloud from a script, or by simply citing scripture. We actually hear and feel how they are not actually using words to express themselves as individuals so much as engaging in a type of ventriloquy – letting Biblical words speak for and in place of them. Yet it is not just sellers of wares or scriptures that do so. Doctors, psychiatrist, business people and professionals of all sorts are often so immersed in their own professional languages, jargons and terminologies that in a certain way they inhabit these languages – live in them.

In front of the Jehovah’s Witness many non-Christians might feel awkwardly stuck for a simple yes-or-no answer when asked if they believe that God exists, or that Jesus was the ‘Son of God’. This stuckness does not necessarily mean they don’t have their own beliefs about religion. Instead, it has more to do with a question hidden or concealed by the question put to them. The hidden question is what words such as ‘God’ and ‘Son of God’ are understood as meaning – both in general and to the particular person using them - or posing or answering questions about them?

For the trap concealed in such questions as "Does God exist?" is the all-too-common assumption that we all already know in advance how the meaning of a particular word such as ‘God’ is to be understood. What this assumption rules out in advance is any deeper questioning of what is or could be understand by a whole range of commonly used words or terms – whether religious words such as ‘God’, scientific words such as ‘energy’, or psychiatric terms such as ‘depression’ etc. It is simply assumed that such words refer to some pre-given thing or being whose nature we all agree on. To simply give a yes-or-no answer to such seemingly simple questions as ‘Does God exist?’ or ‘Is this person suffering from depression?’ is to collude with this assumption - the assumption that we all already know what it is we are talking about in using such words or terms as ‘God’ or ‘depression’. This assumption goes hand in hand with the assumption that language is itself just some ‘thing’ – a mere tool which we use to name and describe, express and explain other things. Yet language itself is no ‘thing’ - reducible to a set of sounds, letters or words. Nor is language something that 'we' speak. Instead, as Heidegger remarked, language itself speaks, and is the "house of being". Each of us inhabits a particular framework or 'house' of language, one that just as much speaks for us - indeed speaks us - as we speak it.

We do not just speak words, using them as tools to express our ideas and experiences. Words themselves also speak us – shaping and colouring the very ideas and experiences that we assume we are simply using them to describe, name or ‘express’. So whether faced with a salesman, doctor, counsellor or psychiatrist we should always be aware of the question ‘who speaks?’ or ‘who is speaking?’ For the answer is often not the person actually speaking but their language – the words or terms that a person lives by - and the ‘things’ that they unquestioningly take these words to refer to.

The whole authority of medical professionals in particular rests on our assuming that they know what it is they are talking about when they use specific medical or psychiatric terms – when in reality they are the very last people to even begin to question the meaning of these words, so well-trained have they been in just seeing the world through these words (dia-logos). Their world-view therefore, like everyone else’s – is essentially a ‘word-view’.


the thing with words

Society quite literally ‘has a thing’ with words. The ‘thing’ is, no sooner has some new word or term been coined and become common currency in everyday language than we assume it refers to some ‘thing’ that has always existed – even before we had a word for it. So it is with the word ‘depression’, which is not just taken as a way of feeling, a subjective state or a set of symptoms but used to denote some object or ‘thing in itself’ – a ‘disease entity’. Paradoxically, the very ‘things’ we think we have clearly and cleanly circled with words only become ‘things’ through the act of circling them – of running word-rings around them. Thus ‘feeling depressed’ becomes the symptom of some ‘thing’ called ‘depression’. Doctors and psychiatrists then explain this thing in terms of some other thing such as a serotonin deficiency in the brain. A practitioner of ‘complementary medicine’ on the other hand, would search their own vocabulary or ‘word-world’ for the explanation – coming up with a phrase such as ‘vitamin deficiency’, ‘energy blockage’ or ‘lack of chi’. Similarly, a shaman or witch-doctor might say that a depressed person was possessed by a malign ‘spirit’ of some sort or the victim of a curse. When it was the word of The Church that ruled large parts of world, it was the universally accepted norm to understand all illness as payment for past sins. And just as in some supposedly ‘primitive’ societies it still is the norm to blame symptoms on malign spirits, so does our supposedly ‘rational’ and ‘scientific’ culture blame many illnesses on harmful bacteria or viruses – even though our bodies are full of them all the time.


word-worlds

The worlds that most people live and work in are not made of concrete and glass, bricks and mortar, but of words. Doctors and psychiatrists for example, don’t just work in surgeries or hospitals. Cleaners or hospital caterers do that. Doctors and psychiatrists, on the other hand, work within a world of words – the ‘word-world’ of medical terms, labels and explanations. And it is this word-world of their work that rules their work.

For most people the limits of their language are, as the philosopher Wittgenstein suggested, the limits of their world. That’s why feelings or questions that they can’t express in words may feel to them as ‘unworldly’ - so much so that they might even end up trying to explain them as something caused by hidden or unworldly beings - by extra-terrestrials, secret governmental agencies or evil or demonic spirits. The fact that a feeling can’t be immediately expressed in words leaves them with a question. Yet instead of giving themselves time to feel the feeling itself as a wordless question, and to find their own words for that question, they grasp for words which provide an explanation of the feeling. In this way they come up with ready-made answers for why they are feeling the way they are - yet without having begin to ask themselves what question or questions it is that may lurk behind those feelings. In a word - people use words to come up with answers without first of all finding words for the questions they are feeling. They do this by circling things with ready-made or off-the-shelf words and phrases drawn from different established languages or vocabularies – different ‘word worlds’. It doesn’t matter which word-world the words they circle their feelings and experiences with come from – whether that of psychiatry, some area of medical science, some form of psychotherapy or some type of ‘complementary’ medicine. The process is the same.


the medical word-world


Psychiatrists and doctors in particular are paid to circle or pigeon-hole things in words - in diagnostic categories for example. If the experience of a large enough number of people nevertheless defies classification in terms of existing, neatly separated diagnostic categories - for example the separation of ‘Depression’ from ‘Anxiety’ - then all that medical professionals do is create a new term (for example ‘Depressive Anxiety’) with which they can continue to comfortably and authoritatively encircle or ‘ring-fence’ those people’s experience. In this way, not just new words and terms but whole new word-worlds are eventually created. Modern science, not least in the form of ‘scientific’ medicine and psychiatry are characterised by jargon-filled ‘scientific’ word-worlds that bear little relation to the words used in previous eras to understand the nature of health and illness. These scientific word-worlds and their vocabularies of word-circles are treated today in exactly the same way as the Word of the Bible and of The Church used to be – as unquestionable representations or symbols of truth.

In the past, doctors who ‘diagnosed’ a patient’s symptoms as signs of such a ‘thing’ – a hidden disease entity that was ‘causing’ them - were regarded by the rest of their profession as unprofessional quacks. Nowadays it is the other way round. A doctor not able to diagnose and label and ‘test’ for a possible disease entity such as ‘cancer’ (or ‘depression’) would be regarded both by himself, the patient and others doctors, as a failure. And it would be doctors who did not seek simply to diagnose or label a disease, but instead gave themselves time to listen longer and more deeply to the words of their patients themselves – taking heed of how they described their inwardly felt ‘dis-ease’ – who would be regarded as unprofessional quacks.

