For the philosopher Plato it is eros - desire, love - which gives shape to our lives. As the later platonic philosopher Simone Weil put it, “All human beings are absolutely identical in so far as they can be thought of as consisting of a centre, which is an unquenchable desire for good, surrounded by an accretion of psychical and bodily matter.” It is in the accretions that we differ, but desire lies at our core. Freud agreed, although he was constrained by the prestige of a certain conception of science, and using scientific language he spoke of the "libidinal drive." Later he too used the language of "eros", which he identified with Plato. It is often said by psychoanalysts that we live our lives in the light of our first loves. And in the shadows cast by them. A certain formation of such shadows can constitute what we call depression.
One of the best ways of understanding depression comes to us from Freud and those psychoanalysts who, over more than a century, have carried forward his work. I am impressed by the explanatory power of psychoanalysis but also quite critical of it, especially as it makes easy the abuse of power by individual therapists. However it is the former I am drawing on here. A Freudian understanding of depression means an understanding of love and loss. To understand the place of love in Freud, I quote him from 1921 (my italics for emphasis):
"We are of opinion, then, that language has carried out an entirely justifiable piece of unification in creating the word 'love' with its numerous uses, and that we cannot do better than take it as the basis of our scientific discussions and expositions as well. By coming to this decision, psycho-analysis has let loose a storm of indignation, as though it had been guilty of an act of outrageous innovation. Yet it has done nothing original in taking love in this 'wider' sense. In its origin, function, and relation to sexual love, the 'Eros' of the philosopher Plato coincides exactly with the love-force, the libido of psycho-analysis [...] and when the apostle Paul, in his famous epistle to the Corinthians, praises love above all else, he certainly understands it in the same 'wider' sense. But this only shows that men do not always take their great thinkers seriously, even when they profess most to admire them."
Elsewhere I explore some existential sources of depression, as well as some ways that meaning and value inform depression. There are many factors. According to psychoanalysis depression forms in the shadows cast by our first loves: our relationship with our parents, especially when very young. A frequent point of reference is some deficit in the parental love. An experience of such deficit is a universal; it is written into the human condition, for all parents are human beings and so flawed. Surprisingly, this flaw may be seen as the seed of love. As Plato saw two and a half thousand years ago (see the Symposium), and as Freud and his students have recognised again, love, or desire, is a consequence of loss, of lack. What I am saying can be understood this way: originally for the child, mother and child were one. Soon however, there was this terrible experience of distance, of absence - the experience that the mother is another, different being, separate from the child. The child lost the wholeness they previously possessed when lacking that awareness. For a psychoanalyst, if you do not feel whole, and if you have ever sought to find wholeness through another, then you are responding to this loss and yearning for a return. As Alcibiades put it in Plato's Symposium, we are longing to find our other half and return to our original state of unity, which he physically describes as a state of embrace. Love arises in an infant as an urge, a desire, in response to their painful new experience of separation from the mother. According to some this separation and loss is the primary human trauma. It casts a shadow over our lives, deeply shaping their form and direction. Love and loss are internal to one another.
Such loss is universal. It is nobody's fault, it is not a flaw in the individual parent, rather it is the human predicament, about which we have no choice. Beyond this fact, however, some mothers and/or children respond to the separation well, while others less so, in ways which vary and which create varied effects, one of which is depression. Leaving aside parents whose behaviour is obviously harmful (the remote, the selfish, the manipulative, the abusive, many of whose children will suffer depression) many depressed people have had good, loving parents. To any perfectionistic parent who is reading this, I would point out that the great child psychologist Donald Winnicott used the term "good enough" to describe the kind of parent whose love and affection leads to healthy emotional development in a child. Yet sometimes parents who would otherwise be good enough, do not or cannot give good enough love. It may be there in their heart, but it is not adequately communicated in action, in their way of being. This lack may occur only for a particular time, or regarding a particular dimension of their being. It may be that the parent was disabled from providing adequate love at a critical point through illness, whether mental or physical, or physical absence. Perhaps the child was ill and could not experience the love that was readily on offer, a point which brings out that what we are speaking of is the effect of the experience of loss, regardless of its objective conditions. Again, as I said, perhaps the parent was good enough in most ways but was absent in some important aspect to their emotional life.
As I say, these same parents may in other respects be very loving. They may also have found it easier to give the love required at later stages in the child's life, such that the child remembers them as warm and loving. What I am pointing to is a highly empirically supported view, to the point of being a fact about human development, and not some idle theory or cliche. It is called "attachment theory." This picture does not invite blame, for these insights should be taken with a sense of compassion for our shared human condition with all its afflictions and limitations. It is the mark of maturity to be able to see one's parents as normal, which is to say flawed, human beings, and to recognise that one will be flawed in their own ways as a parent. Human beings are messy, stumbling creatures, and their parenting is no different. I quite like the first two stanzas of Philip Larkin's poem:
They fuck you up, your mum and dad.
They may not mean to, but they do.
They fill you with the faults they had
And add some extra, just for you.
But they were fucked up in their turn
By fools in old-style hats and coats,
Who half the time were soppy-stern
And half at one another’s throats.
So what happens in a child such that the experience of loss, both as a universal and individual phenomenon, leads to adult depression?
By love we are speaking of such things as attention and affection, the act of meeting the emotional and physical needs of the infant. Love is like food, a need of the soul - or psyche - without which we become sick and starve at the emotional and interpersonal level. When that necessary nourishment is experienced by the child as lacking, as happens through the natural process of separation, then anxiety arises. Anxiety is the first ingredient in depression.
