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The development of the existential model of depression in women

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The development of the existential model of depression in women

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Content THE DEVELOPMENT OF AN EXISTENTIAL MODEL
OF DEPRESSION IN WOMEN
by
Henrietta Cecil Spencer
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(Education)
April 198 3
UMI Number: DP24945
All rights reserved
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Dissertation Pu bl i s hi ng
UMI DP24945
Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author.
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UNIVERSITY OF SOUTHERN CALIFORNIA
THE GRADUATE SCHOOL
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LOS ANGELES, CALIFORNIA 90007
This dissertation, written by
Ilenr i.et.t.a.. . . . C . e . c . i l Spencer........
under the direction of h e r . . . . Dissertation Com
mittee, and approved by all its members, has
been presented to and accepted by The Graduate
School, in partial fulfillment of requirements of
the degree of
D O C T O R O F P H I L O S O P H Y
A -9
Dean
DISSERTATION
Chairman
DEDICATION
This dissertation is dedicated to my son David,
who grew up while I was growing, to my mother who stood
by me in the process, to Don Schrader whose warmth and
friendship encouraged me to keep growing, to Earl Carnes
and A1 Marston who guided me along the way, to Bill Ofman
whose thoughts influenced how I grew, and to my friends
who understood or accepted' it all.
TABLE OF CONTENTS
Page
INTRODUCTION ..... ....................... 1
Chapter
I. A BRIEF INTRODUCTION TO HUMANISTIC
EXISTENTIAL THEORY IN RELATION TO THE
OTHER AND A DESCRIPTION OF THE TYPE OF
DEPRESSION TO BE STUDIED . ....... . . 12
II. AN OUTLINE OF THE PSYCHOANALYTIC
THEORY OF DEPRESSION . . .............. . , . 21
III. THE BEHAVIORAL VIEW OF DEPRESSION. . . .
Inadequate Reinforcement
Learned Helplessness
Irrational Cognitions
Summary of HE perspective of Behavior
Therapy in the Treatment of
Depression
. . 30
•
>
H
AN OUTLINE OF THE SOCIOLOGICAL
PARADIGM OF DEPRESSION ................ . . 47
1
Introduction
The Sociological Perspective That
Depression is Due to Role Loss
The Sociological Position That
Depression is the Result of an
Inadequate Role
V. THE FEMINIST PARADIGM OF DEPRESSION. . . . . 78
•
H
>
THE SYSTEMS VIEW OF DEPRESSION ........ ■ . 92
VII. THE EXISTENTIAL PARADIGM OF DEPRESSION . . . 104
iii
Chapter Page
VIII. A NEW PARADIGM: DEPRESSION AS THE
RESULT OF ONE'S CHOICES OF BEING ...... 114
The Paradox of HE
The Two Positions
Being Object and Encapsulation Within
the Other As a Cause of Depression
in Women
Encapsulation in the Self as a Cause
of Depression in Women
IX. SUMMARY, CAVEATS, PREVENTIONS, PREDICTIONS
AND RECOMMENDATIONS. .......................... 143
REFERENCES............................ 171
iv
INTRODUCTION
Humanistic Existential therapy is a moist psycho
therapy, freshly molded from the underpinnings of the exis
tential philosophy of the theistic writings of such authors
as Martin Heidegger, Paul Tillich, and William Barrett,
and the non-theistic approaches of Jean-Paul Sartre and
Albert Camus. The innovation that Humanistic Existential
ism (or HE) wishes to meld into the therapeutic setting
is based on the existential vision of the nature of human
kind.
The foundation of HE rests upon Sartre's premise that
"Existence precedes essence" (1967, p. 34). For existen
tialists there is, therefore, no inherent human nature,
no basic pattern that guides our existence, and no map of
fundamental laws that rules our behavior. "Man is nothing
else but what he makes of himself" wrote Sartre (196 7,
p. 36); or, as relevant here, woman is nothing else but
what she makes of herself.
Once "thrown" .into a world where there is no blueprint
to guide oneself, we are forced to carve out our essence.
"The only hope is in his (or her) acting and that action
is the only thing that enables man (or woman) to live"
(Sartre, 1967, p. 50). From the foundation of existence
2
preceding essence there has risen the need to choose our
existence, and hence our essence, but there also rises the
overwhelming superstructure of HE, responsibility. We con
struct our world, and on that structure we drape our values.
We choose our essence, and we are responsible for that
choice. The person formulates a basic set of choices, and
in the parlance of HE, those choices are called one's
"cosmology,", "myth" or "project." It would be an over
simplification and a degradation of HE to imply that the
theory of existentialism means that one chooses to be poor,
weak or inferior. Sartre referred to these conditions as
our "facility," or the facts of our existence that are
indeed limiting. Within these objective limitations, how
ever, there still exists a subjective choice of how to view
these limits. For example, as will later be pointed out,
some women will look at marriage as the state where she
caught a man, while others will look at marriage as the
state of being trapped by him. Humanistic Existentialism
posits "consciousness" as our ability to look at a situa
tion and to view it from different angles. Our position
in life, therefore, is not some objective reality, but,
by our consciousness/ we can freely intend that situation
in any way we wish to observe it. This concept of con
sciousness is what Heidegger meant when he formulated that
we not only observe our world, but that we also create
3
that same world. We not only choose a way of being in our
world, but we also choose a way of observing the world we
have created.
Each choice within our world has a negative and a
positive wing. The thrust of HE therapy is to have the
person become aware of one's choices, to realize that one
makes a choice for the best of all reasons, to assume res
ponsibility for the choice, to be aware of the possibility
of negative consequences of the choice, and to realize
that one is always capable of making a new choice, or a
new project.
Although HE therapy does provide this outline and
framework for the therapist, there appears to be no attempt
to operationalize some.of the philosophical constructs of
existentialism. This may be intentional, as it might seem
that a formulation of a model would be an attempt to put a
person into a mold, or an essence. Any attempt to put the
person into an essentialistic framework is looked upon as
being a violation (Ofman, 1976). None the less, people do
put themselves into molds and refuse to become aware of
that process; that is, in bad faith, they do not assume
responsibility for the choice they have made, nor for the
consequences of those choices.
This dissertation addresses the need to operationalize
existential constructs and, specifically, to look at the
4
choices a depressed woman makes and to understand those
choices from the existential perspective. The choice that
will be examined is the relation to the Other.
Although existentialism puts its cornerstone on the
choice a person makes, and the HE therapist seems to
hammer away at this point, an often overlooked attic in
the HE structure, it seems to me, is the role of the Other.
On the one hand, HE sees that a person "makes him (or her)
self," but on the other hand, HE theory (while not often
the therapist) recognizes that a person does not always
see oneself clearly and that "I recognize that I am as the
Other sees me" (Sartre, 1965, p. 189). This is not to
say that the Other knows me better than I know myself,
because only I make and know my choices of being, but that
it is with the Other, in the "engaged encounter" (Ofman,
1976), that I discover who I am. The person then, creates
him or her self, but is only found out with the Other. It
is around the philosophical issue of the choice of the
relationship with the Other that this dissertation is
based. The choice of one's being does not exist in a
vacuum, but exists with the Other.
Depression in women, it is hypothesized, is seen as
the result of two types of being in relation to the Other:
1. Encapsulation within the Other
The state of being thrown into the world with no
5
grounding and absolute responsibility produces a panic and
a state of anguish. In an effort to avoid taking a stand
in a world that is without a platform, a woman could
attempt to avoid the problem of choosing for herself by
fusing with the Other and allowing herself to become en
capsulated with the Other. This project seems to run
smoothly until the Other rejects or ignores her, or dis
appears in separation, divorce or death. When her project
collapses after the Other is gone, the world ends in
depression.