Not having time to listen however, today’s doctors often diagnose patients whose symptoms or dis-ease they can’t pigeon-hole as suffering from a ‘thing’ called ‘depression’. Or if depressive or anxious feelings are the very the symptoms that a patient ‘presents’ with, they are either dosed with medications or packed off to counsellors or psychologists who will actually have a bit more time to listen, and with whom patients can then talk ‘about’ those feelings. In practice this often means receiving a short-course, quick-fix course of ‘thought correction’ of the sort now pompously termed ‘cognitive therapy’. This is based on the belief that depressive feelings have nothing to do with negative aspects of the real world but are nothing more than a result of unnecessary negative thoughts arising in response to that world.


be-aware

The message of this essay to anyone who believes or has been told they are suffering from a clinically diagnosed psychiatric condition or ‘mental illness’ of any sort is - beware. ‘Beware’ means ‘be aware’ – in particular be aware that just because there is an accepted diagnostic word for something does not mean there is actually some ‘thing’ corresponding to that word. If people are not sufficiently aware of this – they may all too easily become trapped in the word-circles and word-worlds of psychiatry and its diagnostic terms. And yet even if they avoid or manage to escape from the trap of this particular word-world, without this type of awareness, they might simply end up trapped in the word-worlds of some other form of medicine, psychotherapy or ‘healing’.

Yet where would we be without such word-worlds, religious or scientific? Would we not simply be left again with the seemingly unanswerable question of how to find words for wordless dimensions of our feeling experiences of the world? It is because all of us face this question in one way or another that we all make use of words to circle and make sense of our wordless experience of ourselves and the world around us.

Is there any way out of entrapment in word-circles and word-worlds, besides running from one to another, and in this way quite literally running around in – within – different word-circles and word-worlds? Yes there is. It is the way of the poet and thinker rather than the officially sanctioned priest, healer, psychiatrist or ‘scientist’. For true poets and thinkers don’t instantly ‘run rings’ around their experience with ‘word circles’ drawn from their own unquestioned ‘word-worlds’. Instead they look for – or rather patiently await and feel for – their own words. Their aim is to create a word-world that truly expresses their world, as they actually sense, feel and experience it on a wordless level. Or else they patiently feel for and seek to formulate – in their own words – the deeper questions they sense lurking within their own experience and their own feelings. We do not need to be poets and thinkers to do this, but we can follow their example in seeking our own words for our own experiential and emotional worlds.

Of course ultimately nobody ‘owns’ words – for by their nature they are not private property but part of a shared language. From this point of view it may appear to make no sense to speak of poets and thinkers finding their ‘own’ words for their experience of the world – unless we mean only that they are not letting themselves be trapped and encircled within the rigid boundaries of unquestioned but officially recognised word-worlds i.e. terminologies and jargons of any sort - spiritual or scientific, medical or psychiatric. Beware then – be aware – of words, of the unquestioned word-worlds they belong to - and of the word-circles they can entrap your unique world of feelings and experiences in.


the word ‘depression’

The word ‘depression’ derives from the Latin verb depressus, past participle of deprimere (to press down, weigh down, dig down or dig deep). As a noun, the word ‘depression’ means ‘a deepening, a ‘digging down’, ‘pressing down’ or ‘weighing down’.

de- (down, away) and premere (to press)

‘Depression’ is one word belonging to a family of everyday nouns, verbs and phrases that include deep, depth, pressure, suppression and oppression, to oppress or suppress, to press or pressure, or to feel pressed or pressured. It was only in the 1950’s that doctors and psychiatrists first started to use the word ‘depression’ to denote some ‘thing’ – firstly a classified psychiatric disorder, and secondly the ‘thing’ that was its supposed cause – a purely hypothetical, invisible and still unverifiable deficiency in the brain of a ‘neurotransmitter’ called ‘serotonin’.

If someone says that they feel heavy, fatigued, drawn or ‘weighed down’ by the pressures of life we know what they mean. That is because the words they use speak for themselves in a vocabulary of the senses – their own directly felt sense of themselves. The same applies if people speak of being in a ‘dark’ or ‘black mood’, of falling into a ‘black hole’, or of seeing no ‘light’ at the end of the tunnel. Here again they are using a vocabulary of the senses – in this case of light and darkness. That does not mean that the words or phrases they employ are just ‘metaphors’. People who feel depressed really do feel an inner darkness, blackness, weight or heaviness in themselves.

For the medical and psychiatric professions however, how people actually sense themselves and their bodies from within – subjectively - is not what it’s all about. Instead it has to be explained by some hidden ‘thing’ - an object that is ‘causing’ them to feel that way. This view lends itself to medical treatments aimed at ‘removing’ this object – even though it is essentially no object or ‘thing’ at all but a subjective way of feeling.

Unless people are prepared to acknowledge meaning in the way they feel, they will be tempted to look for ways to mentally negate ‘negative’ feelings or medicate them away. That itself is a paradox, for feelings as such are no more ‘positive’ or ‘negative’ than colours. What we call a ‘negative’ feeling is really a feeling we would rather not feel and therefore actively seek to negate in different ways, whether by simply suppressing it, or experiencing it as a generalised state that is then labelled as ‘anxiety’ or ‘depression’. And paradoxical though it may sound, the most ‘positive’, freeing and empowering response to any ‘negative’ feeling is precisely not to negate it but instead to positively affirm it; not to try and free oneself of it but to freely and decisively choose to feel it - indeed to choose to feel it even more strongly rather than less, and attending principally to where and how one feels it in one’s body. For the self or ‘I’ that proactively and positively chooses to feel a ‘negative’ feeling is distinct - in principle – from that ‘I’ which merely suffers or feels overwhelmed by that feeling, or is so identified with it (‘I’-dentified) that it cannot, in principle, become free of it.


the medical denial of meaning

After the 2nd World War a concentration camp survivor called Victor Frankl wrote a book drawn from his observation that those who bore the ongoing psychological and physical trauma of the camps best were those who sought, found or felt that there was still meaning in their lives. As a result Frankl disputed the idea that the human being was driven either by sex drives or by a will to ‘be happy’ and argued instead that happiness was a mere by-product of that deeper drive that he called ‘The Will to Meaning’.

