“Nothing happens while you live. The scenery changes, people come in and go out, that's all. There are no beginnings. Days are tacked on to days without rhyme or reason, an interminable, monotonous addition.”
-Jean-Paul Sartre, Nausea
“The most glorious moments in your life are not the so-called days of success, but rather those days when out of dejection and despair you feel rise in you a challenge to life.”
Here is a memory that will never leave me. One morning during a very bad time in my early 20s, I looked into the mirror while shaving and was suddenly overcome. I seemed to stare into an endless repetition of that moment, stretched out as a meaningless series, my whole life nothing more than this. The weight of facing such monotony was agonising. I wanted to kill myself.
[NB this essay was written after my first few years of counselling practice, during my early 30s. I later removed all such writing from the web, for in time I came to feel that much of this writing reflected an younger me, and I had grown. Looking back over these pieces with even more distance, I feel that some deserve to be shared once more.]
What follows is a philosophical reflection on depression. More specifically, it is a moral philosophical analysis of three kinds of depression. As a philosophical counsellor I disagree with the reduction of life's problems, such as depression, to psychological processes. I also reject the popular misconception that depression is usually a biological illness. Ninety percent of depression arises from problems in living rather than biological causes. At the heart of so many problems in living are issues of meaning and value. Moral philosophy, or ethics, is an analysis of meaning and value.
This essay is an exploration of three values as they lie at the heart of three kinds of depression. Inventing names, I will speak first about what I call remorse-based depression. I will write more about that another time, so I pass over it quickly as an introduction to its widespread cousin, guilt-based depression. This will lead to a sketch of a third sort, nihilistic depression.
It my strike some readers as odd, to explore depression from a moral perspective. After all, depressed people often moralistically condemn themselves, and are often moralistically criticised by others. So surely we ought to banish all talk of morality regarding depression. The problem with that idea is that we cannot: meaning and value lies at the heart of human life. Meanings and values nourish life, and sometimes they distort it, or create suffering. Many people wrongly reduce morality to judgments of praise and blame. That is not morality per se but rather moralism. Morality is far more than praise and blame, and at its deepest has little to do with that. I take morality to refer to the values through which we relate to each other and the world. Such values include love, truth, empathy, and goodness. Seen this way, moral philosophy is vital for any therapy that wants contact with the truth, and truths, and struggles, of life.
When a decent person does wrong to another, they tend afterwards to feel remorse(1). Remorse is a moral emotion. It is a pained recognition of the wrong one has done another. Unlike many cases of guilt, remorse is a form of lucidity, of contact with reality through opening one's eyes to other people and the meanings of actions.
Sometimes depression arises from remorse, as a catastrophic experience of pained moral lucidity. This may occur when somebody does something terrible and then comes to see the reality, or meaning, of what they have done. A woman drives while inebriated and kills another; a man tears his family apart through infidelity; a thoughtless high-school bully tortures another who then kills themselves; these are examples of people who, if they come to see what they have done, might be claimed by a devastating realisation of the meaning of what they have done - done to another. In response their inner-world may collapse for a time. A professional working from a mental health perspective might diagnose this as a case of clinical depression, but that may utterly miss the point.
Sometimes friends or therapists try to talk such people out of their remorse, as though to feel so bad must be irrational. In effect these other people invite them to betray their own lucidity. Of course their pained lucidity may be mixed with confusion, misperception, unjust self-condemnation, maudlin self-indulgent guilt, and so on, and of course such things can and ought to be changed. In life things are often an admixture. But the pain of lucid remorse needs to be accepted as a signal of truth, toward which one needs to turn their attention. It is an expression of human decency, and for this reason, for a person genuinely gripped by a love of truth and goodness, nothing would be worse than evading it and so ignoring what they have done. This is one of those occasions in life when it is better to suffer than to feel good. I will write elsewhere about how I think therapists might work with such catastrophic remorse. We all have within us the capacity to do terrible things, but we are also more than that. Indeed, to experience such remorse is to be more than all that is dark in us. More mundanely, it is wisdom to learn to live well, in moral lucidity, with the wrongs we have done. Life is learning.
There are many moral emotions. Remorse is one. Guilt is another. Guilt is a cousin to remorse and sometimes functions in the same way. However guilt is unstable: it can disconnect from reality, becoming the opposite of lucidity by blinding and deluding us. Then its existence is no longer driven by, or proportionate to, any wrong we have done. We can feel guilt for no particular reason, and nothing limits it, such that we descend into depression. The psychoanalytic author Nancy McWilliams (2) writes of such guilt-based depression:
When a client says something like, “It must be because I'm selfish,” a therapist can ask, “Who's saying that?” and be told, “My mother” (or father, or grandparent, or older sibling, or whoever is the introjected critic). Often the therapist feels as if he or she is talking to a ghost, and as if therapy, to be effective, will have to include an exorcism.”