2. Encapsulation within the self
Instead of fusing within the Other, a woman may take
hold of the opposite pole. She may take a stand for her
self, appear responsible for that stand, and seem inde
pendent. This independence, however, may be an encapsula
tion not within the Other, but within herself. The goal
of the project is to function and to stand alone. When
the pain of existence presses in on the woman, however, she
remains isolated and ultimately incapable of reaching out.
The project seems to snap of its own weight, and the
woman becomes depressed.
The existential model of depression in women, there
fore, would include an awareness of one's choice of being,
or one's project or myth, and specifically look at the
project with the Other. To be fused with the Other, or
6
to be isolated from the Other, are projects that may work
for awhile, but are teetering near the negative conse
quences of depression if the Other should leave, or if
existence becomes too painful.
The remaining chapters of the dissertation will out
line other predominant theories of depression in women as
a means of comparison with the HE model, and as a way of
explicating the HE model.
Chapter 1: A brief introduction to existential
theory in relation to the Other. This chapter will briefly
outline the existential position in relation to the Other.
A definition of depression from the DSM III and from the
HE perspective, as well as the specific type of depression
to be studied will be outlined.
Chapter 2: An outline of the psychoanalytic theory
of depression. This chapter will look at the analytic
perspective on depression as an intrapsychic model,
whereas the existential model that will be formulated,
views depression as existing in relationship with the
world.
Chapter 3: The behavioral view of depression. This
chapter will outline three predominant behavioral views of
depression— depression as the result of operant condi
tioning or inadequate rewards, depression as the result of
learned helplessness, and depression as,the result of
7
irrational cognitions. This perspective will be used as a
contrast with the HE view that sees that a person may
choose a lifestyle that ends up not being rewarding, and
that the therapist needs not to explore with the patient
how to get rewards, but, instead, needs to look at what is
the myth that results in a non-rewarding lifestlye for
the woman. Learned helplessness will be looked at as the
result of a reciprocal interaction where a woman chooses
to be helpless, rather than from the position that a
woman is conditioned to become hopeless and helpless. Cog
nitions are examined not as isolated and irrational enti
ties removed from the world, but as thoughts that seem
real and valid for the person in relation to her world.
Chapter 4: The sociological view of depression in
women. This chapter will outline the sociological posi
tion on depression in order to contrast the sociological
idea that society is responsible for emotional distress,
with the HE position that a person's choice of a way of
being results in the negative consequences of emotional
discomfort. Sociologists look at depression in women as
the result of role loss or inadequate roles. The existen
tial perspective points out that even if society does
push women into a role, she still remains free to choose
the role or to find a new one. Instead of changing
society or social roles, HE aims at having a woman become
8
aware of the choices she makes in adopting a role, and at
seeing the possible negative consequences in some role
attitudes.
Chapter 5: The feminist view of depression. This
chapter will review some of the current views of feminists
and others that depression is the result of the role a
woman plays in society. Like the sociological perspective,
the feminists believe that depression for women is the
result of a role. For feminists the role is one where
women are trained to be dependent, and dependency results
in depression. The existentialist would suggest that a
woman is not forced into the role by society but may
choose to be dependent. Moreover, the existentialist
sees that a position of independence, which feminists ad
vocate,- roay become an encapsulation within the self, and
this has its own negative consequences.
Chapter 6: The systems view of depression. This
chapter will outline the systems perspective where de
pression is conceptualized within a self-perpetuating
interpersonal system. The system's view comes close to
fusing with the HE vision, as both see that the individu
al's behavior is not the result of the workings of isolated
spheres; that is, behavior is not the result of isolated
mechanisms within oneself— not as intrapsychic, conflicts,
nor as personal cognitions— nor is behavior shaped by
9
outside society or social roles. Both HE and the systems
model find depression as arising out of the ebb and flow
of immediate interpersonal relationships. The systems
perspective, however, views reactions as conditioned or
behavioral responses to other parts of the system or to
the external environment, whereas this chapter will ex
amine the interactions between individuals in terms of the
HE view of choices in relationships.
Chapter 7: The existential view of depression. This
chapter will review the current perspectives of humanistic
existentialists on depression. It would seem that exis
tentialism, as yet, has not completely described depres
sion. Existentialists do suggest that meaning comes from
engagement, but engagement, so far, is translated into
signifying only action. For this dissertation, meaning
will be described as engagement and action with the Other.
Chapter 8: A model of existential depression. This
chapter will describe depression in women as the result of
being either encapsulated within the Other and having the
Other leave, or by being encapsulated within the self, and
being unable to reach out in times of stress. Using the
HE model, this chapter will also hypothesize why some
women choose the project to be encapsulated within the
Other, and why others choose the project to be encap
sulated within the self. This chapter will also theorize
10
how some women escape the trap of either project, and thus
escape depression.
Chapter 9: Summary of the chapters, warnings to the
HE therapists, recommendations for therapy, and forecasts
for women and depression. This chapter will review and
summarize the preceding chapters, issue warnings to the HE
therapist regarding the depressed woman, and will also
describe the implications of the model formulated here.
This dissertation sees depression as the result of one's
project. One would not choose to be depressed, but de
pression is the negative consequence of the project of
being encapsulated within the Other or within the self.
Perhaps in the past, the therapist would be more likely to
see women who were depressed because of being encapsulated
within the Other, but because of a variety of social
changes, women may be more likely to become depressed
because of being encapsulated within the self. This
chapter will discuss these changes. The chapter will also
describe how the therapist using the HE perspective will
incorporate this model into his or her work.
Two specific points need to be addressed concerning
the present dissertation.
First, the theoretical models discussed below are not
limited to the existential view of women only. Indeed, the
same polar extremes— encapsulation within the self, and
11
encapsulation within the Other--could also be applied to
men. Women were chosen as the emphasis here because of a
personal interest in depression in women, because of
changing social conditions which may affect women (see
Chapter 9), and because traditional perspectives used to
treat the depressed woman may be altered by the current
social evolution.
Secondly, the genesis of depression may be traced to
causes other than the models presented here, and this dis
sertation does not deny the importance of other theoreti
cal perspectives which have been revolutionary in their
time and have helped to develop effective therapeutic
approaches. However, the attempt in this dissertation is
to suggest an existential paradigm for the study of de
pression which might enhance the understanding of depres
sion in women from an existential perspective, and which
might expand the possibility for therapeutic intervention
and the maintenance of therapeutic gain.
12
CHAPTER I
A BRIEF INTRODUCTION TO HUMANISTIC EXISTENTIAL THEORY
IN RELATION TO THE OTHER AND A DESCRIPTION OF
THE TYPE OF DEPRESSION TO BE STUDIED
Estelle: I feel so queer...Don't you
feel that way too? When I can't see
myself I begin to wonder if I really
exist. I pat myself to make sure, but it
doesn't help.
Inez: You're well off. I, I always
feel conscious of myself. It's a feeling
in my mind.
Estelle: Yes, in one's mind. But
everything that goes on in one's head is
so vague. It puts me to sleep...I've
six huge looking glasses in my bedroom.
I see them...But they don't see me...
When I used to talk with people I always
made sure there was one nearby in which
I could look at myself--that kept me
awake...
Garcin: You're crazy, both of
you...Let's all of us sit down again
quietly, close our eyes. Each of us must
try to forget the presence of the other...
Inez: Forget? How silly can you
get!
(Sartre, 1965, pp. 186-187)
"No Exit" can be found from the Other..."How silly
can you get?"
In dealing with depression, however, much of psychol
ogy seems that "silly." Cartesian thought separated mind
from matter, person from the world, and human reality from
the Other. With the nature of humankind thus encapsulated
and dissected from the world and from others, psychological
13
theories of depression spun off as a phenomenon that
existed within the person. Depression has been seen by
Freudians as introjected hate (Freud, 1957), and by be-
haviorists as ideosyncratic learning resulting from
inadequate positive rewards (Lazarus, 1968), from learned
helplessness (Seligman, 19 75) , or from irrational private
cognitions (Beck, 1967). In another realm, sociologists
have put the nature of human reality solely in the world,
leaving out individual choice. Depression for sociologists
is the result of alienation and role loss (Durkheim, 1899/
1951; Bart, 1971). Feminists likewise view women as help
less victims not of their own choices of being, but of
outer social conditions (Chesler, 1972).
