existential blues …

Today I’m looking at the experience of depression, from an existential viewpoint. An existential approach to life and all its dimensions, depression being one of them, is primarily based on a philosophical investigation of human experience in a non-pathological way, while attempting to bracket assumption and values judgements of what might be good or bad. Human experience is understood as an interpersonal process as part of our fundamental interrelatedness and is not treated in isolation. This is highlighted by several psychiatrists who maintain their existential stance as part of their medical profession together with existential philosophers and therapists who will be reviewed in this section.

R.D. Laing was a psychiatrist who challenged the medical status quo and used existential phenomenology to understand what his clients expressed.  He argues that mental illness is not in the mind but part of the embodied, contextual and interpersonal environment (Laing, 1960). Another psychiatrist, Jaspers (1913), suggests the use of a phenomenological method of enquiry with mental health patients in order to promote self-understanding and move beyond the restrictions of the diagnostic criteria. Jaspers (1959), describing depression notes the ‘changes in bodily feeling’, an overall sense of apathy and ‘the feeling of having no feeling’ (pp 110-111).

Similarly, Medard Boss attempts to understand the worldviews of his clients. Boss (1994) argues that the depressive stuckness keeps the one who suffers from actualising possibilities and potentials. In experiences like these, there seems to be no future to be seen while been exposed to a burdensome and guilty past within a meaningless present. ‘The melancholic sees in himself nothing but emptiness, inferiority, worthlessness, and culpability. Anything that may remain open to his limited perception is experienced as an accusation, as a proof of his worthlessness’ (ibid: 219). This depressive stuckness and one’s inability to open to one’s existential potential would contribute to deep senses of existential guilt. Boss sees those experiencing depression trapped in a self-evasion and denial of their life, ‘afraid to risk losing the favourable regard of others’ and insisting on self-annihilation that can lead to the extreme act of suicide. Strasser (1999) also suggests that the downward spiral of depression refers to a continuous loss of meaning and purpose: ‘When clients lose their meaning, depression ensues. Meaning is interconnected with our values our aspirations, and our strategies for survival (p. 16).

Existentially, feeling and being depressed is seen as an embodied experience. Binswanger suggested three world dimensions of experience, referring to the physical, embodied world (Umwelt), the personal world (Eigenwelt) and the social world (Mitwelt) (van Deurzen, 2005). Depression would be manifested across these intertwined human dimensions. Similarly, Jaspers argued that ‘[b]odily feelings are basic to the feeling sate as a whole’ expressing a great variety of vital and organic embodied feelings. Schneider, describing one of his patients, sees a change in embodied feelings as the core of depression with the depressive malaise been located in the limbs, forehead, chest and stomach (Jaspers, 1959). Schneider’s depressed patient says: ‘I always have an oppression in my stomach and neck; it feels as if it would never go away, it seems fixed; it makes me feels as if I would burst, there is so much pain in my chest’ (Jaspers, 1959:110). Another patient speaking of her chest says: ‘I have such terrible misery there’ (ibid).

Leo Dolias

www.northlondoncounselling.com

Desert