As we have seen, the word ‘depressed’ is part of a word family that includes the words deep and depth. Could it not be that language itself is trying to tell us something here – namely that ‘depression’ itself might have a deeper meaning – not as a mere disorder of the brain but as a specific way of feeling that tends to lead us back down into the innermost depths of our being? Underlying the whole ‘medical model’ approach to both ‘mental’ and ‘physical’ illness however is a basic belief which can be seen as the most sacred dogma of modern medicine. This is the belief that any sort of symptom or felt ‘dis-ease’ has no deeper meaning – except as a sign of some medically recognised disease. That is why medical professionals make no attempt whatsoever to explore the personally felt meaning or ‘sense’ of a patient’s symptoms. For this would require them to inquire much more about the life context in which they first emerged and to seek to make sense of them in that context. Instead, doctors and psychiatrists take symptoms merely as diagnostic ‘signs’ or ‘signifiers’ of some ‘thing’ – the mysterious ‘disease entity’ again. Every symptom has meaning or significance to them only in terms of some already signified medical sense. The doctor’s medical catalogue of already signified senses (potential ‘diagnoses’) rules out from the start any way of helping a patient explore or understand the sensed significance of their symptoms – the meaning or sense they themselves might personally feel or discover in them. This replacement of directly felt sense or significance with already labelled or signified senses belongs to the very essence of the medical-model approach both to somatic and ‘mental’ illness or ‘disorders’ – not least 'depression'.


the depression ‘thing’

Most people know what it means if someone says they “feel depressed”. They know it from their own experience. That ‘knowing’ is therefore innately ‘scientific’, since it is ‘evidence-based’ or ‘empirical’ in the most direct sense - coming from the direct evidence of people’s immediate sense of themselves, a sense that takes the tangible form of sensations such as feeling pressed or weighed down, heavy, dark etc.

‘Feeling depressed’ then, is a self-evident subjective experience that no one can deny or invalidate - and that no medical tests are needed to ‘prove’. To take it as a sign of some thing called ‘depression’ is quite another thing however. And to then explain that ‘thing’ as a product of some other thing that a person does not feel or experience directly (a defective gene or lack of serotonin in the brain for example) is not ‘evidence-based’ science in any sense of the term but medical mystification. It does not ‘make sense’ of depressive symptoms but quite literally makes ‘non-sense’ of them – attributing them to some ‘thing’ that is not actually sensed at all, like a serotonin deficiency in the brain – itself something scientifically unverified.

Arguing that depression is caused by a lack of serotonin or some other neurotransmitter is like arguing that just because cocaine gives people a high and makes them feel good, feeling low or depressed ‘proves’ that they lack cocaine in the brain. Diagnosing people who feel depressed as suffering from a ‘thing’ called ‘depression’, and then prescribing them legal drugs (so-called SSRI’s or ‘selective-serotonin-reuptake-inhibitors’ such as Prozac) is therefore like prescribing people illegal drugs such as cocaine. In fact, from the evidence of the awful, acute and often chronic side-effect of such ‘legal’ drugs it is far worse. The fact that this evidence is not merely ‘anecdotal’ (such a useful word in ‘scientifically’ dismissing the evidence of so many patients’ actual experience) is proved by the bizarre paradox that pharmaceutical companies are legally bound to warn users of ‘anti-depressants’ that their side effects might include suicidal thoughts. Unfortunately this warning has proved all too true in far too many cases – not least in the form of countless actual suicides or acts of self-harm violence towards others.


prejudicial words

Society officially frowns on the use of illegal drugs – whether ‘uppers’ or ‘downers’ – even whilst pharmaceutical companies make huge profits from the legal prescription of both types of drug in the treatment of ‘mental illnesses’. Society also officially frowns on the stigma attached to ‘mental illness’ and on prejudice or discrimination towards them – not least those suffering from the variety of ‘disorders’ known as ‘depression’. Yet we need only consider everyday words and phrases to see how this prejudice is part of everyday language use itself. Just as in Orwell’s famous book ‘Animal Farm’, the slogan of the revolutionary pigs (later reversed) was ‘Four legs good. Two legs bad’, so in ordinary language can we find a hidden slogan: ‘Up is good. Down is Bad’. This slogan takes many different forms, for example ‘High is good. Low is bad.’ This message finds expression in countless common phrases:

‘Feeling low’ (bad), ‘a high point’ (good), ‘a low point’ (bad), ‘high status’ (good), ‘low status’ (bad), ‘a record high’ (good), ‘a record low’ (bad), ‘going up in the world’ (good) ‘going down in the world’ (bad), ‘coming up with something’ (good) ‘coming down with something’ (bad), ‘standing up for something or someone’ (good), ‘standing down’ or ‘letting someone down’ (bad), to ‘upgrade’ (good), to ‘downgrade’ (bad), ‘upturn’ (good), ‘downturn’, (bad), ‘upbeat’ (good), ‘downbeat’(bad) etc. Whilst the clichĂ© goes that everyone has their ‘ups and downs’ in life, the linguistic prejudice remains that ‘Up is good’ and ‘Down is bad’. ‘Heaven’ itself is seen as ‘up’ there in the ‘highest’ spheres, whereas Hell is seen as ‘down below’ in the lowest depths. Here we find a hint of yet more slogans or mantra concealed within language itself: ‘Above is good. Below is bad’. ‘Rising is good. Falling is bad’. Thus we rise up into the heights of success or Heaven itself, whereas we fall into the depths of Hell or failure - for ‘to fail’ is a verb whose root meaning is ‘to fall’. Given all this prejudicial language it is no wonder that people find it difficult to admit to feeling ‘low’ or ‘down’ or ‘depressed’ – let alone extremely depressed – and may indeed feel all the more ‘depressed’ just for feeling ‘low’ or ‘down’ in the first place. For just doing is to go against the prejudicial grain of language that tells us that ‘Up is good. Down is bad’, ‘High is good. Low is bad’ - thus making people who feel ‘bad’ or ‘low’ not only ‘feel bad’ but feel bad - as if they were literally lowdown ‘losers’ or ‘failures’.


whatever happened to ‘melancholy’?

In the past ‘depression’ was referred to in the West as ‘melancholy’ or ‘melancholia’. Melancholy itself was understood as one of the four basic ‘temperaments’ (the sanguine, phlegmatic, choleric and melancholic) that made up human nature, and each of which could be a more or less dominant element in each individual’s make up. The term melancholy comes from two Greek words (melas and kholĂ©) which meant ‘black bile’ – this being one of the four basic substances or ‘humors’ to be found in the human body. As a temperament or humor, melancholy was acknowledged as an intrinsic and basic aspect of human nature and of the human body, corresponding both to one of the four humours, to one of the four elements of nature (earth) and to one of the four seasons (autumn). Unlike ‘depression’, melancholy was not simply seen as something alien to the human being, human body and human nature – an unnatural bodily disorder or dysfunction of mind in need of ‘treatment’. Similarly, in India, the symptoms associated with ‘depression’ were understood as expressions of ‘tamas’ – this being one of three basic and natural qualities or ‘gunas’ of the soul, also associated with the colour black, along with feelings of inertia, lethargy, heaviness, and darkness of mood. Though the symptoms of melancholy or ‘melancholia’ as a ‘disease’ or ‘distemper’ have been recognised by physicians for millennia, since Aristotle onwards it has also been associated with great achievement, creative genius and deep wisdom. Indeed the 19th century philosopher Friedrich Schelling wrote of “the deep, indestructible melancholy of all life.” Similarly, perhaps the greatest 20th century philosopher - Martin Heidegger –wrote that philosophy as such was founded in a “fundamental mood” of melancholy.

It was Freud however, who presented the first modern and purely psychological analysis of melancholy, in his essay entitled ‘Mourning and Melancholia’ (1915). In this essay Freud compares and contrasts the nature of mourning and melancholia.