Nowhere in the Freudian or behavioral theories is
depression viewed within the interpersonal dyadic circuit,
where depression would be seen as constantly being tied to
the person's choice of being with the Other. "Let's all
sit down quietly, close our eyes...try to forget the
presence of the others," is Sartre's satirical way of
saying that we have "no exit" from the Other.
A revolution in terms of the image of humankind is
expressed in Humanistic Existentialism (HE) which des
cribes human reality as residing with the Other (Ofman,
1981) . In this view, the nature of humankind does not
exist as all within the person as many psychological
14
theories view humankind--as hydraulic energies within the
psyche, or as conditioned operations within the organism's
response repertory— nor does human reality exist as all
outside the person as sociological theories have put the
nature of humankind--as external forces that exert the
press of social conditions. Human reality does not exist
as all action within the self, nor as all reaction to the
world, but human reality, for HE, exists as an interaction
with the world of others. "We are a conversation," wrote
William Barrett (1978, p. 189), quoting the poet Holderlin.
The conversation, or the woman's 'choice of interactions
with the Other, and disclosing of self to the Other, is
the theme of this dissertation.
It is proposed that a break in the conversation, that
is, the back and forth interactions with the Other, is
the cause of depression. Further, it is suggested, that
a woman, for her own valid reasons, chooses a particular
tone of conversation with the Other, but that tone may
result in a break in the dyadic conversation.
HE looks at itself as a scientific revolution, in the
sense that Kuhn (1962) meant (Ofman, 1981). The revolu
tion aims to heal the split that locked human existence
into an insulated being that could be looked at and
treated as a machine that could subliminate or recondition
forces. Humanistic Existentialism wants to correct what
15
it sees as an anomaly, because such a mechanistic view of
therapy violates a person who already suffers in the world
(Ofman, 1976). Instead of attempting to treat symptoms,
the HE position is that it is essential to become aware of
one's choice of project, as the project is the source of
one's pain. This philosophical or theoretical concept is
critical because the therapist's belief system regarding
the nature of human reality has a bearing on one's concept
of therapy, on the nature of the relationship between
client and therapist, and on one's method of treatment
(Singer, 1965; Karasu, 1977). A philosophical acceptance
that the pain of depression is the tragic result of a
woman's choice of being with others would allow the thera
pist to work with the client to determine how she has
constructed her world, and the consequences of her way of
being there. Depression will be examined as the symptom
of the woman's choice of a particular project.
The two basic modes of being— encapsulated within the
Other, and encapsulated within the self— are suggested as
the ways of breaking the conversation with the Other and
resulting in depression. The therapist using the HE model
does not attempt to cure the person of depression. The
only change would be in the awareness of the person's myth
(Ofman, 19 76), and the negative consequences of the lone
liness of living without a conversation.
16
Definitions of Depression
To define depression means that one must examine the
HE conflict with diagnosis. Any definition of depression,
however, seems hazy. The nosological conflicts result
from the various clinical elements used to define depres-
sion--emotional, somatic, behavioral or cognitive (Bonine,
1975). The American Psychiatric Association's (1980)
standard nomenclature, the Diagnostic and Statistical
Manual of Mental Disorders, 3rd edition, qualifies a
"major depressive episode" as a "dysphoric mood or loss
of interest or pleasure in all or almost all usual activi
ties and pastimes" (p. 210). The manual further quanti
fies depression as consisting of "at least four" symptoms
of depression for at least "two weeks" (p. 213). Dystonic
Disorder consists of a "depressed mood," but not of
"sufficient severity or duration to meet the criteria for
a major depressive episode" (pp. 220-221). Rather than
having clarified depression, however, the DSM III may
have confused the nomenclature by trying to put depres
sion into categories.
In reviewing the obscurities of the refinements,
Ascher (1952) wrote that "the diagnostic features of
depressive illness do not show differential characteris
tics specific enough to permit the distinction between a
neurotic and a psychotic group" (p. 908). Rather than a
17
categorical view of depression, Bonine (1975), suggests a
"gradient" from normative to disturbed that would deal
"with the total span of depression from moping to psychotic
withdrawal" (p. 303). Although the gradient view of de
pression helps to remove depression from being seen in
boxes of nosological categories which may have artificial
lines of separation, the approach still looks at depression
as an illness in the person. As Bonine sees it, "depres
sion is a way of living— a sick way" (p. 301).
Existentialists resist any definition of depression
that would depend on diagnostic quantities of somatic symp
toms, emotional responses or affective expressions. De
pression, for HE, is not a quantity, nor do existentialists
make categorical distinctions between psychoneurotic to
psychotic, exogenous to endogenous, major disorder to
"other" disorders. Existentialists discourage categorical
distinctions because they feel that diagnosis is an
"ensickening act" (Ofman, 1976) which communicates that the
patients are "appropriate objects for evaluations" and
"joins with the person's ongoing self-objectification that
has brought that person to the consulting room in the first
place" (Ofman, 1976, p. 198). Not only do HE therapists
feel that diagnosis objectifies the client, but they feel
that diagnostic formulations interfere with the thera
peutic relationship. "The standard diagnostic formulation
18
tells the therapist nothing about the unique person he or
she is encountering; and there is evidence that diagnostic
labels impede or distort listening," explains the exis
tential therapist, Irwin Yalom (1980, p. 410).
Depression, for HE, is not an illness that lies within
the person in any category or in any "gradient." For
existentialists, the "symptom expresses the way a person
chooses life" (Ofman, 1976, p. 94). Depression is the
symptom that the person's personal myth is not working
in the world. For HE, it is not simply that the person is
depressed, but, as van den Berg explains, when the "person
is ill, this means that his (or her) world is ill" (1972,
p. 67). Rather than examining the inner workings of the
person, the HE therapist has the patient describe his or
her world. "The depressed person speaks of a world gone
gloomy and dark. The flowers have lost their color, the
sun has lost its brightness," is van den Berg's (1972,
p. 67) description of depression that emphasizes that
depression is not an insulated illness, but that it
affects one's world. Existentialists also believe that
we are not separated from that world, but in fact, we are
that world. "We often are the objects" declares van den
Berg (1972, p. 67). In depression, however, the objects
no longer seem to call us to them, or call us "yonder"
(van den Berg, 1972), and the body seems to shrivel. The
19
body is reflecting and illuminating our world view (Sartre,
1948). HE, then, does not define depression in categories
or gradients inside the person in order to treat and cure
the person, but, instead, the therapist has the person des
cribe one's world, become aware of the one's project within
the world, and the negative or depressing aspects of that
project.
For this dissertation, any type of depressive experi
ence, where "the world has gone gloomy and dark," will be
looked at as the result of one's project to be encapsulated
within the Other or within the self. Although this view
sees depression as the result of a woman's choice of her
project, it would be a cruel therapeutic error to allow
a person to suffer endlessly without relief. Some crude
determination of a diagnosis is needed. The HE therapist
must recognize that there are some depressive experiences
that demand chemotherapy in order to reduce the pain and
be able to see the project more clearly. Further, there
are some depressions, such as endogenous depression or
manic-depressive diathesis, that are the result of a
chemical imbalance, and to ignore or deny drug treatment
would seem to be a sadistic, ignorant or stubborn choice.
Irwin Yalom (1980), describes the responsible position,*
"...one needs to ascertain whether the patient is suf
fering from severe affective disorder of biochemical
20
etiology...which requires pharmacological treatment"
(p. 410). Without glossing over the possibility of chem
ical therapy, the perspective described here will look at
any depressing experience of any time duration from the
perspective of one’s choice of relationship with the Other.