As well as anxiety, frustration arises in the child. Frustration quickly changes shape, for love is other-directed. It turns into hostility, into rage at the parent who is disappointing their need. How the parent responds matters, for many parents have difficulty tolerating that rage. This may be due to those same factors which led to problems in their ability to give love. The parent's difficulty only serves to create more problems, for without reassurance in the face of their rage, the child begins to dread retaliation, such as further withdrawal by the parent or punishment. To make things worse, the child 'knows' (instinctively - they are not yet reflective) that they are completely dependent upon their parent. They cannot bite the hand that feeds them. So they feel that they cannot give expression to their rage for fear of retaliation. They must swallow it.
This anxiety and rage, layered with dread of punishment, creates quite a mess in the child’s emotional life. For they recognise (again, so to speak - none of this is reflective) that the object of their hostility – their parent - is also the object of their love. In therapy this is known as ‘ambivalence’: "I hate you, and I love you." This ambivalence becomes an inner emotional dynamic, a pattern that is played on repeat. It is the reason that so many people have difficulty with commitments, especially romantic ones. It is the root of many of the psychological defenses which enter into a person's personality, such as "undoing" and "reaction formation."
It is at this point that guilt makes an entrance. “Because I have been bad (felt rage) toward the one I love, therefore I have lost their love - it is my fault.” Plus “I have been bad, and will surely be punished by them (for example by their withdrawal and rejection of me).” And again, "Because I have hate (alongside love) for my parent, therefore I have harmed them." In essence the child blames themselves for the experienced absence of their parent’s love. And they blame themselves for their own response to that absence. And they blame themselves for anything bad that happens to their beloved parent. Guilt is self-accusation. They swallow the rage, turning it on themselves. They attack themselves, which is to say they become guilty. As the psychoanalyst Lacan once said, "The Christian injunction to love thy neighbour as thyself must be ironic, for people hate themselves!" To include another feature in this tormenting picture, all of this is exhausting for a child. That is, it leads to a state of exhaustion. The child becomes hopeless.
As a child grows they develop many defenses to cope with these problems, cutting them off from conscious awareness and managing to do well despite them. But sometimes, say due to a traumatic event or an ongoing strain, cracks appear and widen to the point that the defensive wall collapses. The adult may now enter a state of depression, which is simply to say that they can no longer defend themselves adequately from what was inside all along. The loss shows itself. Take note of how much depression looks like grieving. And the anxiety shows itself too; for example the person wakes early every morning and cannot return to sleep. The rage and hostility shows itself, turned inward as guilt, for example in the form of self-recriminations, self-loathing, and poor self-esteem. The exhaustion shows itself in a helpless-hopeless sense of life, a sense that there is no point to anything, as well as in the lethargy that affects their whole being.
So depression is grief at a fundamental loss, a loss of contact with love which is reacted to in certain ways, but the depressed person cannot see this, let alone say what that loss is. For the problem originally occurred at a pre-verbal period of their early life, such that it is now largely unconscious, a pattern. For the child had not yet developed language, had not developed the intellectual capacity to represent to themselves what they were experiencing or how they were reacting to it. In a certain sense, it is all instinctual. As they grow it may not be lifted up into language, and so it remains inchoate. Second it is unconscious because much of this is intolerable to the child, therefore it is pushed out of awareness, or rather forces within them will not let it show itself to consciousness even as their capacity for awareness grows. Even as an adult they do not recognise these aspects of their inner life, for the defensive repression continues, usually with greater strength. The psyche is dynamic like that, seeking to maintain emotional equilibrium by making problems seem not to exist - by deluding the self.
Freud wrote, "When I set myself the task of bringing to light what human beings keep hidden...I thought the task was a harder one than it really is. He that has eyes to see and ears to hear may convince himself that no mortal can keep a secret. If his lips are silent, he chatters with his finger-tips; betrayal oozes out of him at every pore." To the casual observer depression arises (shows itself) as though from nowhere, and seems to lack meaning. This is why the medical picture of depression is so popular among both lay people and many professionals. However for those with eyes to see, the inner dynamics that lead to an outward depression show themselves.
Freud’s Law: That which I cannot represent to myself, I am doomed to repeat. When something is unconscious, I neither see nor understand it. And it is unconscious because there are forces within me pushing against it, pushing it out of my awareness as a reaction to the anxiety it arouses. Our mental life is a marvellously restless, dynamic phenomenon, full of drives and desires which span across conscious and unconscious levels. A major work of psychoanalytic therapy is to help a person represent to themselves the unseen workings of their inner life. To see what is really going on. In the case of depression, to see the loss of needed love, the rage, the guilt and attack on the self, the despair and exhaustion. Because so much of the psychological problem formed in the early years of life before the person developed sophisticated language - before they developed self-awareness and self-understanding - therefore they now need to connect this inner ‘stuff’ with language, to bring these conflicts into language. This is why there is such thing as a "talking cure".
This is why we value of insight in therapy. Therapeutic insight is much more than hypothesis or detached description. In philosophical terms, therapeutic insight means bringing an inner state, especially an inner struggle, into the domain of logos – reason, the adult human mind - where we can see with our intelligence, and judge according to our better values, and make choices, and enact those choices by reshaping things. And such things are shaped, moreover, through the very fact of their entry into this sphere of adult awareness. This is one reason why the therapeutic relationship is so important: a great deal of trust and care is required for the person to soften their defenses and step into their inner world, which in a depressive situation is a world of grief and loss, rage, and fear of retaliation. In therapy we make the unconscious conscious, and do that which we were originally unable to: we work through these things.
I am not a psychoanalyst however over the years I have read deeply in psychoanalysis, among other forms of therapy. These days I think that the historical explanation of a depression within the self is often less important than a here-and-now description of its form, including its unnoticed subtle dimensions, and a shift from that to enacting what might shift the depression: the connecting and valuing that disappears in depression.
Author: Matthew Bishop
Image: Bernard Safran