Posted on April 11, 2015 in Depression Therapy
Victor Frankl believed that depression had more to do with thought patterns than a physiological cause. Time has shown that he was wrong, but many continue to believe that depression is the fault — rather than the affliction — of the sufferer. In Man’s Search for Meaning — a book I commend despite the flaw I am about to assess — Frankl relates this case:
Once an elderly general practitioner consulted me because of his severe depression. He could not overcome the loss of his wife who had died two years before and whom he had loved above all else. Now, how could I help him? What should I tell him? Well, I refrained from telling him anything but instead confronted him with the question, “What would have happened, Doctor, if you had died first, and your wife would have had to survive you?” “Oh,” he said, for her this would have been terrible; how she would have suffered!” Whereupon I replied, “You see, Doctor, such suffering has been spared her, and it was you who have spared her this suffering — to be sure, at the price that now you have to survive and mourn her.” He said no word but shook my hand and calmly left my office.
The psychotherapist apparently doesn’t see him again.
Frankl, I think, — like many psychotherapists and pop psychology book authors — is too quick to congratulate himself for a coup de grace on his patient’s malaise. I asked myself “How would I feel if I had gone into a therapist and was told that I shouldn’t feel depressed for such a reason?” The word “guilty” came to mind. “He’s telling me that I shouldn’t be depressed,” I would think. “What a bad person I am for being in this state.” We now know that depression isn’t so simple. When we fall into one, we are powerless over the fatigue, the sadness, and the despair that washes over our minds. Strange thoughts begin to collect in the reservoir of our mind and poison that precious pool of identity. Suggesting that we shouldn’t feel depressed for any reason only worsens the stagnation.
Therapy — including Frankl’s logotherapy — can help the depressed patient if it is compassionate and recognizes that the patient is largely not responsible for his condition. Now I have been told many things by therapists and self-appointed helpers over the years including “snap out of it”, “get over it”, and “stop whining”. All of these things made me feel more isolated than before and deepened the melancholy so much that Milton’s description of Hell as “darkness visible” comes to mind. I was not helped by these remarks: my suffering intensified. Positive thinking also did not help. As has been shown by more than a few studies, this tended to crash me into a worse despair than the one from which I tried to extricate myself. Pessimism, of course, is a symptom of depression, but the best thing for it has been realism: recognizing it as a delusion and setting my mind to the purpose of seeing the world as it is. People in depression actually do a better job of seeing the world as it is despite their cognitive impairment. Researchers have tested depressives against the so-called sane by making them play a rigged video game, for example. The depression sufferers recognized early on that the game was unwinnable, but the “normals” kept at it, believing that they could win.
We may see that which is invisible to you.
Encouraging me to see the world as it is rather than try to reverse my pessimism with equally delusional optimism made the burden of my melancholy easier. No one ever argued me out of a depression, but some listened and helped me dismantle the cognitive structures that caused my more intense suffering. Only a few very depressed people have told me that abuse broke the cycle; when I questioned them closely, I had reason to doubt that they had been depressed at all. Many have told me about hearing some piece of wisdom similar to that proffered by Frankl and feeling immediate relief; the next morning, however, the improvement was gone. The blues drowned them once more.
If you want to help a person in depression, listen. Do not judge, do not attempt to apply folk psychiatry, do not attempt to talk them out of it. If they are suicidal, see that they get help. Otherwise encourage them to visit a psychiatrist or a cognitive behavioral therapist. Recommend a support group, invite them out to dinner, spend time with them. These things ease the pain. You are dealing with an irrational disease not a philosophical system.