21
CHAPTER II
AN OUTLINE OF THE PSYCHOANALYTIC
THEORY OF DEPRESSION
A shift from just describing the pain of depression,
to the dynamic classification of depression began in 1971
with Abraham (1949), who recounted how "psychotic" depres
sion arose from repressed hostility towards a love object.
The by-product of this repression was guilt which lead to
anxiety, self-reproach, and paralyzing depression. It
remained for Freud, in 1917, however, to build on Abraham's
work and to further refine the separation of categories
of depression between ordinary mourning and clinical melan
cholia, and to provide a mechanical model in which de
pression occurred (Freud, 1957).
Unlike Abraham, Freud saw depression as eminating not
just from the loss of a loved thing, but also from the
"loss of some abstraction which has taken the place of
one, such as fatherhood, liberty, an ideal and so on"
(Freud, 1957, p. 25). The dynamic process of "mourning
and melancholia" begins with identification, and energies
are cathected upon the loved object, person or abstrac
tion. In mourning, reality testing reveals that the
object is lost, and the libido is summoned to remove its
22
attachment from the object. The libido rebels against the
removal with hallucinated "wish psychosis," and insists
that the object still remains. Slowly, however, reality
seeps back into the libido and with tremendous costly ex
penditure of cathected energy, the libido gives deference
to the orders from reality. Each memory which tied the
libido to the object is brought up and tossed out. Once
worked through, the libido is free again and uninhibited.
The mourning process of detaching the libido from the
object requires work of the ego "which leaves nothing over
for other purposes or other interests" (Freud, 1957,
p. 126). The ego, in the Neutonian model, has no more to
give, and with the lack of steam, it shuts down in depres
sion .
With the melancholic, however, the identification
with the object represents a libidinal regression to the
primative "oral cannibalistic" stage. Ambivalent feelings
of love and hate are generated in the process of oral
incorporation, dependency, and attachment. With this
original form of narcissism, the melancholic identifies
with and incorporates the love object into the ego. The
love object can be lost, but it is too late. The object,
person or abstraction lives on within the ego. The libido
has been sucked into the ego and used to establish .an
identification of the ego with the love object. The oral
sadistic stage of narcissism is not abandoned, and criti
cism for the "forsaken object" is deflected back and
misplaced upon the ego which now stands for the object.
Whereas in mourning, there is a longing for that which is
lost, in melancholia, there is a mourning for the loss of
the libido. "Thus the shadow of the object fell upon the
ego..." (Freud, 1957, p. 131), is Freud's poetic transla
tion of the mechanical manner that he has described as the
melancholic's process of self-punishment.
Other analytic theories of depression have been con
structed on the Freudian model. In 1928, Rado conceived
of melancholia as a despairing cry for love. The lost
love object had gone. The good parent, incorporated into
the superego, punished the bad parent, incorporated in the
ego. Klien (1948) sees depression developing if the first
year of life is ungratifying and the depressive position
is planted to emerge later as depression in adulthood.
The rage toward the frustrating mother is intrapsychically
undone by the self-punishment of the incorporated bad
mother introject. Bibring (1953) postulated that depres
sion was an ego state of helplessness that resulted from
a loss of self-esteem from repeated childhood experiences
of helplessness.
The landmark of the analytic theory is not just the
centrality of loss, but the mechanistic description of the
24
loss that occurs totally within the person. For Freudians,
melancholic-psychotic depression occurs within the intra
psychic sphere. A trench is dug between the person and
his or her world and the relationships with others there.
Depression is not connected with the world or with others,
but is severed and shoved inside the person. "Psychology
became the science of the subject," explains van den Berg
(1972, p. 40), describing the Freudian geologic expedi
tions that created the gap between the person and the world
outside. The "science of the subject," however, becomes
for existentialists, the "science of emptiness, of nothing
ness," because for existentialists, the "pure subject, the
completely unsubstantiated inner man does not exist" (van
den Berg, 1972, p. 40)-. Depression, for HE, cannot be
understood in the emptiness of the intra-psychic realm.
Inside the mind, say existentialists, there exists only a
contentless vacuum. Depression, for HE, is understood as
the person-in-the-world, that is, as the person's inter
actions, projects, and relationships with others.
Existentialists are critical of the Freudian paradigm
of depression, because feelings are removed from the
reality of the lost object. Feelings for the object are
boomeranged to being within the person and disconnected
from the object. Freud describes the boomerang-like
notion of deflected feelings, "...self-reproaches are
25
reproaches against the loved object which have been
shifted onto the patient's own ego" (1957, p. 130). Exis-
tentilists aim at liberating the encapsulated dynamic view
and releasing the person back into one's world. "The de
pressed person speaks of a world gone gloomy and dark," is
van den Berg's (1972, p. 45) way of describing that de
pression occurs in relationship to the world outside and
not to something inside one's mind. For HE, inside the
head nothing is seen, but the gloom of depression is
turned outside by existentialists .
Not only are existentialists critical of the
Freudian view of an intrapsychic depression where the
lost object becomes introjected and embedded in the
psyche which then is subjected to deflected hostility,
but existentialists are also critical of the Freudian
notion that the loss can be an unconscious one. "Melan
cholia can be due to a reaction to loss of a love object,
[but]...melancholia is in some way related to an uncon
scious loss of a love object" (Freud, 1957, p. 127). HE
is critical of the idea of the "unconscious" (Sartre, 1956;
Ofman, 1976), because "consciousness can hold no secrets
from itself" (Ofman, 1976, p. 49). In this context,
existentialists would question how a person could be
"unconscious" of what one has lost. Even for an object
to be incorporated within the ego, as the Freudians
26
describe, it would seem that one must first be aware of
the object of identification. The loss of the introjected
object results in deflected hostility upon the ego. To be
unconscious of the loss, must mean that the feelings
spring from nowhere. Freud seems to have postulated an
objectless depression.
The truth for existentialists is that depression is
popped wide open and placed in the world outside. When a
person is depressed, something in one's world is missing.
The world is "gloomy." Something which lit up the world
and made it work right has gone out. The job of the HE
therapist is not to work through the unconscious loss that
propels itself from a vacuum inside the person, nor to
strengthen the ego in order to subliminate the deflected
anger. The job for the HE therapist is to work with the
person to illuminate the myth, that is connected to one's
relationship to the world, and to see how the project no
longer works in the world.
For women, Freud does not even begin to interpret the
unconscious loss. The analyst knows what depresses women.
The repressed wish for a penis is the "source of outbreaks
of severe depression." What makes the loss of a penis
even worse is her "internal conviction" that the analysis
will be of no use and that nothing can be done to help
her; "...her strongest motive in coming for treatment is
27
the hope that after all, she might obtain a male organ..."
(Freud, 1964, p. 252).
Feminists castrate Freud for his view of women as
being obsessed with growing a penis. The real obscenity
of the phallocentric view, however, is that the analyst's
superior position in assuming to know more about the woman
than she is capable of knowing of herself, puts women
into a laced up position. By staring at organs, the
analyst is also staring from above, as an authority on and
over the woman. He or she (but usually he) is assumed to
know the source of her depression, and to know it better
than the woman does. With a superior position, the analyst
is unable to gain any perspective on the woman's world.
The vulgarity of seeing "penis envy" as the source of
female depression, then, is the violating view*from above
that the analyst casts on the woman, and the focus on her
organs, rather than on her total being-in-the-world.
