Table of Contents
Preface: Locating Myself in the Work xi
Acknowledgments xvii
Introduction: Defining Depression xix
Existentialism, Mortality, and the Human Condition xx
Hippocrates and Humouralism xxiii
Aristocratic Notions of Melancholic Temperament xxiv
Galen and the Theory of Temperaments xxv
Stoicism and Emotionality xxvi
Demonic Possession, Witches, and the Sin of Melancholy xxvii
Treatment of Depression Throughout the Ages xxix
Where Are the Voices of Subjectivity? xxx
Subjective Accounts of Depressive Experience xxxi
Subjective Darkness xiii
Part I Theoretical Exploration of the Origins, Maintenance, and Psychosocial Aspects of Depression 1
1 Psychodynamic Interpretations of the Origin of Depression 3
Depressive Roots: Attachment, Mirroring, and Transformative Experiences 3
Unarticulated Loss: Present Absence, Absent Presence 9
2 Identity Formation: Subjectivity Within the Shadow of Darkness 13
Internalized Relational Schemas: The Self as Its Own Object 13
Alienation: The Self as Other 15
3 Language as Trauma-A Fatal Threat: The Rupture in Meaningful Communication 19
4 Maintenance of Depression 23
Depression as the Primary Object: Cynicism Is Safe, Hope Can Be Devastating 23
Defense Mechanisms 26
5 Disconnection: Social Ruptures 29
Relationships Define Us 29
Lacking Agency: When Effort Is Futile 32
Gender Differences and the Manifestations of Depression 33
Part II Case Studies: Subjective Accounts of Depression 39
6 Interpretative Phenomenology and Narrative Research 41
7 Richard 47
Bullying and Becoming the Other: "I Just Didn't Have that Social Ability." 47
Existential Meaninglessness and Failures of Symbolization: "It's Unsolvable," and "This Is Probably Going to be My Life." 49
Family Life, Disconnections, and the Burden of Sharing: "It's Just a Bunch of Notes … Floating Around." 52
Depression and the Necessity for Disclosure: "If I Tell Someone My Life Story, that Definitely Is Part of It." 58
Making Peace and Positive Growth: "I Learned How to Accept Myself and I like the Person I am Now." 60
8 Judy 67
The Chaotic Climate of Childhood: "Do You Love Me?" "Are You Mad at Me?" 67
The Experience of Depression: "On My Bad Days … It's Like Fallin' into a Dark Cave." 70
Family Secrets and Exclusion of the Other: "You Told them but Not Me. Why?" 72
Navigating the Emotional World: "My Whole Family Is Alcoholic." 75
The Loss of Ted: "I am Now My Husband's Voice, and I Will Continue Tellin' My Husband's Story." 77
Concluding Thoughts: "There Is a Reason Why I'm on this Specific Path." 80
9 Lena 83
Theory of Origins: "I Know that this Feeling I Have, it…Goes Back to … My Childhood." 84
Interpersonal Conflicts and Family Dynamics: "We all … Verbally Attack Each Other." 88
Shame and Worthlessness, Escape and Repetition: "I Feel Guilty … all the Time, Like Ashamed." 94
Alienation and Misrecognition: "I was Convinced that I was this Monster." 97
Concluding Thoughts: "I Think Maybe I Did Go Through a Lot." 101
10 Steve 103
The Idealized and Feared Father: "The Most Important Person in the Whole World" 103
Inadequacy, Worthlessness, and the Denigrated Self: "Why are You Just Not as Good as Everyone Else?" 107
Anxiety and Fear: "I was Always Waiting for Something Bad to Happen." 108
Alcoholism: "I'm Convinced that My Need to Escape the Worthless Feelings that I Had about Myself are Directly Related to My Alcoholism." 112
Medicalization of Symptoms: "It was Like Somebody Had Pulled up a Shade and All the Sudden, I Could See the World." 115
Concluding Thoughts 119
11 Alexa 121
A Break with Reality and the Loss of Meaning: "I was Living in a World that I Didn't Understand." 123
Social Disconnection: "I was an Assignment to them … and It was their Job to be Nice to Me." 128
Annihilation and Persecutory States: "They're Trying to Kill Me and Get My Soul." 130
Emotional Turmoil, Self-Denigration, and Suicidality: "I Can't Explain the Ttortures that I have." 133
Concluding Thoughts 135
Conclusion 137
References 145
Index 153
About the Author 157