This is a striking example of how such guilt can take on a life of its own, such that McWilliams likens it to a ghost - a separate, critically oppressive voice within a person, dwelling at the centre of their depression.
An antidote to guilt-based depression is moral lucidity. An obstacle to that antidote is the fact that people who suffer such depression - and this is the most common type - often adopt some popular theory of moral relativism. They do so, as I say, at a theoretical level, even while their inner life and way of being expresses an implicit sense of moral reality - they claim that morality is relative, and yet often act as if it is real and vitally important. They do this as a reaction: because morality has turned toxic within them - has turned on them - they fight it by means of disbelieving in it. This does not truly work, however, indeed it may lead to nihilism; what they need is lucidity. THe toxic morality of praise and blame, of self-blame and self-loathing, is the corruption of morality, it is the bath water, not the baby. Morality is also compassion, it is love, it is a surprising truth about oneself for which we hoped.
There are many reasons for this distortion of an otherwise fine moral emotion, this distortion of guilt into self-condemnation which becomes depression. A person might live in a culture which fails to apppreciate, or even to recognise, their unique and better qualities, and which sees in them only deficits or vices. In his memoir, Romulus, My Father, the philosopher Raimond Gaita looks back at the social-moral context for the suicide of his depressed mother in 1958,
But for someone like my mother, highly intelligent, deeply sensuous, anarchic and unstable, this emphasis on [moral] character, given an Australian accent, provided the wrong conceptual environment for her to find herself and for others to understand her. Tom Lillie's contempt for her was common. It was also emblematic of a culture whose limitations were partly the reason she could not overcome hers.(3)
The society is often the family. When the parents' values are to a child, what 1950s Australian values were to Gaita's mother, then that child may grow up feeling inexplicably, but intrinsically and fundamentally, in the wrong and condemnable. They are then at risk of guilt-based depression. This is not limited to those who grow up amidst old-fashioned values, as many depressed adult children of modern, left-wing families can attest. In either case greater wisdom and magnanimity is needed from the parents, an appreciation of difference in the full sense of the word. This is why friendship is so important and so healing. If we have just one or two friends who can see us without moralistic judgement, who can behold us in our fullness in ourselves and value us without a sense that we need to change, despite whatever they might prefer that we change, we might be able to find ourselves, to find a home in the world. Not everybody receives this, for not everybody gives it. Some people cannot or will not receive it even when it is given.
Other conditions for guilt-based depression appear at first to need a more psychological, than moral, description. Attachment or relations theorists, who theorise that personality structure is rooted in early childhood experiences with caregivers, have shown that early childhood loss, neglect or abuse can lead to depression in adulthood. However their theories contain moral elements too, at their very core. Typically such a child (and later adult) will have responded to the loss of, or abuse by, a parent, by blaming themselves. This feels much better than believing that the world really is this uncaring or cruel, or that their parent really does not love them. Hence the child grows up feeling flawed and contemptible. Notice how the distinction here between morality and psychology becomes blurred, as moral language is needed to described the process. Valorisation - the task of finding oneself to be valuable, worthy of love - is at the heart of the childhood psychological processes described by attachment or relations theory.
Guilt-based depression has dominated psychotheraeutic theory up until now. However a change is, and has long been, afoot. It was 130 years ago that Nietzsche wrote, regarding the great religious and moral changes in society: “Whither are we moving? [...] Are we not plunging continually? Backward, sideward, forward, in all directions? Is there still any up or down? Are we not straying, as through an infinite nothing?" In these words Nietzsche observed that, with the loss of our traditional religious beliefs, a new age had arisen: the age of nihilism. This is our present age. With it comes a new form of depression, which I shall call nihilistic depression.
The present nihilism which we face and which existentialism seeks to overcome, is the consequence of major changes in our civilisation. Morality used to gain its validity through Christianity, and with the widespread collapse of religious belief there has been a loss of confidence the reality of value and meaning in our lives. Indeed the consequences have been a continual domino effect of deconstruction of everything we held sacred, right down to our very sense of our own individual nature. Despite what I take to be highly persuasive secular visions of our moral lives, suggesting that the ultimate source of meaning and value was never religious but always human (I think for example of Jean-Paul Sartre, Iris Murdoch, and Raimond Gaita) yet the consequence of God's death in our culture is a nihilism which has seeped into much of our life.