The Freudian conception of depression has been
carried down in the paradigm of the treatment of depressed
women. Depression is seen as not only the response to a
\
loss of some ambivalently loved object, but also the result
of anger towards the object or abstraction which is de
flected inward towards the self. Men are viewed as being
aggressive in response to the loss, whereas women respond
with depression. Without looking at her other
28
relationships off the psychiatrist's couch, the analyst
delves into the woman's psyche to uncover the anger and
have it worked through. Depressed women have been seen
as less verbally hostile and aggressive than non-depressed
women or even depressed male patients. "It may be,"
writes Alfred Friedman, "that it is [the depressive*s]
inability to verbalize hostility spontaneously to the
person for whom they feel it at the time when it is
appropriate [that] is a part of the predisposition to be
come depressed" (1970, p. 532). The analyst works on
having the woman express her anger. Primal Scream therapy
and the Gestalt approach of "getting in touch with your
feelings" are outgrowths of the Freudian germination.
Instead of viewing women intrapsychically, existen
tialists aim as seeing persons interpersonally. Off the
couch, and out of the office, a woman my be less repressed.
In looking at the hostile reactions of 4 0 depressed and
40 matched controls, Weissman, Klerman, and Paykel (1971)
found that the depressed women reported more hostile be
havior to others than with the psychiatrist. Friction in
general seems related to intimacy; that is, most anyone
will express less hositility to an experimenter or
analyst, than one would to one's mate or children. How
ever, Weissman and others also found that depressed
women were more likely to have more friction in their
29
lives than other women, and a depressed woman was signifi
cantly more hostile to her children and spouse. Rather
than trying to stir up the depressed woman's hostility
towards others to affect a cure, the therapist may need
to work on a reconciliation. Women who were able to
improve marital relationships and reconcile marital dis
putes, were more likely to become less depressed and *
improve social functioning (Rousanville, Weissman,
Prusoff, Heraey-Barpn, 1979).
Freud did open up a new paradigm when he viewed de
pression as something other than the bubblings of black
bile or the curse of devils. It was a radical, perspective
to see depression as the result of a mental phenomenon.
What this chapter aims at pointing out, however, is that
what may be needed is a paradigm that views depression not
as the result of inner mental workings seen on the couch
and in the office, but looks at depression in terms of the
person's interactions and relationships with the others.
30
CHAPTER I'll
THE BEHAVIORAL VIEW OF DEPRESSION
Existentialists have christened the heir apparent of
psychoanalysis to be behaviorism (Ofman, 1981) . For HE,
both psychologies trace their lineage back to machanistic
Neutonionism which bequeathed to its descendents technolo
gical characteristics to explain human reality. Existen
tialists see psychoanalysis as marked with a mechanistic
psychic apparatus, and they see behaviorism as having
altered this birthmark into the S-R bonds. As HE sees
them, the resemblance of psychoanalysis and behaviorism
is strikingly revealed in the mechanistic treatment of
depression. As the analyst works with the patient to
strengthen the ego against the assaults of ambivalent
hostility, so the behaviorist works to increase some form
of positive response. In both, the therapist executes
the treatment from an asymmetrical relationship, where
the patient is taught how one Should change (Ofman, 1976) .
Three behavioristic theoretical models of depression
will be reviewed--depression resulting from inadequate
rewards, from learned helplessness and from irrational
cognitions. These theories will be presented to review
the behavioral paradigm, to present the HE contrast, and
31
to continue to orient the reader to the perspective that
will be developed in this dissertation.
The HE View of the Behavioral Perspective
of Depression Resulting from
Inadequate Reinforcement
Behaviorism, as does psychoanalysis (and most other
theories), views depression as a loss. "There is a loss
and deprivation— loss of money, or love, station or pres
tige, recognition or security," wrote Lazarus (1965,
p. 85), echoing back to Freud's idea that the loss may be
due to some thing or to some "abstraction"; but, in be
havioral form, Lazarus responds that the loss is due to
a lack of positive reinforcers— "a depressed person is
virtually on an extinction trial" (p. 84). The behavior
therapist devises some schedule of reinforcement, and
prods the patients with the "need to learn a way of recog
nizing and utilizing certain reinforcers at their dis
posal" (p. 85). Non-rewarding "inimical circumstances"
such as "an unsatisfactory job, an unhappy marriage or
social isolation" are environmentally manipulated or
"altered by a touch of assertiveness," or else some
"therapeutic ingenuity in fostering recreational pursuits,
meaningful friendships, hobbies or other constructive
activities" (p. 86).
Existentialists are critical of behaviorists because
32
the person*s world view is not accepted, validated nor
affirmed. Not only do existentialists insist that a ther
apist try to look with the person to affirm one *s world
that is depressing, but HE is also critical of behavior
ists who try to zap away that world with positive rein
forcement and "touches" of manipulations to alter the
patient's behavior. From the existential perspective, the
person's world may remain untouched, because the behavior
ist only conditions the symptoms of existing in a gloomy
world. "Nowhere is the person's symptoms given the dig
nity of being a meaningful symbol for the choice the
person has made" (Ofman, 1976, p. 92). The choice of
one's myth, say existentialists, results in an "unsatis
factory job, an unhappy marriage, or social isolation,"
and the myth creates the "inimical life situation" with
depression being the symptom. Existentialists feel that
changing the environment will only shift the myth to new
ground where the same project will likely be planted and
yield the same bitter and sour ends. "Recreational
pursuits" or "hobbies" might get the patient to garden,
says HE, but gardening does not change the gloom in the
patient's world. The therapist, from the HE way of
seeing, needs to look with the patient through the gloom
and see what project the patient has chosen to create
the world. Instead of affirming the patient's view of
33
the world, behaviorists want to change the symptoms of
that world.
The perspective of depression resulting from inade
quate reinforcement was used to emphasize the HE position
that sees a person as choosing a project that results in
depression. Instead of trying to condition behavior, the
HE therapist seeks to look with the patient to understand
the myth that results in the negative consequences of
depression.
HE View on the Behavioral Perspective
That Depression is the Result of
Learned Helplessness
Existentialists consider that behaviorists are
harnessed into the technology of learning and reinforce
ment. When behaviorists see a person who is not acquiring
available reinforcement, then some behaviorists consider
that the person has learned a helpless mode in the envi
ronment .
In developing an analogy to explain depression,
Seligman (1975) and his associates subjected dogs 'to
unavoidable shocks to their hind paws. These trauma
tized dogs were later transferred to a box with a parti
tion and shocked again. Unlike "naive" dogs placed in a
box, the traumatized dogs behaved passively in the new
adversive context even though a response was available
that would have allowed escape. The dogs seemed
34
paralyzed into accepting the shocks and huddled and
wimpered in a corner.
In converting the dogs' experience to humans,
Seligman suggested that an episode of uncontrolled noxious
stimulus leads to learned passivity and interferes with
learning of new responses and relief contingencies. A
person learns to be helpless and that one's actions are
not effective. The helpless, passive attitude in the face
of pain is typical of the depressed person and Seligman
attributes this to learning. Making a fragile switch from
a depressed response to a causal theory, Seligman is
saying that depression results from learning that res
ponses do not pay off.
From looking at traumatized dogs to depressed women
may be a strange view, but many behaviorists, as well as
feminists, have gazed with an uncritical, and even favor
able eye, towards the comparative sight. Women, so the
analogy goes, have undergone childhood experiences where
"their personal worth and survival depend not on effective
responding to life situations, but on physical beauty and
appeal to men--that is, that they have no direct control
over the circumstances in their lives" (Beck and Greenberg,
1977, pp. 120-121) . In this perspective, women are not
shocked in boxes with no escape, but receive parental and
institutional barbs from which there are no secret exits.
35
"Women, like dogs...lose their ability to respond effec
tively and to learn that responding produces relief"
(pp. 120-121).
In a critical look at the transformation of shocked
dogs to traumatized women, Rohrbaugh (1979) points out
that "the experimental animals were not encouraged to be
generally helpless and dependent, as the argument main
tains that women were while growing up" (p. 4 05). The
dogs were shocked and if the theory of learned helpless
ness is to be valid and generalizable to women, Rohrbaugh
feels that "one would have to specify what painful ex
periences^— at least emotional if not physical--occur only
to girls with no hope of escape."
