Manufacturing depression

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Manufacturing depression Page 13

by Gary Greenberg


  In “Beyond the Pleasure Principle,” Freud describes how the ego gets this idea in the first place—and how important it is that it does so. He tells us about the time he observed his eighteen-month-old nephew playing a game with a wooden reel designed to be pulled along the floor by a string. The nephew never used it in this fashion; instead, he repeatedly threw it out of his crib and retrieved it, saying “fort” (“gone”) and “da” (“there”) as he did. This game, Freud said, was “related to the child’s great cultural achievement—the instinctual renunciation (that is, the renunciation of instinctual satisfaction) which he had made in allowing his mother to go away without protesting.” By finding a way to control his rage at being abandoned by his mother, the boy had renounced the pleasure of vengeance and taken a decisive step toward reining in his destructive impulses. This, Freud said, was the basic building block not only of maturity but of civilization itself.

  Freud also noticed that his nephew seemed much more interested in the throwing than the retrieving, which he took to mean that mastering loss was more compelling than seeking the pleasure of return, that getting hold of himself “carried along with it a yield of pleasure of another sort but none the less a direct one.” It’s the pleasure of self-control, of efficacy and self-reliance, and of living in a world where effect follows upon cause, where what happens next can be predicted and controlled. The boy’s delight in his game was the precursor of a grownup’s comfort in the civilized world.

  No matter how well a child accomplishes this task, however, the hatred and violent impulses remain, held at bay by individual effort—particularly the conscience—and by the collective force of civilization. Without this achievement, life would be nasty, brutish, and short; with it, however, the nastiness is merely pushed back to the distant reaches of our minds, into the unconscious. The unconscious never forgets, and trouble like melancholia is kindled when the original hurt and the violence it conjured reemerge to consciousness—a catastrophe that doesn’t require anything as dire as death, that could be as simple and banal as the demise of a bad marriage or any other disappointment through which an opposition of love and hate can be introduced to a relationship or an ambivalence already present can be intensified.

  Whatever insult set off the hatred in the first place can’t be avenged—maybe the loved one is dead or just not available or doesn’t see what he has done—and whatever history gives the ambivalence its peculiar shape is long past. Not only that, but unconscious longings are deep and intense, their satisfaction forbidden.

  For some unlucky people—those with parents who repeat those insults and disappointments, who thus provide a feast to feed our ambivalence—melancholia is the only available currency with which to buy off their hatred.

  Patients manage to avenge themselves on the original objects along the detour of self-punishment, and to torment their loved ones by means of being ill, having taken to illness in order to avoid showing their hostility directly.

  This is why, Freud says, “Prince Hamlet has ready for himself and everyone else” a catalog of his own shortcomings, and why so many other melancholics do the same: “Because everything disparaging that they express about themselves is basically being said about someone else”—the person who died or left or didn’t come through, and all the other people who did that, and so on back to the original objects of ambivalence: mum and dad. Whom you cannot hate or kill because, incompetent or mean or neglectful as they may be, they are all that you have.

  This is also why self-reproach is the identifying mark of melancholia, whether the occasion is the loss of love or the rise of ambition and success: because it signals that the crucial fiction—that we are wholly on the side of our own better angels, that we don’t also hate those whom we love or want to destroy the people who have hurt us—has failed. “The loss of the love-object is an excellent opportunity for the ambivalence of love relationships to come to the fore,” Freud wrote, which means that it is a likely time for us to glimpse the bottomless, destructive desires that haunt our conscious lives. The melancholic is the person whose mum and dad made it impossible for him to maintain the illusion that normally keeps this awareness at bay.

  The biggest weakness in Freudian theory—and perhaps the major factor in its fall from grace—is that it is, as philosophers of science like Karl Popper would put it, nonfalsifiable and therefore not subject to scientific test. Psychoanalysis is a self-contained system, its basic tenets impossible to verify. How do you test for the presence of the unconscious, which exists largely as an absence? The answer is that you don’t. You accept it on faith and go from there. In this respect, psychoanalysis is a throwback to Hippocratic medicine, to a time when wise men postulated forces that no one could see but that must be lurking behind, and causing, what was visible.

  But every so often, one of Freud’s theories is inadvertently supported by science. The central idea of “Mourning and Melancholia”—that the disease consists of the loss of an illusion—is one instance. In the modern version of melancholia, the story that I would have told my doctors—the one in which I concluded that I had no business writing books, that my success was at least as much a fluke as the just reward for my effort—is not a clearheaded assessment, but the sign of pathology. Indeed, according to a theory developed in the 1960s, depressives make themselves sick by persistently and pervasively overestimating just how bad things are. This cognitive distortion is actually the pathogen. Something has gone haywire in a patient’s thinking—and, in later versions of this theory, in a patient’s brain—and caused him to become unduly negative. Cognitive-behavioral therapy, in which a therapist helps a patient correct this bleak outlook, is the cure.