“It is well worth noticing that, although mourning involves grave departures from the normal attitude to life, it never occurs to us to regard it as a pathological condition and refer it for medical treatment. We rely on it being overcome after a certain lapse of time, and we look upon any interference with it as useless or even harmful. The distinguishing mental features of melancholia are a profoundly painful sense of dejection, a cessation of interest in the outside world, loss of capacity to love, inhibition of all activity...a lowering of the self-regarding feelings to a degree that finds utterance in self-reproaches and self-revilings, and culminates in a delusional expectation of punishment.”

The thesis of Freud’s essay is that melancholia is similar to mourning, being fundamentally a response to a grievous experience of loss. What distinguishes mourning and melancholia however, is that "In mourning the world has become impoverished and empty, during melancholia, it is the ego itself.” The ego direct its feelings of reproach toward the object of loss not towards that object itself (for example a lost person) but towards itself – feeling itself as lost or as the “shadow” of the lost object. In essence, melancholia arises from a denial or lack of awareness of what has been lost.

“One cannot see clearly what it is that has been lost, and it is all the more reasonable to suppose that the patient cannot consciously perceive what he has lost either. This, indeed, might be so even if the patient is aware of the loss that has given rise to his melancholia, but only in the sense he knows whom he has lost but not what he has lost in him. This would suggest that melancholia is in some way related to an object-loss which is withdrawn from consciousness, in contradistinction to mourning, in which there is nothing about the loss that is unconscious.”

People suffer from unaware feelings of loss or absence of all sorts – loss or absence of love and understanding, of an authentic sense of self, of lasting and fulfilling relationships - and last but not least, a feeling of connection with the universe and with the divine. Freud’s fundamental distinction between mourning and melancholia sheds light on an important characteristic of ‘depression’ as a feeling rather than as a disease entity. For whereas in mourning the mourner might, through completing a process of grieving, eventually come to find renewed meaning in the world of human life and relationships, the depressed person is ‘shadowed’ by a sense of loss or absence of meaning which (quite literally) nothing in the world can make up for - for it is not consciously bound up with the loss of some easily identifiable thing or person.

As a result, the individual experiences a fundamental loss or absence in their sense of self, what Freud termed ‘the ego’. “Thus, the shadow of the object fell upon the ego, and … object-loss was transformed into an ego-loss.” In response, and unlike the mourner, the melancholic becomes ever-more ‘narcissistically’ self-oriented – in an attempt to be that which fills their own sense of an inner void or absence, or else to obtain it from the world. For we live in a world dominated by a an egotistic and narcissistic culture in which consumer commodities are presented as essential foundations to or enhancements of our sense of self, as well as boosts to our social status and self-esteem. Indeed people actually speak of ‘retail therapy’. Both retail commodities and psychiatric medications have today become the principal, culturally ‘prescribed’ means of filling a felt void or absence at the heart of our soul or psyche, and of maintaining a connection with the world in the face of loss or absence – not however, the real world of living human relationships but a world of material commodities and medical treatments. This is a world far removed from the values of freedom, creative achievement and philosophical wisdom hitherto seen as latent in the mood of melancholy itself – not despite but through its burdens.
“Freedom is only to be found where there is burden to be shouldered. In creative achievements this burden always represents an imperative and a need that weighs heavily upon man’s mood, so that he comes to be in a mood of melancholy. All creative action resides in a mood of melancholy, whether we are clearly aware of the fact or not, whether we speak at length about it or not. All creative action resides in a mood of melancholy, but this is not to say that everyone in a melancholy mood is creative.”

Martin Heidegger


depression and ‘no-thing-ness’

A famous German poet once wrote: ‘Where word breaks off no thing may be.” Reversing this motto it would read: “Where thing breaks off no word may be.” ‘Depression’, though it is itself a word is essentially a wordless state – sometimes leading an individual into a total speechlessness or muteness. Whence this wordlessness or speechlessness? One important reason is that whilst we have words for things that are actually there – present - we don’t have words for the feeling of something or someone not being there, for a sense of absence. Similarly we don’t have words for an absent or unthought thought or an absent or unfelt feeling. Just as we also don’t have words for an absent sense of self or of our own bodies - for a sense of being ‘no one’, ‘nothing’ or ‘nobody’. With this in mind, it is worth asking if the whole idea of ‘depression’ as some ‘thing’ – one that can in turn be explained by other things - might not be the very opposite of the truth, or rather its mirror image? For what if, in contrast to this idea, the very essence of depression lies precisely in a felt absence of something or someone, or alternatively in the experience of being mistreated or abused as a mere ‘thing’ or ‘body’ – and thus effectively treated as ‘nothing’ and ‘nobody’? This would account for the way in which ‘depression’, far from being a ‘mental’ state or mental ‘illness’, is a state which pervades our entire felt body, in this way helping us to feel our own self more fully - not just as a bodiless mind but in a fully embodied way, as ‘some-body’. It would also account for the close relation between the depression and mourning – for though we may name the person we have lost, the feeling of their bodily absence is not itself anything nameable – it just weighs or presses down on us, leaving us feeling ‘de-pressed’. What ‘presses’ or ‘weighs down’ upon the ‘de-pressed’ person then is no ‘thing’ but the absence of something, an absence that, by its very nature, cannot be expressed in words.

Considerations like these make the very word ‘depression’ into a very paradoxical one of the sort that certain types of language theorist call a ‘floating signifier’. This is a sign or symbol that is said to ‘float’ because it does not refer to or ‘denote’ any actual or definable thing - because there is nothing ‘signified’ by it. The same considerations also make the ‘thing’ that is called ‘depression’ into a very paradoxical sort of ‘thing’, being precisely a feeling or mood that serves to fill the empty gap or vacuum created by what is essentially a sense of nothingness or no-thing-ness – one that is not so much caused by some ‘thing’ so much as evoked by the absence of something - or by an absent sense of being someone and somebody.

Being someone - a self or ‘subject’ - is quite different from being a mere ‘thing’, a mere mental, emotional or physical ‘object’ for oneself or others. Yet in a culture dominated by the need to perceive things as objects and possess them as commodities, being a self or subject tends to be identified with conceiving and perceiving the world as a world of objects. So whilst our entire experience of ourselves and of reality is essentially something subjective, in this culture both science and medicine identify reality only with objects and ‘objectivity’ – reducing the body to a clinical object and the self itself to a mere fiction created by the brain. It would be surprising if, in such a culture, most people did not feel depressed. This applies particularly to those at the sharp end of this culture – people whose depression stems from being objects of political or economic oppression, or from the pressures of what Marx called ‘wage slavery’ - earning a living through producing objects for others. It applies also to people whose early relationships were ones in which they themselves were perceived or treated as mere objects of use and abuse.


the logic of ‘depression’

When people feel ‘low’, ‘down’ or acutely or chronically ‘depressed’ for no apparent reason they naturally see no rhyme or reason in it. It confronts them – and is seen by doctors and psychiatrists – as an innately ‘irrational’ or ‘illogical’ state to be in, one that therefore needs to be mentally or ‘cognitively’ corrected (‘cognitive therapy’) and/or pharmaceutically treated with ‘anti-depressants’. Older ways of seeking to understand the meaning of depression, such as those that evolved among psychoanalysts, have since been discarded as ‘old hat’ under the pressure of the pharmaceutical industry. Yet due to the ever-increasing costs of prescription drugs, medical psychiatrists today are beginning to acknowledge these older insights indirectly. Indeed some fashionable psychiatric trends have begun to bring them back in the much diluted and distorted form of supposedly ‘new’ theories, along with new forms of ‘psychological’ rather than purely pharmaceutical ‘treatment’.