Coming close to understanding the "conversation"
that is telephoned through the lines of interactions in
one's world, Rohrbaugh reads into the dialectical message
of helplessness. "The cringing, passive behavior in
females... usually influences the situation in some way"
(p. 4 05). Unlike dogs where no behavior on their part
could influence the duration of the shocks, "many girls
are indeed taught that they can control their lives by
appealing to or manipulating men" (p. 4 05).
For existentialists, Rohrbaugh goes far in correcting
the behaviorists' view, but a closer inspection needs to
be made for HE.' As the HE view does not see the nature
S '
36
of humankind in boxes of mechanically encapsulated psychic
systems, neither does it permit a view that sees us as
experimental animals of a different degree. "Man is a
different being," reminds. Ofman (1981), meaning that we
are not animals of a different degree, but of a different ?
kind. Part of the difference is what Rohrbaugh is seeing.
Helplessness could be a code for "manipulating men" and
for control, however, helplessness could be decoded into
taking on several different meanings. The helpless person
can, with the therapist, become aware of the meaning of
the symptom for that person. There remains more, however.
Modern HE has rewritten phenomenology into reading the
"conversation" with a new translation; not only can the
person become conscious of the meaning of the symptom
for oneself, but also, the person can become aware of the
meaning that the symptom has "for you and for me" (Ofman,
1981).
We live in a participatory world, and, what modern
existentialists are saying is that the symptom of help
lessness and depression is held in the context of the
conversation with the Other. Helplessness means some
thing, and it means something with another. Depression
also means something with another. Depression is the
communication of a project that has failed (Sartre, 1956).
We are not simply wimpering dogs in boxes, but
37
existentialists view depression as a cry of some failed
project that we have had with another.
The perspective of depression resulting from learned
helplessness was presented to illustrate the HE view that
any behavior, even helplessness or depression, has a
symbolic meaning, not only for oneself, but also has a
meaning that stems from our interpersonal relationship
with others.
The HE Perspective on the Behavioral
Theory of Depression Resulting
From Irrational Cognitions
Behaviorists have recently evolved from looking at
external to internal targets of change— from behavioral
to cognitive manipulations. The miessage behind the evolu
tion, however, remains fixed within the behaviorist's
genotypic theoretical constructs— the message is control
(Ofman, 1976; 1981). Depression is to be controlled, or,
at least, depressive symptomatic behaviors, or the cog
nitions leading to behaviors, are to be counteracted.
In examining the depressive behavior, Aaron Beck
(1976; 1976) pinpoints depression in the spot of the
negative cognitive sets. Following Ellis' rational
emotive therapy, Beck explores the covert beliefs, rather
than the overt behaviors. For Beck, the depressed per
son's thinking is "erroneous." The negative cognitions
38
lead to dysphoria, passivity and despair. Instead of the
psychoanalyst effort to pry loose the "engrammata," or the
messages of the traumatic events that are "stored in a
closet called the head" (van den Berg, 1972, p. 88), Beck
tries to elicit the cognitive scripts within the mind. As
the analyst scrupulouly tries to untangle the repressed
meaning of mental events to resolve neurotic conflicts,
so Beck tries to correct erroneous cognitions that cause
defeating behavior. For existentialists, Beck's own
evolution from psychoanalysis seems apparent.
For Beck, the loss is in the form of a subtraction
from one's "personal domain"--the self, a significant
Other, or some valuable object or attribute, ideal, belief
or goals. The loss, from the existential perspective, does
not appear to be valued by Beck, but is looked at as an
irrational tape that runs through the patient's mind.
Once the patient is able to play back the tape, then the
therapist confronts the patient to "question their 'sense'
and reality test their appropriateness in the patient's
life" (Kovacs & Beck, 1978, p..53). The dysfunctional
thoughts are then modified with theoretically more
realistic cognitions. Once new tapes are played, then
new behavior is supposed to follow the rhythm of the new
tune. The positive behavioral alterations are fed back
into the cognitive loop, processing, recording and
39
playing out a crescendo of ever new reinforcing thoughts
to reproduce positive behaviors.
Cognitive therapy seems to hold some of the answers
to depression. It has been shown to be effective in pro
ducing fewer depressive symptoms than a no treatment
group (Shaw, 1977), and more effective than anti-depressant
medication (Rush, Kovacs, & Hollan, 1977). Questions
remain, however, for existentialists and others..
In an appraisal of "Contemporary Theories of Depres
sion," Paul Blaney (1977) scratched the veneer with
criticisms of Beck's cognitive model as being "unsatis
factory as a scientific theory" (p. 212). Blaney just
touches the surface for existentialists, by suggesting
that, "what is needed is a specification of what role
what cognitions have in what stage of development or main
tenance of what kinds of depressive conditions" (p. 212).
The questions, for existentialists, however, may not reside
in a more technical analysis of answers to "what," nor in
behavioral questions of "how" or "how to." "The very
basic question," answers Ofman (1981), is "why." The
question is not "what" specifics, nor how to change them,
but "why" does a person see the world as he or she does?
The answer lies in where one looks for it. Behaviorists \/
see responses reacting and existing inside the person,
whereas existentialists see the person acting with an
40
existing world outside; "the person does not just react to
the world, but acts in the world" (Ofman, 1981).
"Behavioral man," writes Karasu (1977) in comparing
different images of humankind, is "reducible to stimulus-
response connections th&t can be isolated and altered in
piecemeal manner... Behavioral man (or woman) is infinitely
manipulable. . . 1 1 (p. 857). Existentialists, on the other
hand, attempt to see human reality in a connected whole,
and resist manipulation of the person.
At first glance, Beck appears to have made a pheno
menological transformation because he searches for covert
meaning; but when looked at longer and with some distance,
cognitive therapy maintains, from the HE perspective, the
same overall behavioral view of human reality. The person
is viewed as a series of links, the links need to be
straightened out, and the therapist alters the links that
motorize mechanical humankind, or that still the depressed
person.
Unlike classical behaviorists who had ignored any
unmeasurable data between the stimulus and response,
modern Skinnerians see some intervening variable, that is,
some thought, as a stimulus or an intervening link between
one stimulus and the eventual response.' Keen (1970) scans
the connections between the stimulus and response, and
sees "experience" as not just a link, but, instead, "it is
41
critical and informs the input as well as the output"
(p. 6). Beck grabbed onto the connections between the
stimulus and response, and instead of calling it
"experience," he put "conscious meanings" in its place.
For Keen the model reads:
STIMULUS-^EXPERIENCE-^RESPONSE
While for Beck, the model is diagrammed:
STIMULUS<—CONSCIOUS MEANINGSC—RESPONSE
In Beck's model,, cognitions, or "conscious meanings"
are behaviors, and as behaviors they are objects that can
be changed to alter the depressed response. It is as if
consciousness is changed into an object to conform to the
behavioral process of systematically altering behavior.
Existentialists object to cognitive therapy because HE
does not view consciousness as an object, nor as a process.
HE, reminds Ofman, "views man and man's consciousness
uniquely as completely free and thus free of any process"
(1976, p. 219). If consciousness is not a process,
contend existentialists, it cannot be the mechanical
object that Beck seeks to grab onto, tie down and re
structure .
Existentialists let "experience" or "consciousness"
or awareness go free of any object definitions or any
process model. As Keen attempts to explain the amorphous
concept, experience or consciousness is "not an object and
42
cannot be described in metaphors that are derivatives of
the object world,..hence the 'somethings' that goes on
between the individual and an object...is neither in the
organism", (as cognitive therapists would put consciousness)
"nor in the object" (where environmental Watsonian deter-
minists would put it) "nor someplace between then" (as
the analysts might put genetic history) "it is not any
where" (p. 7). Laing (1967), however, does help to ex
plain where consciousness might be. He dumps experience
out of Beck's processing model as he evaporates experience
as "not inside my head. My experience of the room is out
there in the room" (pp. 6-7),
Consciousness, for existentialists then, is not
viewed as a process, nor as an object, but it is a
"nothingness" (Sartre, 1956). We create our consciousness
from our experience of something "in the room," and exis
tentialists would be critical of cognitive therapists for
putting consciousness in one's head. It might seem as if
this is picking fibers off some theoretical net, but it
is a critical point that outlines the distinctions between
the psychologies and therapies. For Beck, the person's
reality is distorted; "The therapist helps the patient to
unravel his (or her) distortions in thinking and to learn
alternative, more realistic ways to formulate his (or her)
experience" (1976, p. 193). For existentialists, Beck
43
seems to have transformed consciousness into a being-in-
itself, or a thing, a wart in the brain to be burned out.