  This theory, it turned out, could be tested. You could, for instance, break the unspoken rat-experimenter pact, the one that says you reward and punish a rat depending on what behavior you want to reinforce, and instead administer electrical shocks at random. And when you find that the rat eventually just curls up in a ball and stops eating, you can call that learned helplessness and extrapolate that this is what happens in depressed people—they get the idea that they can’t make things better and give up. Then you can offer to help them by showing them that they aren’t helpless, that they can improve their circumstances, that their lot is not as bad as they think. And you can turn to your Freudian friends and say that things just aren’t that complicated and dark. You don’t even need a human mind to get depressed, just an expectation that no matter what you do you are going to get hurt.

  But a funny thing happened to learned-helplessness theory. Cognitivists predicted that depressed people would be significantly more likely than non-depressed people to blame themselves when things go wrong. In 1979, a couple of psychologists, Lauren Alloy and Lyn Abramson, decided to check out this hypothesis. They set up a series of studies revolving around a green light and a button. In the first experiment, subjects were told to push the button and decide whether or not it made the green light come on, a condition that was controlled by the experimenter. Over and over again, the depressed people were better than their normal peers at assessing their role in the light’s status.

  Then Alloy and Abramson introduced money into the equation. They gave some subjects five dollars and told them that they’d lose money every time the green light failed to light. They gave other subjects no money but told them that they’d get money if the light came on. What they didn’t tell them was that the button was completely irrelevant and that everyone who started with money was going home broke, while everyone who started with nothing was going to win five bucks. Then they asked them to estimate the extent to which they were responsible for their fortunes—a task at which depressed people excelled. And when the experimenters started to give subjects control over the light, the nondepressed people turned out to think that they deserved to win but not to lose regardless of the actual facts. Depressed people, in the meantime, continued to be superior at figuring out their role in events. The experimenters concluded that “
depressed people are ‘sadder but wiser’…Non-depressed people succumb to cognitive illusions that enable them to see both themselves and their environment with a rosy glow.”

  Alloy and Abramson noted that depressive realism, as this phenomenon came to be called—and, by the way, this work has never been refuted; cognitive theory, as we will see in later chapters, chugs along as if it never happened—raises a “crucial question”: Does “depression itself [lead] people to be realistic, or [are] realistic people more vulnerable to depression than other people?” They did not mention that Freud had already posed this question when he wondered why we have to get sick in order to have access to the truth. But then again, Freud wasn’t bringing up the question in order to answer it. He was making a point: that an excess of truth is bound to make a person suffer. Just ask Job.

  It would be tempting to see Freud’s increasing pessimism about the prospect for escaping ambivalence—or, to put it more directly, to achieve happiness—as his response to the excess of truth imposed by World War I, in whose shadow he wrote “Mourning and Melancholia.” That cataclysm, as he put it in “Transience,” an essay published in 1916, “brought our instincts to the surface, unleashed within us the evil spirits that we thought had been tamed by centuries of education.” It was in the aftermath of the war that Freud developed the idea of the tripartite self, an ego stretched between id and superego, never quite up to the task of mediating between these protean forces. Eventually he would liken the ego to a garrison occupying a rebellious city, one whose walls would sooner or later be breached by the rest of the unruly psyche.

  But historian Eli Zaretsky reminds us that the war’s depredations showed up for Freud and other clinicians in a very specific way: the veterans on both sides of the conflict returned home plagued by nightmares and agitation and depression, by what the DSM now calls post-traumatic stress disorder, but which Freud knew as shell shock. Shell shock, Zaretsky argues, forced Freud to reconsider the significance of trauma in mental suffering. Although he once had seen external events—specifically, childhood sexual abuse—as the culprit in the hysterias he was treating, he had come to think of the memories of abuse as fantasies spun out by the psyche as it manufactured a Manichaean reality in an attempt to come to terms with its own divided nature. But the whole world had witnessed the horror that gave rise to shell shock; there was no use denying that the trauma was real.

  Still, it took an active mind to turn shells into shell shock—which it did, according to Freud, by what he came to call the “repetition compulsion.” The veterans’ psyches forced them to repeat their experience in flashbacks and dreams and in the unending anxiety—so much like their lives in the trenches—that plagued them. Freud had no question that this was an attempt to master the experience in fantasy if not reality, but he also saw something darker at work. It wasn’t only wars and sexual abuse and other overwhelming experiences that breached the garrison; it was a desire, built into our animal nature, to return to our inorganic origins, to obliterate life—or, as Freud named it, Eros—before it obliterates us. “What lives, wants to die again,” wrote Freud’s earliest biographer by way of explaining this. “Originating in dust, it wants to be dust again.” A veteran relives the trenches for the same reason that another man recreates the trench warfare of his family—not only to revisit and “work out” that formative trauma, not only to have the opportunity to play out the drama with the odds evened up a bit, but also out of an inborn and perverse attraction to horror itself: the Todestrieb (“death instinct”), Freud called it.

  Even as he formed these dour theories, however, Freud retained some optimism that the war, and the truths about human nature that it seemed to reveal, would be the occasion for mourning more than for melancholia:

  Once mourning is overcome it will be apparent that the high esteem in which we hold our cultural goods has not suffered from our experience of their fragility. We will once again build up everything that the war has destroyed, perhaps on firmer foundations and more lastingly than before.