The term ‘psychology’, though it did not exist in ancient Greece, is derived from the Greek words ‘psyche’ and ‘logos’. The Greek word ‘logos’ meant ‘word’, ‘speech’ or any form of spoken ‘account’. It is from the Greek logos that the modern word ‘logic’ is derived. What characterised the older psychoanalytic logoi or ‘accounts’ of depression was that they were derived from the word or logos of patients themselves rather than from the pseudo-scientific jargon of psychiatrists. Freud himself worked in this way, being the first to attend so closely to the word of the patient as to begin to hear its inner ‘speech’ or logos and discover an inner ‘logic’ to their symptoms. It was Freud who first began, in a way yet to be properly understood by today’s psychiatrists, a wholly different type of ‘logic’ in the relation between words and things – a relation fundamental to thinking as such. His insights were taken up by others, in particular by Melanie Klein, Wilfred Bion and Donald Winnicott, in a way that led them to see in what they called ‘the depressive position’ something that had a healing and maturational value, enabling the individual to experience both self and other as ‘whole’ beings, rather than as things.


transformations

What follows is my interpretation, based on Bion’s ‘Theory of Thinking’, of a sequence of ‘psycho-logical’ transformations that the psychoanalysts referred to above identified as occurring in the absence of some ‘thing’, transformations that lead all individuals to inwardly alternate, to one degree or another, between what Klein called a ‘paranoid-schizoid’ position on the one hand and a healthier ‘depressive position’ on the other.

1. the loss or absence of a good thing (for example the absence of the mother or breast for the infant) is felt as bad, or the experience of a bad thing leaves the individual with a feeling of absence (for example an absent feeling of being loved or worthy).

2. the experience of feeling bad through the absence of a good thing is experienced as the presence of a bad thing. Thus ‘feeling bad’ is experienced as a bad thing – a ‘bad feeling’ - rather than as the expression of an absent thing or ‘no-thing’.

3. the incapacity to tolerate or contain ‘bad feelings’ that arise from experience of a ‘no-thing’ (for example the infant’s experience of a ‘no-breast’) leads to those feelings being neither fully felt nor thought. And dimensions of reality that are clearly not ‘things’ (such as awareness, time and space) are felt as innately threatening.
From this basic set of transformations a whole sequence of others can follow:

4. Incapacity to tolerate the frustration of absence - the ‘no-thing’ – leads to it not only being felt as a bad thing (a ‘bad object’ in analytic terms) but also gives rise to an intense need to identify the ‘no-thing’ with some actual thing or object – whether in the form of a person or place, a part of the body or any perceptible object, real or hallucinated.

5. The object having been a ‘bad object’, it is also a source of persecutory or paranoid fears, phobias and anxieties, being perceived as something that has done or might do bad things to the individual.

6. Externalising or ‘projecting’ bad internal bodily feelings into external objects of all sorts makes the individual feel more empty – more of a ‘nothing’ or ‘nobody’ than before.

7. Internalising or ‘introjecting’ those bad objects or feelings makes the individual feel they are bad – and thus in fear of retribution by externalised bad objects.

8. Whichever way it goes, the individual’s whole sense of being a self or ‘subject’ – their whole identity - becomes entirely dependent on a relationship to a ‘bad object’ – whether external or internal.

9. Real or imaginary perceptions of concrete things (including people) as good or bad objects become a substitute for the conception of abstract thoughts.

10. Some thing (whether in the form of an object or person, internal or external) is always sought as the cause or explanation for feeling bad. Feeling bad is always turned into a bad feeling towards that object and a persecutory fear of it. In this way a fight-flight relation to all ‘bad feelings’ - based on an absent sense of self and a generalised fear of absence or ‘no-thing-ness’ - replaces a feeling relation to others and a capacity to think with words.

What we call ‘depression’ is not itself a ‘thing’ – a disease entity - but a process that can serve to overcome this fight-flight relation to the ‘no-thing’, ultimately leading to the recovery of a fully embodied sense of self based on tolerance of bad feelings, and the capacity to represent and communicate in words a sense of absence or ‘no-thing-ness’. For words and verbal thinking do not arise as representations of things but rather as ‘placeholders’ for their absence – for ‘no-things’.


the nature of ‘anxiety’

What is called ‘anxiety’ is essentially a fight-flight response to absence characterised by paranoid or persecutory feelings towards a ‘no-thing’. Yet the types of anxiety or ‘paranoid transformation’ that take us, for example, from (1) ‘feeling bad’ to (2) labelling certain feelings as bad (3) seeing them as ‘negative’ or ‘bad’ feelings, and then (4) identifying these bad feelings with some thing and then (5) feeling this thing as bad - a ‘bad object’ - are nothing abnormal or unusual. Take for example ‘writers’ block’ or difficulty in writing or communicating in words. These are related to fear of the ‘no-thing’ and the ‘no-thought’ - the emptiness of the blank page or ‘blank mind’. Or take even a competent writer who is feeling ‘bad’ about (stuck, bored with or critical towards) a piece he or she is writing. The sense of ‘feeling bad’ towards the writing easily becomes turned into a ‘bad feeling’ - one which is not only felt as a thing in itself, but identified with and ‘projected’ into the piece of writing itself. It is then that the actual physical form of the writing, whether as a paper manuscript or a computer file, may be felt by the author as a ‘bad object’ - and avoided because of the bad feelings it has come to be identified with and symbolise.

Any person or place, thing or thought associated with feeling bad may come to be felt as a bad thing in itself - a ‘bad object’ to be avoided. Even an object initially felt as good, whether a person, place or part of the body, a type of food or a cherished belief, a once idolised figure or a mere item of furniture, can easily and even instantaneously be transformed into a ‘bad object’ through becoming a receptacle for bad feelings. Alternatively, people may alternate, sometimes very rapidly, between seeing a thing or person as a good or loved object and seeing them as a bad, feared or hateful object to be avoided or fought.

This ‘splitting’ of things and people into good and persecutory bad objects - which results also in a splitting of the self or subject - was one of the ‘primary defences’ against absence that Klein saw what she called “the depressive position” as overcoming, leading to a greater awareness of both self and other as whole beings, and a greater capacity to relate to them as such.

From this point of view ‘anxiety’ can also be understood both as a defence against the depressive position and at the same time as a potential threshold state to entering it. Anxiety is not accentuated but relieved by depressive states in which senses of absence or loss – the ‘no-thing’ can come to be fully felt, thought and communicated in words.