Existentialists, on the other hand, put reality,
even depressive reality, into the world, and see each
person as correctly viewing one's world. For HE, experi
ence, or consciousness, is not distorted. The person's
"experiential perspective is his (or her) correct invention
to be able to exist in his (or her) situation" (Ofman,
1976, p. 139). Because Beck is able to separate conscious
ness from the patient's world, and hold it down inside the
mind, he is able, as HE sees it, to violate the person.
By declaring that thoughts are "maladaptive," "warped"
and not "correct," Beck can straighten out a person. Like
behavior therapy in general. Beck emphasizes a technique.
Analyzing brhavior therapy, Haigh (1965) criticizes be
havioral techniques because "they involve the very same
programming approach which induced this neurotic problem
in the first place" (p. 150). Existential therapy works ^
on confirming the person's vision, rather than altering
it, and Ofman defends the patient against the violation
of seeing one's reality as a distortion; "always, always
it is a search for the truth and correctness of the
client's position, rather than pointing out distortions
of his (or her) vision" (1976, p. 161). Beck takes a
counter position, and sends up "trial balloons... to
44
determine whether the patient is ready to examine evidence
regarding distortions" (Beck, 1976, pp. 222-223). Eventu
ally the patient doubts oneself and concedes to Beck that
"a perception of reality is not the same as reality itself"
( p ' ; 233). Existentialists see this end as a Kantian rup
ture of one's connection to the world. For HE, the
perception of reality is the same as one's reality.
All this is not to deny that Beck has investigated
an important aspect of the intrapersonal processes of de
pression, nor to detract from cognitive therapy as an
important therapeutic tool. What is the goal here, how
ever, is to suggest -that existentialists view depression
as not the result of distorted thoughts, but that
depression is the result of how one does experience the
reality of one's world. Instead of trying to alter
cognitions, existentialists try to affirm the reality of
one's world. The difference in the perspectives is exemp
lified in the treatment of depressed women.
In outlining "cognitive therapy for depressed
women," Beck and Greenberg (1974) direct women to pay
attention to their "automatic thoughts" of their own
worthlessness and to generate new feelings to propel, some
active competent behavior.
From the existential perspective, however, what a
woman would need is an awareness of her myth within the
45
world that results in the negative consequences of depres
sion, and that creates the depressive perspective. Instead
of altering the symptoms, or plugging in new cognitions,
a
the existential therapist attempts to bring the project
into focus. "The symptom does not afflict the patient,"
diagnoses Wheelis, "it is the patient" (p. 17). In other
words, the person follows Neitzche's dictum and "acts
rightly." It is not the goal of the He therapist to get
a person to act differently, because the person is acting
i n
correctly according to the truth of one's world. The
only "stake" the HE therapist needs to have is for the
"client's assumption of responsibility for [one's] engage
ment into the world... and the explicit awareness of the
person's basic way of being-in-the-world" (Ofman, 1976,
p. 25).
The perspective of depression resulting from irra
tional cognitions was presented to explain the HE position
that the person always views the world correctly, and that
depression makes sense according to that vision. Rather
than trying to alter the cognitions, or change the person,
the HE therapist affirms the person's view of the world,
and attempts to work with the person to become aware of
the project that is resulting in the negative consequence
of depression.
46
Summary of HE Perspective of
Behavior Therapy in the
Treatment of Depression
The purpose of this chapter was to provide an outline
of behavior therapy in the treatment of depression and to
continue to build a framework for the theoretical structure
to be examined in this dissertation. The behavioral idea
that depression results from inadequate reinforcement
(Lazarus) was used to reiterate that a person may, in fact,
for one's own good reasons, choose a project that results
in a lifestyle that is not rewarding. The idea of depres
sion resulting from learned helplessness (Seligman) was
used to explain the HE idea that behavior, such as help
lessness or depression, may be communication with another
person. The cognitive model (Beck) was used to emphasize
that existentialists view a person as correctly seeing
one's world, and that the therapists' goal is to affirm
that vision and to have the person become aware of the
project that results in the depressive world.
The next chapter, the sociological perspective of
depression, will begin to examine one pole of the model
described in this dissertation; that is, depression could
be the result of being encapsulated within the Other.
V '
47
CHAPTER IV
AN OUTLINE OF THE SOCIOLOGICAL
PARADIGM OF DEPRESSION
Introduct ion
The sociological paradigm begins to approximate the
He model described in this dissertation. Sociologists
see roles as giving meaning to existence. If one loses
one's role, or if the role is, or becomes, inadequate,
sociologists believe that the person will have lost meaning
and depression will ensue. The slant of the HE model in
this dissertation is that roles are not isolated phenomena,
but that roles exist in a relationship with the Other.
The essence of the HE model described here lies in the
word "relationship." If the person attempts to fuse with
the Other, or to close off from the others, then a rela
tionship, or the interaction back and forth, ends.
The sociological perspectives that will be outlined
see depression in women as either the result of the loss
of a maternal role, or the result of an inadequate house
wife role. These sociological perspectives will be exam
ined from the HE position of the choice to be fused
within the Other, or the choice to be isolated within
oneself.
48
The Sociological Perspective That Depression
Is the Result of Role Loss
Depression often gives way and plummets into the
mangled form of suicide. Even in the Second Century A.D.,
Aretaeus of Cappadocia was able to trace the breaking
point; "...the patients are dull and stern, dejected or
unreasonably torpid. . .they become peevish, despirited,
sleepless and start up from a disturbed sleep. Unreason
able fear also seizes them, if the disease tends to
increase... they complain of life and desire to die"
(Goodwin & Gaze, 1974, p. 4). Aretaeus, like Hippocrates
before him, linked depression back inside the person in
the form of a black bile that Hippocrates believed would
result in "darkening the spirit and making it melancholy"
(Goodwin & Gaze, 1974, p. 4). Existentialists believe
that psychology reduced its perception of human reality
by continuing to swallow the theories of forces which lay
within the person. Sociology, on the other hand, bit off
the other side of the mushroom, and looked at the wider
realm ouside the person. Existentialism, as different
from either of the previous psychological or sociological
positions, aims at looking at the connection between the
person and one's relationship to the world.
The fine line between depression and suicide was
also connected by Robert Burton (1625/1965), who in 1625
wrote that depressed men pursue "feral thought to offer
violence to their person" (p. 145). Rescuing depression
from the physical disease model, Burton put suicide, and
with it depression, into an interpersonal world. For
Burton, being upper class was lethal because the "badge
of gentry is idleness" (p. 214), and scholars "came to
the malady [of depression] by continual study" and because
of a "sedentary, solitary life" (p. 103-104). The remedy
Burton prescribed was the converse of the etiology—
"honest sports, companions and recreation" and being
"excited to Venus by seeing and touching beautiful woman. .
and not be an auditor or spectator but sometimes an actor
himself" (p. 186). If isolation and idleness caused
depression, then, for Buron, activity and "companions"
could cure it.
If Burton’s prescription is behavioral in nature and
reverts to the medical model of illness and cure, Burton
did, at least, escape Hippocrates' trap of seeing depres
sion as the result of humoral and chemical forces. Had
psychology followed Burton, instead of Descartes, perhaps
psychologists would have avoided the mind-body split and
not have seen depression as the result of Neutonian intra
psychic forces, individual reactions or intrapersonal
cognitions.