  By 1930, however, even this pale optimism—which biographer Peter Gay describes as “far more a matter of duty than conviction”—had nearly disappeared. “I can no longer get along without the assumption of this [death] drive,” he wrote to a fellow analyst. And he was deeply worried about its implications for a people in possession of even the prenuclear version of weapons of mass destruction:

  The fateful question for the human race seems to be whether, and to what extent, the development of its civilization will manage to overcome the disturbance of communal life caused by the human drive for aggression and self-destruction…Human beings have made such strides in controlling the forces of nature that, with the help of these forces, they will have no difficulty in exterminating one another, down to the last man…And now it is to be expected that the other of the two “heavenly powers,” immortal Eros, will try to assert himself in the struggle with his equally immortal adversary.

  These were the final sentences of Civilization and Its Discontents when Freud sent it to the printer on October 29, 1929, the day that the New York Stock Exchange collapsed. The following year nearly one hundred Nazis were elected to the Reichstag, and in 1931 Freud added a new last line, one that made it clear he no longer considered a victory for Eros a safe bet: “But who can foresee the outcome?”

  As much as the book (whose German title, Das Unbehagen in der Kultur Freud once proposed translating as Unhappiness in Culture) keeps returning to the large scale, it also considers the fate of individuals, and here Freud is, as Peter Gay puts it, “pitiless” about our prospects. “The life imposed on us is too hard for us to bear,” Freud wrote. “It brings too much pain, too many disappointments, too many insoluble problems.” The worst by far of those insoluble problems is what Freud calls the “sense of guilt,” which he says differs from guilt itself in that we, rather than some external authority, inflict it upon ourselves. Developing a conscience, we control our instincts and use the channeled energy to erect a civilization; keeping ourselves in line, we can dispense with the dictators in favor of modern nation states and all the liberties they bring. But the price of freedom is high: “the threat of external unhappiness…has been exchanged for an enduring inner unhappiness.” Modern civilization requires a mutilation of the self, less barbaric than circumcision or ritual scarification, but still leaving a permanent mark.

  Your mum and dad, whatever trauma they inflict upon you, are only determining the particulars of how the conflict between your boundless instinct and the demands of civilization is going to make you suffer. The garrison of the ego is under constant assault from within and without; how and where the shells penetrate its walls is a matter of your personal history, but in the war between Eros and Thanatos you are mere collateral damage.

  Our existential condition, then, is one in which both Job and his comforters are correct. The game is rigged against us, as Job complained, but our misery is a function of how we have played the game, as Eliphaz insists. Which means that a very peculiar form of comfort is available: psychoanalysis, which is not a technique for correcting those negative thoughts and achieving happiness, but merely the crucible, some would say the ordeal, from which the patient emerges with the strength and courage to face the truth about himself, to resist what he must resist and enact what he can enact, to live without the illusion that he is not guilty of what he accuses himself of and yet to stop accusing himself. You don’t have to surrender to the whirlwind. If you face it, which is to say if you are an assiduous patient, you can trade in your neurotic misery for normal human unhappiness and carry on with a better story, one in which self-knowledge is your only consolation.

  You have to marvel at the fact that this unrelentingly bleak philosophy, and its expensive, inefficient, and not terribly warm and fuzzy therapy, ever caught on in the United States. The full story of how this happened is too long and complex for my purposes, but Eli Zaretsky has done a very good job of telling it in Secrets of the Soul, and Joel K
ovel has given an alternate account in The Age of Desire. What you have to know is that some things did change—notably Freud’s conviction that the ego would never do better than to hunker down behind some imaginary green line while civilization and instinct relentlessly lobbed their mortars. Within a decade of his death in 1939, Freud’s followers, including his daughter Anna, having left a broken Germany for England and the United States, saw to this, decreeing that the ego was at least potentially a commander-in-chief capable of leading the psyche beyond discontent. By the 1950s, psychoanalysis was dominated by the ego psychologists, whose job was no longer to acquaint people with the source of their discontents, to clue them in to the endless conflict that raged in their psyches, and to console them as they faced their inescapable suffering, but to help them manage their impulses and adjust successfully to civilization. And by the 1950s, psychoanalysis had become what Kovel sneeringly called a “psychology for winners,” which of course made it a much easier sell in the land of opportunity.

  Even before this transformation, however, psychoanalysis had made deep inroads into American popular culture. Zaretsky is among the historians who argue that Freud came along at just the right time: in the first half of the twentieth century, when “personal life”—the interior world that had once been the province of philosophers and priests—became a sphere in which everyone had a stake. “Freudianism helped construct a new object—personal experience,” Zaretsky says. “It gave [people] a new sense, according to which individuality was rooted in one’s unconscious, one’s desire, and, above all, one’s childhood.” As John Calvin had done for an earlier generation, Freud provided the template for the new story that Americans were telling themselves about themselves, their mental hardships, and the means for overcoming them.

 

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