‘the depressive position’

In essence, what Klein termed ‘the depressive position’ was less a ‘position’ than a process. And yet the direction of this process was such as to lead to what she called the depressive position. Implicit in her understanding and use of the term ‘depressive position’ however, is the suggestion of a specific ‘place’ or ‘bearing’ within ourselves from which we can come to experience both things and people in a more healthy, hale or ‘whole’ way - as whole beings rather than as more or less fragmented or integrated collections of parts - and thus ultimately come to an awareness of reality as such as a singular whole or unity. Given this understanding of the term, it is odd that this ‘position’ should be described as ‘depressive’ in the first place (a word weighed with negative connotations) were it not for the fact that in Klein’s view, the process of arriving at it was an on-going difficult and tenuous one requiring the surrender under pressure of psychological defences such as ‘splitting’ and ‘projective identification’, and the acceptance instead of feelings of loss, absence and ambivalence towards things and people previously or otherwise split into good or bad, loved or hated parts – what Klein called the 'paranoid-schizoid position'.


reasons for feeling depressed

“Just because you’re paranoid doesn’t mean they’re not out to get you.”

It doesn’t take much thought to realise that most of the real life reasons - good reasons - for people feeling depressed have to do with ‘object loss’, the loss of some ‘thing’. This includes loss of jobs or income, loss of loved ones or relationships, loss of freedom or potential loss of life – that which ultimately confronts us all through death. Along with such losses may go a loss not just of happiness but of hope or health, a loss of trust or security, a loss of identity or sense of belonging, a loss of feeling and vitality, and last but not least a loss of meaning and of will - in particular the will to live. Suicide is not loss of self through self-inflicted death. On the contrary it results from an already lost sense of self – from a sense of already being dead – from which perspective continued life is felt as a form of living death, artificially sustained. Understanding the many good reasons for feeling depressed provide us with all the more reason for not seeing or seeking the meaning of the word ‘depression’ in some actually present ‘thing’. For at its heart is a sense of absence, loss and, ultimately, a felt dread of ‘no-thing-ness’ or ‘non-being’ that lurks at the very core of our being.


‘depression’ and ‘dread’

What people experience as ‘depression’ is expressed in a different way through the German word ‘Angst’ – usually translated as either ‘anxiety’ or ‘dread’. The German philosopher Martin Heidegger had a lot to say about ‘Angst’. His words echo in some ways the psychoanalytic viewpoint of Klein, but seek to go even deeper in exploring the essential nature and meaning of what we call ‘depression’ – not simply as depression, nor even as some new clinical category of ‘depressive anxiety’ (or some mere admixture of anxiety ‘and’ dread) but rather as ‘Angst’. For this is a word which, precisely because there is no easily definable ‘thing’ through which it can be translated in conventional clinical terms, led Heidegger to see nothingness as its essence - in a way that corresponds also to what I have suggested may be the essential nature and meaning of what we call ‘depression’.

“All things, and we with them, sink into indifference. But not in the sense that everything simply disappears. Rather, in the very drawing away from us as such, things turn toward us. This drawing away of everything in its totality, which in angst is happening all around us, haunts us. There is nothing to hold on to. The only thing that remains and comes over us--in this drawing away of everything--is this "nothingness.”

As Jorn K. Bramann writes:

“That things do not “simply disappear” in the experience of angst is important. Things actually “turn toward us” [Klein’s ‘bad objects’] as things that are alien and uncanny. In the experience of angst things have, in fact, a peculiarly ominous presence … Heidegger compares the experience of angst with the dread that we may feel in the dark: without light we see nothing, yet the feeling of dread arises precisely because things are present — somewhere out there, vaguely threatening, but without revealing any danger in particular. It is in this way that the totality of what exists remains present in the state of angst, even though we have the feeling that everything is "drawing away."

What Heidegger refers to as “nothingness,” in other words, appears in the presence of things - in the presence of the world that has become thoroughly alien and “indifferent.” This shows that the “nothingness” Heidegger talks about in … is not anything like a physical void, but a void - as one might say - of sense, of significance, or of meaning.”

What sort of meaning? Bramann again:

“We have our more or less regular tasks, familiar routines, and customary expectations. People have their known occupations and places, and things their more or less traditional appearances and functions. Even if occasional changes take place with respect to this or that detail, the over-all nexus of activities, functions, and goals remains a more or less ordered environment, a familiar context. Ordinarily we are at home in an organized world. It is the feeling of being at home in such a familiar world that is suspended in the experience of angst: Ordinary objects look strange, everyday activities pointless, and common sense objectives outlandish. Encountering “nothingness” means to feel uncanny and dislodged in a perfectly familiar world. There are several reasons why Heidegger finds the experience of angst important. One of them is the fact that it brings us closer to an understanding of Being - of what it means to be … For in the state of angst nothing particular matters anymore; everything in the world is equally indifferent to a person who is caught by this kind of dread …Thus the only thing left is the pure “being-there” of everything, the baffling fact of the world’s indifferent existence. This existence becomes the ultimate enigma for the person in angst; it prompts the wondering question: "Why is there anything at all - and not rather nothing?”

While this question is a gateway to Heidegger’s inquiry into the nature of Being, it is also a way of approaching and coming to terms with the quality of one’s own existence. The encounter with nothingness, according to Heidegger, puts me into a position where I can choose an authentic existence, or where otherwise I can allow myself to fall back into a sort of life where most things are decided by others, or by circumstances of a more or less impersonal nature. Angst, in other words, reveals to me my fundamental freedom. As ordinary individuals we are part of the world, and thus part of what "draws away" in the experience of angst. When seized by angst we become strangers to ourselves: our ordinary identities recede, and the everyday lives we live become as uncanny as the world around us. Suspended in angst I am not this or that person anymore, but an undefined being whose only characteristic is being-there. This pure being-there, according to Heidegger, is our most basic existence. In facing the nothingness revealed by angst all the activities I engage in and all the things I represent in everyday life fall away as so many roles and masks. In this "standing out into nothingness," as Heidegger puts it, I have a chance to make a new start, and to choose my life with a conscious resolve that had not been available to me in the routines of my ordinary everyday life. Angst is thus not necessarily a negative experience; it can be understood and seized as a precondition for waking up, for a personal liberation. In ordinary everyday life we tend to be locked into routine, and being preoccupied by practical tasks and busy with their execution we rarely question the sense of the whole system of cares, goals, and activities. To a much larger extent than we usually realize, the cares, goals, and activities that define our lives are determined by others instead of ourselves. I do what “one” is supposed to do; I have the goals in life that people generally have. I follow the herd, as some philosophers put it. It is, of course, not always wrong to do what others do. But it is one thing to do so because others do it, or to do it for specific and sound reasons. Angst relieves us, as it were, from our herd instinct and enables us to make our own personal decisions. Angst can be the means to become our own selves. By prompting us to become genuine individuals, it can make our lives authentic.”

“The capacity to wonder and inquire, grounded in that distance, is a manifestation of a fundamental freedom, the freedom to conceive and re-conceive the world in many ways, and to change one's relation to it accordingly. Instead of being locked into a particular cultural tradition, for example, with its fixed and established ways of looking at and relating to things, human beings are endowed with the capacity to take a step back from everything and to look at the world at any time as if it were entirely new, i.e., strange. This capacity … is the basis for the possibility of taking a hold of one's life in a way no other kind of being has.”