I am referring here to a cultural problem which enters the inner-lives of individuals. For example, in the vacuum of nourishing values which is nihilism, we witness the rise of both neoliberalism and what the Melbourne writer Anne Manne calls “the new culture of narcissism”(4). Neoliberalism and cultural narcissism are economic and social expressions - and consequences - of nihilism, which in turn breed further nihilism. [Edit: I wrote this essay before the real explosion of social media in the 2010s. As well as before the increasing social fragmentation in the late 2010s and beyond through Covid. It is interesting to look at this thought again in such a light.]
Like a narcissistic personality disorder, the moral structure of the new narcissistic culture involves a loss of intrinsic values, replaced by extrinsic ones. The same is true of neoliberalism. There is no intrinsic worth, only performance and consequences. Hence our society's disregard for the natural world except as resources, contempt for the poor and vulnerable, and general cynicism about moral motivation. To exist in such as society is to exist as a being with no intrinsic value, alongside other beings with no intrinsic value, in a world of no intrinsic value. Everything is a means, and the only end is a base self-interest. To the degree that a person fails 'to achieve' in such a society, then despair and resentment is their lot. And others who are sensitive enough will experience this despair even if they do succeed. In both cases nihilistic depression is a possibility. In essence it is a emptying out of value from life.
Nihilistic depression is that same despair described in 20th century existential literature: an alienated existence in a meaningless world. Ultimately, the alienation is even from oneself. Albert Camus' Stranger is empty inside. He is incapable of feeling or caring. He has no sense of meaning in his actions. Everything is mere happenstance. So too is the life of Antoine Roquentin, narrator of Sartre's novel Nausea, whose experience is expressed in the quote that begins this essay. The individual in Sartre's novel feels that he doesn't matter. That nothing matters. This experience is often felt as numbness, emptiness, incompleteness, meaninglessness, boredom. It is an utter deflation, or as I say an emptying of life. A depression. Sometimes it manifests as anger, often based in resentment. This can be directed to others as envy and hate, or toward oneself as self-loathing (of a sort which expresses shame rather than guilt).
It strikes me that the pervasive emotion above is despair. Despair, as a nauseating emptying out of any meaning or deeper sense to life. It is a loss of the love of life, and therefore a loss of hope in life. In the film adaption of Cormac McCarthy's 2006 dramatic novel The Sunset Limited, the character White has been halted in his suicide attempt by Black, an evangelical Christian. At Black's apartment, White explains his nihilistic vision of life which has led to his desire for death:
Rage is really only for the good days. The truth is there's little of that left. The truth is that the forms I see have been slowly emptied out. They no longer have any content. They're just shapes. Only a wall, a tray, a world, a man. A thing, dangling in senseless articulation in the howling void. No meaning to its life. Just words. Why would I seek out the company of such a thing? Why?
Elsewhere in the film White describes his contempt for his colleagues, his lack of friends, and his loathing towards his family. He is trapped in a world of self-interest and isolation. His life is thus emptied out and there seems nothing to do but die. White experiences that which I call nihilistic depression.
As a cure for this nihilistic depression and desire for death, Black attempts to convert White to Christianity. A tag to the movie poster said, Nothing is ever black or white. For many of us the answer must be secular, or at least it must lie outside of a fundamentalist religious conversation. So how do we answer these depressions, both the guilt-based and nihilistic, in therapy?
In my first draft for this reflection I wanted only to discuss nihilistic depression, and so I will focus on how we might respond to that kind. There is much written already about how to address guilt-based depression, even if most of that writing is psychological and more needs to be said from a philosophical therapeutic perspective. As I have tried to show, the form of each depression is different, so each needs a different response. I will speak briefly about what can be done about guilt-based depression, as a context for understanding the differences in how therapists might address nihilistic depression.
Answers to these depressions
Psychodynamic therapists often suggest that to overcome guilt-based depression we must attack the attacker - the critical, guilty voice. Cognitive-behavoiural therapists agree. Critical thinking is commonly used as an exorcism of the guilty, attacking voice, by assessing it rationally and rejecting disproportionate forms of guilt. After such critical work, the sufferer then finds ways to enter back into the stream of life, to forget about themselves and the old self-obsessed belief in their sins, through nourishing their connections with things outside themselves. Then, hopefully, they return to a state where their life continues to have moral weight, but not a disordered kind which oppresses.
