The existential philosophy of the 20th century is rooted in the lebensphilosophie or life philosophy of the 19th century. It is philosophy as "thinking which comes out of living." Accordingly, an existential therapy focuses on challenges in living. This is in contrast to, say, a clinical therapy which focuses on problems as mental disorders. Existential therapy helps people deal with their challenges using the resources contained within their own humanity: their intellect, their will, their loves and desires, their values and motivations, their context and relatonships, and so forth. It is not surprise, then, that an existential therapeutic understanding and response to depression is quite different that of a clinical mental health service. This essay gives expression to just a few aspects of how depression is conceptualised and responded to in existential therapy.
When people try to understand depression, whether for the sake of a general theory of depression, or in terms of understanding one's own depression in a counselling context, they usually start by thinking about its causes. I suggest that this pre-occupation is an unhelpful one. Much of the theorising about causes of problems in human life is fictional, even when done by researchers and academics. We feel better when we define a cause, and this is perhaps the real reason for our pre-occupation. A better starting point might be to ask about the contexts in which depression arises. After all, it may be that depression is not an alien to the human condition, and that in the thread of one's life it simply will rise and fall. Perhaps to be human is to experience depression, and like the rest of human experience some people are more prone to this spectrum of emotion than others? In this reflection I set out some contexts that offer insight into the rising and falling of depression, using the lens of existential philosophy and therapy.
One of the primary contexts for the experience of depression from an existential perspective is the experience of meaninglessness. We might even say that the experience of meaninglessness is itself the experience of depression, or that it soons becomes depression as other parts of us are infected. When people feel that their lives lack purpose or significance, they can become overwhelmed by feelings of despair and hopelessness. This may arise in a variety of contexts, including a lack of connection with others, a sense of disconnection from one's values and goals, or a loss of faith in the possibility of a meaningful life. Rather than think of the depression as simply a symptom of one of these problems, we might see it as a meaning: the meaning of the depression lies in its alerting us to these realities, just as the meaning of physical pain is to alert us to a problem and to motivate us to do something. The almost ironic meaning of depression as an experience of meaninglessness, is that this meaninglessness has a deep meaning. It is shouting out to us that important things in life need attention, such as our forms of connection, or the kinds of values we are holding, or how well we are living them out.
Another key context for depression from an existential perspective is the experience of "death anxiety." In the face of mortality, individuals can feel a sense of dread and fear. I have often observed how in some individuals depression seems to be a reaction to overwhelming fear and anxiety: spend too long in such a heightened state, and eventually you collapse into the exhaustion of depression. The philosopher Jean-Paul Sartre suggested that depression is even a defense against sustained anxiety, a kind of grey wet blanket we place over the painful spikes of our angst. Of course, more simply, death threatens our sense of meaning and value. What is the point, after all, if everything that matters is going to die or pass away?
The Australian writer David Malouf's beautiful novel The Great World is an exploration of struggle and depression in the face of such a sense of loss. The existential therapist Irvin Yalom points out, however, that while the fact of death destroys us, the idea of death can save us. Death can wake people up from a life of avoidance through fear and anxiety. On the other hand, many people suffer death anxiety precisely because they are not living as they should. As they should, in the sense of some deeper calling to meaning and purpose within them. Or as they should in terms of everyday matters of authenticity, of taking responsibility for their lives. I remember a friend from the past who, in her relationships always kept one foot out the door, and was with a man who did the same. She suffered terrible death anxiety, and it seemed to me that her avoidance of real commitment - which in fact she so wanted - had much to do with it. So long as she had more life, she could pretend that her avoidance would turn into commitment tomorrow, but the idea of death put a full stop on that notion, waking her up to the possibility that her avoidance and all the unhappy emptiness it caused, would become the definition of her whole life. I have seen clients in the same state, and at this point all that unhappy emptiness would flood, so that not only did they suffer death anxiety - which as I say can as anxiety lead to depression - but also in these simple terms (i.e "unhappy emptiness") they suffered chronic depression.
I flagged an issue, above, which is the problem of alienation or disconnection from others, which can lead to feelings of loneliness and isolation, and a lack of identity or value. This can be particularly challenging for individuals who feel that they are not living up to social or cultural expectations, as they may feel a sense of shame or inadequacy or rejection. These final emotions lead to anger, and anger is a deep aspect of depression, although I will not explore that here, rather I want to focus on depression in the context of alientaion and disconnection. We are social animals, and we need others and community far more deeply than we tend to admit. Indeed our culture shames people for needing others. "You must to sort yourself out first before you can be with somebody." Maybe that's true, or maybe many people will do a far better job of sorting themselves out (whatever that means) in the context of a loving, honest relationship. People have a need to be loved, as well as having a need to love. People need some kind of unconditionality in their relationships and communities if they are to feel safe enough to experience higher emotions, and to feel that they have personal value and worth. Of course there are pathways to these things even in a collapsed society, but it is no surprise that depression arises when the culture and society - or the individual's experience - is bleakly empty of true connection and valuing. A world which is highly individualist, competitive, objectifying, transactional, reductive, exploitative, and so forth, is not a world in which people can easily feel a sense of connection. It is a world of the opossite, where many become depressed, where many suffer the "diseases of despair" such as addiction (to substances, but also we might add compulsions and dissociations) and suicide, as well as the triad which logotherapists discuss: depression-addiction-aggression.
Something important happened in the midst of these problems in the 20th century, when Carl Rogers bravely stepped forward with a new, paradigm-breaking form of counselling. In cotrast to the technical and objectifying therapies of the behaviourists and the psychoanalysts, Rogers propsed not techniques, but a relationship, as the core of therapy. That "therapeutic relationship" is characterised by severeal core conditions:
In a sense this is a vision of how to be in life, turned into a therapy. This is the contrary of the toxic world described above, which objectifies people and creates a whole culture of depression, manifested in those who are overtly depressed, as well as others who are addicted, aggressive, obsessed and so on. Rogers core conditions largely match "the common factors" discussed in the research by that name.
There is much more I could say here, in terms of contexts for depression, but I will leave it here for the moment. Much that I said about anxiety applies here. I will make one final observation. I have been exploring contexts in which we find ourselves. In which we become a certain way. The philosopher Jean-Paul Sartre showed that we are in our essence free. He also had a pithy way of putting things, and he is relevant here when he says: "Freedom is what you do with what has been done to you." If I were asked to recommend more reading here I would suggest Viktor Frankl's book Man's Search for Meaning, which lays out the development of his existential therapy during his years as a Jewish slave in the Nazi concentation camps, where all his family were murdered. That was a depressing context, but Frankl transcended it precisely through that which Sartre captures in his words.