“Heidegger describes another way in which a person can encounter nothingness, and thereby take hold of his or her existence authentically: by facing death … Again, this is not accomplished by simply thinking about the matter, not even by very serious thinking. According to Heidegger it is only the feeling of angst that genuinely reveals nothingness - in this case the possible not-being of everything that I personally am. Only the feeling of angst reveals death as my death, the death that only I will die. And in doing so angst individualizes my existence, for the life that I live authentically is the life that is defined by my personal death.”

“In an abstract way all people know, of course, that they are mortal, and that they can die at any moment. In ordinary life this knowledge tends to become diluted or diminished; most people suppress the awareness of their own possible death by keeping themselves occupied by all sorts of other things - comparatively trivial things for the most part … The full awareness of my death brings my existence into a clear focus that is absent from the average sort of life that is frittered away on unimportant details and cluttered with superficial distractions. A conscious "being-toward-death" will encourage me to stop running with the herd, escape the anonymous dictates of what "one" is supposed to do, cease moving through life like a somnambulist--and actively take hold of my life with conscious resolve and deliberate determination. Facing my death in earnest provides me with the possibility to make my life truly my own, and thus authentic.”

“When we stare out to the darkness or, more precisely, stare into the darkness, into the world of infinity, we see nothing – we grown-ups, we who are all-too grown up. But let us look into the darkness like the child we once were … yes perhaps that is it.”


depression, death and the self


"All the world's a stage, and all the men and women merely players: they have their exits and their entrances; and one man in his time plays many parts, his acts being seven ages."

William Shakespeare

Many people believe that death ‘is it’, a threshold to a realm of nothingness beyond which both our being and consciousness are annihilated and cease to be. Part of the fear of experiencing what ‘no-thing-ness’ is, is its association with death understood and anticipated in this way as a realm of absolute nothingness or as a non-being void of consciousness. Even people with this view of death however, are prepared to accept the common idea that the process of dying culminates in the unfoldment of a type of panoramic vision of our entire life in all its stages, as if viewing it as a play or drama unfolding on a stage – and as a sequence of all the situations we have been in, all the events we have experienced, all the people we have interacted with - and all the roles or parts we have acted or identified with. The retrospective unfoldment of the ‘life panorama’ as the vision of the entire life drama is like a parade of all those many different ‘part selves’ or ‘part identities’ that we were not fully aware of whilst living – precisely because we were so busily engaged in identifying with them and acting them as life roles or parts. Yet given the multiplicity of roles and part, selves or identities - actual or potential - that make up each individual a fundamental question arises. The question is this – what or who is the ‘self’ capable of becoming aware of our life-drama in all its stage and with it of all the parts we have taken - all our dramatis personae - yet doing so from a position ‘off-stage’ and independent of that parade of multiple identities, selves or personae? When we watch a play we can identify with any of the different characters portrayed and in this way perceive the entire drama from each of their quite different perspectives. A part, well-acted, allows us, even whilst being off-stage, to look out upon the stage itself through the very different eyes of each and every character that stands before us on it. Yet the awareness that enables us to so identify with each and every character on stage, cannot by definition, be reduced to the property of any one such character. Similarly, neither can the awareness of our lives as a panoramically unfolding drama - one involving the interplay of many different personalities and sub-personalities, parts and identities - be reduced to the property of any of these ‘selves’. Indeed we can argue that, – in principle – the awareness of any self or set of selves cannot itself be reduced to the property of any self or selves, of any experienced identity. Instead the awareness of any self or identity transcends that self or identity.


on the ultimate meaning of depression

“Death is not my process, even if I belong to it. It belongs to the one who grants us life.

“Death is my constant shadow, is stranger than I am. Or is it HE himself, the God who experiments with himself as a man, in another life form?”

“In the hospital world … I sit on the bed and write music that has nothing to do with the world of that last station [death]. The surroundings force me, as always, to force my way down within me, in order to reach the roots of my life. It is just that, the fact that something in me preserves its integrity, does not let itself be destroyed, that fills me with wonder, as before a miracle.”

Swedish composer Allan Pettersson


Like language, awareness as such is no ‘thing’, but that which alone makes it possible for us to be aware or conscious of anything and everything. The only ‘self’ capable of being aware of our many selves and identities is not some self with a particular identity and awareness all of its own, but can only be a self with no particular nature or awareness of its own, a self that is nothing except awareness as such – not my awareness or yours but an awareness that is not the private property of any self or being. That self, which is nothing but awareness, is no ‘thing’ and yet it is not ‘nothing’. It is not any particular self and yet it is no mere absence of self or ‘no-self’ – for it is an awareness of every possible self we can be or have been. It is no ‘being’ and yet it is no mere void of ‘non-being’. Not being a being or self, however, it can neither die nor be born - and can have no fear of either birth or death. The Japanese sage Bankei called it our eternally unborn nature. It is that self which, as nothing but pure awareness, embraces, unites and transcends all things, all selves, all lives and all beings – all that was, is and can be. It is both no-thing and everything. It is both an absolute emptiness - an awareness as distinct from all its contents as empty space is distinct from all the objects within it. Yet this awareness is also an absolute fullness - for like empty space it also embraces all the things within it. This awareness is ‘no-body’ and yet it is not ‘nobody’. For neither life nor consciousness begin with just being a body or mind, but rather with an awareness of being and an awareness of body and mind. It is towards being this singular and paradoxical awareness, one that is no-thing and no-body and yet all things and all bodies, that I believe the ‘depressive process’ is destined to ultimately lead us – allowing us to discover that ‘God’ which is no-one and every-one, no-being and all beings, no-self and yet at the same time our very deepest self. In this sense the ultimate meaning of ‘depression’ is the ultimate reality, not of some psychological category or state - but of life as such and all that is.


from the word to awareness

Through circling any element of our experience and turning it into what we think of as a clearly separable and identifiable ‘thing’ we do nothing but circumscribe and limit a larger and deeper awareness of that thing – and of other things. This does not mean that words do not or cannot speak truly - that they cannot speak for us truly, speak to us truly and ‘speak us’ truly. Words of this sort however - like those of a great seer, poet or thinker - arise not as names or denotations of things, but rather from depths and breadths of awareness transcending all things. They do not name things but name and in turn evoke a new awareness. It is this that enables such words to ‘speak to us’ - to take our awareness beyond - or deeper within - the narrow ‘circles’ of their conventionally accepted meanings.

Even so, we cannot circumscribe the world in words. That would be like trying to cover a blank white page with circles without leaving any gaps or empty spaces between them - whereas in reality it is that blank page and its empty spaces – not only those around but also those within all the circles we draw on - that is the very condition for drawing them in the first place. Awareness, like a blank page, is that which first makes space for the circles we draw in words. So let us not let these circles, and those who believe in the ‘things’ they circumscribe, run rings round us – but instead allow ourselves to feel embraced by the singular awareness that embraces and fills them all. For as the great 10th century Indian sage Abhinavagupta recognised: “The being of all things that are recognised in awareness in turn depends on awareness.”


the depressive process

“To me it seems more and more as though our customary consciousness lives on the tip of a pyramid whose base within us (and in a certain way beneath us) widens out so fully that the farther we find ourselves able to descend into it, the more generally we appear to be merged into those things that, independent of time and space, are given in our earthly, in the widest sense, worldly existence.”