Whereas in guilty depression it is a distortion of morality which oppresses, in nihilistic depression it is a lack of morality, or value, which is oppressive. The sufferer has lost their love of life, their hope in life, and experiences despair instead. How is this kind of depression overcome?
The psychoanalyst Julia Kristeva suggests that depression involves a disconnection between words and affect. Remember White's emptied out forms and senseless words in The Sunset Limited? What is emptied out is not simply emotion as a feeling, but emotion as connection. The philosopher Heidegger drew our attention to the fact that human existence is above all relational. From the womb to the tomb, we exist in and through others, in webs of care and valuing and meaning. In essence, in love. In nihilistic depression we have lost such webs, become disconnected, and have lost our love of life and therefore hope. We need to recreate these. The loss and recreation may exist at the objective level - we have become literally alone - or it may exist in the midst of love from others, and the work is to be done within ourselves. After all, you can offer a starving man food, but if they cannot or will not eat, it makes little difference.
I said that morality amounts to ways of being with ourselves, others, and the world, which give life meaning. At its heart, especially as seen in its narcissistic and neoliberal expressions, nihilism is a loss of love. A love of ourselves, of each other, and of the world. Human beings gain a sense of intrinsic value - in their own eyes and in the eyes of others - through the many forms of love we have for one another, from the deeply intimate to the more universal. Because love is both an act of discovery, and a creative act, through it we can re-invest life with value. Love enables us to discover and to create a life that is different to nihilism, a life of value.
Furthermore, as Albert Camus suggested, love is the source of hope in life. For Camus, such hope is different to that other form of hope which is an empirical prediction that things will go well. Indeed, the sort of hope I am describing is consistent with the prediction that things willl get worse. To be alive is to be stretched out in time. It is to live in anticipation. The hope I speak of is the sort which looks into the future with a love of being alive, despite life's difficulties, tragedies, and cruelties.
Philosophical counselling of any real depth goes beyond rational analysis. Ideally the therapist is somebody who knows the struggle with nihilism well. They are somebody who manages to maintain their love of, and hope in, life, despite their sensitivity and to, and suffering from, life and the threat of nihilism. They have spent much time exploring the varieties of ways that people overcome nihilism or find or create value in life.
Such a therapist needs to be able to attend to another (to their client) with a hard-earned view of life constituted by love and hope in the face of the threat of nihilism. This attention to the other – in the form of conversation and relationship – comes to constitute a new way for the nihilistically depressed person to see themselves and life. That is, they are implicitly invited to see themselves, life, and the world, in the light of the therapist's vision of these. This is not coaching in positive thinking. Nor is it CBT. Nor is it hypnotism or brainwashing. Philosophical therapy for nihilistic depression is critically-minded, and detailed in its explorations of the client's life. It goes into the unique dimensions of problem as present in this particular individual. In doing so it sheds light into the emotional recesses where nihilism has set its roots. And it shines a different kind of vision on both the particulars of a person's life, and on life itself, for them. So yes, philosophical counselling as I envisage it is committed to a vision of life. Of course it does not prescribe how an individual life must be lived. The truth is that all counselling and psychotherapy is morally committed, written through with values, despite some people's false pretensions to neutrality. As a philosophical therapist, it strikes me that to love life, and to live in hope, is one of the great challenges of life. Despair is always a potential, but I believe that it can usually be overcome. Of course it might take much courage and hard inner-work to overcome nihilism when it has poisoned one's inner-world, but it is certainly possible to do so.
Aristotle said that Man is a political animal. He meant that we are communal creatures. I would add that humans are moral animals, where morality has that broad meaning which I gave to it at the start of this essay. For too long our models of therapy have been medical-biological or psychological. We should not reject these, indeed it would be unwise to do so, but we need to expand our understanding. What I propose is not the addition of something to the side, moderated by the medical and then psychological experts, as per the usual pecking order. If we are moral creatures in a fundamental way, if our very perception, language, knowledge and interaction with each other and the world is at heart moral, determined by meanings and values, then a therapeutic perspective which attends moral dimensions of life in the individual and society needs to take a central position in therapy.
1.For a more detailed analysis of remorse, see Raimond Gaita's A Common Humanity. Gaita has greatly influenced my thinking on these matters.
2.See Nancy McWilliams' Psychoanalytic Diagnosis.
3.Raimond Gaita, Romulus, My Father.
4.Anne Manne, The Life of I: The New Culture of Narcissism.