Confusion governs our treatment approach to the epidemic of clinical depression. by Bigstock.com
Crippling confusion governs our treatment approach to the mental-health epidemic of clinical depression. Typically, sufferers who ask what causes their depression are told it's a mysterious and complex brain disorder.
This answer does a grave disservice to millions of suffering Americans. So-called experts have dragged depression sufferers into a limbo of ignorance, dependency, and escalating misery. Meanwhile, with no cure in sight, the percentage of Americans taking anti-depressants has grown by 400 percent in the last 23 years.
Many factors can contribute to depression, including social circumstances, environment, diet, exercise, genetics, and seasonal weather effects. The problem is that a major cause of depression--the inner conflict described below--is almost completely overlooked by the prevailing medical-model treatment approaches. Wikipedia has an 18,000-word entry under "Major depressive disorder" (clinical depression), and only about one percent of that content (180 words) approaches the psychological heart of the problem--and even that is couched in vague terminology.
Through depth psychology, we learn that our psyche is a battleground between inner aggression (as represented by the inner critic or superego) and inner passivity (as represented by our self-doubt and subordinate ego). Much of our thoughts and feelings, whether conscious or unconscious, are reflective of one or the other of the points of view of these opposing factions in our psyche.
Depression is the emotional price we pay in our unconscious effort to fend off our hostile, often cruel inner critic. This inner agency harasses us with accusations, sarcasm, mockery, and ridicule. On an inner level, we fight back, usually rather weakly, through the thoughts, feelings, and instinctive defensiveness of inner passivity.
Often times, the inner critic runs people down and demoralizes them to the point that they sink into apathy, hopelessness, self-rejection, despair, and depression. The inner critic's accusations against us are usually negative, unfair, and unjust. While we do try to deflect this inner assault, we absorb much of the aggression because, through inner passivity, we can't represent or protect ourselves strongly enough.
Our authentic self, the part of us that would be free and clear of any depression, is buried under the weight of the conflict. In inner weakness, our consciousness simply shifts back and forth between the influence, in one moment, of inner passivity, and the influence, in the next moment, of our inner critic.
Many of the symptoms associated with depression are the same symptoms associated with inner conflict. Depressed people, according to Wikipedia , "may be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness, hopelessness, and self-hatred." These painful feelings also arise from the inner conflict between inner aggression and inner passivity. Our inner critic assails us with accusations of our worthlessness, and through inner passivity we experience helplessness, hopelessness, and guilt.
Many people have a particularly harsh inner critic (genetic factors are a likely contributor). Such an inner critic is particularly vicious and cruel. Without insight, the person presumes that the harsh criticism or hatred he or she is feeling is somehow validated by his or her faults and failures. The individual can absorb the negativity to the point that he or she is soon brimming with self-hatred. Often, a person with self-hatred is especially hateful toward others.
It's also the case--again often for genetic reasons--that some of us are particularly burdened with large deposits of inner passivity in our psyche.
The presence of guilt (another common feature of depression sufferers) is a more complex matter--and it involves a controversial concept. The guilt is associated with the degree to which the individual is unconsciously willing to soak up or absorb the negative, aggressive energy of the inner critic. Hence, there is likely to be some unconscious, non-sexual masochism associated with the conflict. Many of us find this to be a startling idea, and often we can't come to terms with it. In any case, this thesis contends that the guilt is produced as part of our defensive effort to deny recognition of the masochism.
Many people suffering from depression frequently blame themselves for negative occurrences in their life. Our inner critic is also quick to blame us for our real or alleged faults and failures. Our inner passivity, as well, grapples with the blame dished out by our inner critic, although inner passivity often tries to shift the blame to some allegedly "lesser crime" (as adjudicated by the inner critic). Depression is also associated with bodily tension and stress, and this symptom correlates with the anxiety produced by psychological inner conflict.
Some experts say that depression arises when we are unable to attain our needs or realize our potential. Again, inner passivity in particular creates an inner blockage to creativity, purpose, confidence, and the full range of our intelligence. We can be very smart and capable, yet through inner passivity remain completely bewildered and overwhelmed by the demands of achieving success.
Depression sufferers need to be provided with better knowledge. Many of them can apply this knowledge to relieve their suffering. In this process, relief from depression involves a learning process. We learn the dynamics of the inner conflict that produces depression, and we become insightful enough to see these dynamics at work in our own psyche. This strengthens our intelligence and consciousness. For now, very few psychotherapists, even among psychoanalysts, practice a method that employs this knowledge. So individuals who wish to try the process may have to learn it and apply it on their own.
Many people escape from depression by engaging in healthy and enjoyable pursuits and activities. By taking control of their life, they have emerged to some extent from their inner passivity. With this expression of inner strength, they make their inner critic less troublesome and their depression abates.
In summary, inner conflict as a feature of the human psyche was a mainstay of classical psychoanalysis. But hard science was unable to detect or quantify this conflict of the unconscious mind. In the attempt to understand human suffering, psychiatrists beginning in the 1960s shifted to the "more promising" materialistic realm of brain, genetic, and chemical study. This shift, whereby so-called experts claim to possess the answers to our suffering, is a secular version of the religious authority that ruled the minds of the people in past centuries. Meanwhile, psychiatrists have conceded that they do not know the origins of depression, and there is no laboratory test for the condition.Psychological insight bestows personal power upon us. We're no longer dependent on expensive medications that are little more than pain-killers. Inner knowledge belongs to us. We can use it to make sense of our life as we extend our intelligence into realms we once ignored.