Rainer Maria Rilke

The ‘depressive process’ is essentially a natural direction and movement of awareness - one in which we are drawn back down into ourselves - and ultimately also beyond ourselves. The awareness itself is nothing purely mental but a feeling awareness, in particular of the different ways in which we sense the inwardly felt spaces, tones and textures of our own body. In letting that awareness so descend, under the external pressure or internal weight of whatever problems we experience, we are also responding to the gravitational pull of our own spiritual and physical ‘core’ – our centre of gravity in all senses of that word. This core - the “depressive position” - is an inexhaustible inwardness that some feel as a bottomless and threateningly dark black hole. And yet like the type of black hole described in cosmology, going through it takes us ultimately out of and beyond ourselves into a larger awareness. Identifying with this awareness overcomes all sense of self-centredness, allowing us instead to feel the core of our being as a centre, not just of our personal self, but of that larger, trans-personal awareness itself - an awareness free of self-preoccupation, spacious enough to fully take in and respond to other people and the world around us, and one that widens rather than contracts the circles of awareness we previously inhabited. This widening of awareness is important, because in the simplest of terms, what we call ‘depression’ has to do with lack of awareness – not so much of things that are there in our lives but of dimensions of our lives that are absent - lost or missing. It is the void of these absences that depressive feelings fill - but which, if followed, can also bring forth an awareness of.

Depressive states are states in which we are 'pregnant' with this still unborn awareness of absent or missing dimensions of our lives. Understanding this makes nonsense of the whole idea of ‘treating’, ‘managing’, ‘fighting’ or beating ‘depression’ - which makes no more sense than the idea of managing, fighting or beating a state of pregnancy. And if the depressive state is a state of pregnancy, then the depressive process is the process of gestation - one which can lead to us giving birth to a new awareness of ourselves and of our lives. That is why psychiatric medications and other means used to 'fight' or 'beat' depressive states are all effectively an attempt to medically or psychologically abort the new awareness pregnant in depressive states and gestated in the depressive process, thus preventing its birth and realisation.


‘depression’, ‘self-esteem’ and the capitalist ethos

Just as we live in a culture in which ‘depression’ is treated as a ‘thing in itself’, so is our culture also one which treats ‘self-esteem’ as some ‘thing’. If there is one type of ‘loss’ or ‘absence’ which this culture does associate with ‘depression’ – regarding it even as a key symptom of it, it is the absence, loss or depreciation of ‘self-esteem’ or ‘self-worth’. This correlation between depression and loss of self-esteem however, is itself a product or symptom of that culture – a culture in which individuals are encouraged to evaluate their value or self-worth and estimate their ‘self-esteem’ according to standard cultural criteria. ‘Self-worth’ and ‘self-esteem’ in other words, are seen as quantitative variables - conditional on comparing ourselves with others or rating ourselves according to criteria which apply to others. This is a contradiction in terms – for if self-worth or self-esteem is made conditional on measuring, estimating or in any way rating ourselves in comparison with others it is not self-worth at all, for the self is essentially unique and beyond all comparative measures and ratings – all of which imply which that the unique value or ‘self-worth’ of the individual can be evaluated, judged or rated by a common set of values shared with others, and not unique to the self at all.

Like ‘depression’, just because we have words for them, ‘self-worth’ and ‘self-esteem’ are not ‘things in themselves’. Nor do they mysteriously or symptomatically go up and down like the value and worth of stocks and shares. Instead, like share and stock values, they are the result of subjective acts of evaluation and estimation. In the case of self-worth and self-esteem however these are acts of self-evaluation and self-estimation on a culturally, socially and economically determined rating scale. This rating scale makes self-worth and self-esteem conditional on a whole range of factors – wealth and health, physical attractiveness, salary and job status, employability and value on the job market, and degrees of ‘success’ or ‘achievement’ measured or maintained according to such criteria. The paradox of treating feelings of low ‘self-esteem’ or ‘self-worth’ as a symptom of depression is revealed as soon as we consider that one of the chief scales on which people evaluate their worth and estimate the esteem they deserve is by rating their own mood on a scale of ‘positivity’ and rating their being on a scale of ‘wellness’ or ‘well-being’. If their score on this scale falls into the negative – often through failure in meeting the countless other social, cultural and economic criteria by which people estimate their self-worth, they end up feeling worthless and depressed. Far from being symptomised by lack of self-worth, their ‘depression’ is at least partly a product of them rating their self-worth negatively - and feeling bad or worse about themselves as a result.

Albert Ellis identified this depressive syndrome with what he termed “the doctrine of variable worth.” As long as self-worth is seen as a variable dependent on one’s psychological, behavioural, social or economic ‘performance’ on the comparative (and therefore also competitive) cultural rating scale it becomes something conditional, wholly constituted by the comparative and competitive ethos of capitalist culture. Low self-ratings, or the fear of them leads depressive states and ‘performance anxiety’. Conversely however, as soon as we cease to see self-worth and self-esteem as something in any way variable or conditional, and instead see them as rooted in an attitude of unconditional self-acceptance, then we are no longer justified in speaking of psychological ‘issues’ of ‘self-worth’ or ‘self-esteem’ at all. Instead the sole ‘issue’ becomes the fundamental ethical choice between conditional and unconditional self-acceptance. Unconditional self-acceptance means self-acceptance not conditional on and independent of any rating on a scale of health, wealth, skill, success, status, accomplishment, ability to cope or get things right – and independent also of degrees of positivity or depressive negativity of mood or ‘affect’.

“The doctrine of variable worth” replaces desires with Jehovah-style commandments. In place of the desire to do X (for example the desire to achieve something, feel better or improve oneself in a particular way) comes the belief that “To be worthy of self-esteem I must do X”, and its converse: “Unless I do X, I am not worthy of self-esteem.” Failure to fulfil natural desires is felt as sinful – as a failure to fulfil commandments or ‘musts’ - with a deprecation of self or annulment of self-worth as its self-punitive consequence.

Awareness of self and such unconditional acceptance of self go hand in hand. For since the awareness of any judged ‘deficiencies’ of the self is not itself a deficiency, and since the awareness of the ways we judge and rate our self-worth is not itself a judgement or rating of self-worth, awareness is what also allows us to be aware of our self-judgements and self-ratings – which are not essentially self-judgements, self-ratings or self-evaluations at all, since they ultimately derive from the values of others – not those values unique to and constitutive of the individual self.

Awareness of self is essentially awareness of being. Being however is no ‘thing’ that can be measured on any scale or by any criteria. Indeed being and 'no-thing-ness' are the same. Nor does the meaning or value of being lie in being ‘this’ or being ‘that’. The meaning of being is simply to be. Only out of an awareness that places unconditional value on just being can a truly unconditional sense of ‘self-worth’ - and of well-being – arise.

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