As psychology continued to look deeper for physical-
50
chemical or intrapersonal forces within the organism, so
sociologists looked farther outside the person for social
forces of organization. The French sociologist, Emile
Durkheim (18 99/1951) was attracted to the view outside.
Rather than bio-chemical forces or a psychic apparatus,
Durkheim believed a social force regulated individual
malaise. Because mental illness had not yet followed the
Darwinian framework of being classified into distinct
categories, Durkheim reviewed suicide rates as his reliable
index of individual psychopathology.
Society, Durkheim felt, was usually cemented together
with the notion of shared meanings, traditional friendship
groups and family relationships. When contact with the
binding forces began to chip away or dissolve, the result
was "anomie"— or, the lack of social norms to guide be
havior. Anomie would liberate the person from constrict-
*
ing social norms, but the resulting freedom ended in
divorce, mental illness and suicide.
Sorting out the suicide rates in Europe, Durkheim
discovered that cultures that were less strict in regulat
ing behavior, i.e., more anomic, had higher suicide rates.
Urban and Protestant groups had higher rates than the more
constricted, less anomic, rural and Catholic populations.
Widowed persons and unmarried men were also more anomic,
and more suicidal.
51
For women, Durkheim found that it was not marriage
that immunized them from the pangs of isolation, anomie
and suicide, but that the birth of children was protective
for women. When the children left, however, the normless,
anomic, and vulnerable state returned.
The statistics Durkheim collected have been ridiculed
by quantitative analysts who seek only to find objective
validity without ever looking at the vision the results
point to seeing. An overall view, however, sees the nature
of human reality as being connected with others. In terms
of this dissertation, Durkheim began to listen to the
"conversation," or to the connection with others.
Like sociology in general, however, Durkheim looked
at the connections and then tied human reality to social
forces, and left out the fundamental existential position
of the person's choice in those connections. On the other
hand, much of psychology has tied human reality inside the
person. What this dissertation is aiming towards is a
position which would unite the vision of humankind into
an interaction between what goes on inside a person and
what occurs outside the person. Further, the position taken
here is that a person always has a choice in either the
interaction itself, or in the way of viewing the inter
action.
Following Durkhheimian thought, Elwin Powell (1970),
52
in The Design of Discord, traced the design of anomie
around the life cycle. "Retirement in our society is vir
tually excommunication" (p. 16), is the premise of Powell's
conclusion^. The "menopausal trauma" Powell linked to the
cycle of the white woman's life. If function, identity
and meaning are all built into the wife-mother role, then
when the children leave home, Powell reasons, the mother
becomes obsolete. The loss of role does coincide with
the rise in the rate of suicide and mental disorder
(Powell, 1970).
The Black mother, however, rather than becoming
disfunctional and disposable is upgraded to the grand
mother role (Frasier, 1951). Even in the transition to
the northern urban family, the grandmother in the Black
family could still function as a nurse to the grandchild
ren (Kardiner & Oversy, 1951).
In sociology, which is built on role theory, the
"empty nest syndrome" has become a comforting paradigm.
In trying to determine the variables to fit into the
paradigm and feather the nesting theory, Pauline Bart
(1971), like Powell, followed Durkheim's findings and
looked again, but more closely, at depression in women.
As Durkheim saw children integrating women to the ties
of society and sanity, so Bart saw menopause as the time
when the "props" of women's life drop out as the children
53
leave. Bart speaks in Durkheim1s language: "...from being
over integrated into society through the props of domestic
and maternal roles, she becomes unintegrated and anomic"
(p. 103).
From sociology, Bart adopted the language of role
theory. She posits that "the most important roles for
women in our society are wife and mother" (p. 103). The
loss of these roles "might result in a loss of self-
esteem— in the feeling of worthlessness and uselessness
that characterizes depressives" (p. 106). After speaking
as a sociologist and talking of roles, however, Bart then
switches tongues and speaks in psychoanalese. Women who
have conformed to norms expect to be rewarded, Bart feels,
but if their husbands and children leave them "tragedy
strikes." Still conforming, women become "intrapunitive
[and] turn anger inward against themselves rather than
express it" (p. 107) . Bart sounds Freudian in the idea
of depression resulting from deflected anger.
Going back to a sociological accent, Bart looked at
different cultures to explain why social forces did not
execute a uniform sentence on women when children left
home. Like other sociologists, Bart found "the pattern of
Black female role behavior rarely results in depression in
middle age" (p. 112). Because Bart looks at facts with a
sociologist's eye, she attributes lower Black rates to
54
roles. The Black woman changes to the "'granny' or
'aunty,' lives with the family and cares for the children,"
or else, because "Black women traditionally work, they are
less likely to develop the extreme identification, the
living through their children" and therefore, Black women
have alternative roles to fall back on when motherhood
ends (p. 112).
Of all cultural groups, Bart saw the Jewish mother
as suffering most in menopause, although "you don't have
to be Jewish to be a Jewish mother" (p. Ill). As Bart
appraised roles, the price of over-investing in the rela
tionship with the children is costly to the motherland
she could be wiped out when the kids are gone. The more
the mothers feathered their emotional nest with their
children, Bart found, the colder it got when the children
left. Housewives who did not work, lost their children,
and their role, while working women could continue in
another integrating sphere. The middle class housewife,
however, who had time and resources to devote only to her
children, would go through the most depressing of menopause.
The empty nest appears to leave the mother with an
empty shell of a self that is fragile and easily shattered.
The sociological vision may be seeing correctly as
far as it is looking. The facts are there. There is a
rise in depression that coincides with role loss and
55
middle age (Powell, 1970; Barr, 1971). Mothers who over-
protect are the hardest hit (Bart, 1971). For existen
tialists, the problem with the sociological vision is that
it can be looking as broadly as the psychologist view was
looking too deeply inside, that is, as the psychoanalyst
and the cognitive therapists have looked too closely inside
the person and missed seeing the interactions with others
outside the person, so the sociologists may be looking too
far away at social forces, and overlook the person stand
ing there. For HE, to see correctly requires a fused
vision of a being—in-the’ -’ world, that is, of a person's
choices and interactions with others.
As Wheelis (1972) has criticized the behaviorist—
"what destroys the behaviorist*s argument is not the
evidence marshalled to demonstrate that we are controlled
by the environment— that is utterly convincing— but the
use of that evidence to deny freedom" (p. 88); so, the
sociologist is chastized by existentialists. We are regu
lated to some degree by social forces as the sociologists
argue, but within those degrees, the existentialist sees
that the individual has the choice either to exert a
pressure against, or to yield to, the forces. Existen
tialists demand that a person always has a choice even in
the face of social forces.
From the existential way of looking, the world does
56
not only emit a force for women to yield to the demands
of a role, but women also choose to absorb that force.
Sociological facts do point to depression for women who
are overly protective mothers, or who are overly absorbed
in that role, and then lose that role. The point here,
however, is that for existentialists, these sociological
facts are not isolated entities in themselves. One is not
determined totally and sent into a trajectory because of
sociological forces. Bugental (1965) put facts straight
when he writes that "any statement we make about the world
is inevitably a statement about our theory of ourselves"
(p. 196). Sociological theory, it is argued here, heaps
responsibility for choice on the social forces of the
world, and for HE, sociology neglects the person choosing
the role. In looking at depression, the existentialist
would need to examine the woman * s choice to decide to
become encapsulated within one's children, or within any
Other, as well as the valid reasons for such a choice,
and the negative consequences of encapsulations with the
Other.
Bart (1971) almost seems to battle against roles.
She campaigns for "women's liberation" to point out "alter
native life styles" and to provide "emotional support
necessary for deviating from ascribed sex roles" and to
emphasize "the importance of women actualizing their own
57
selves, fulfilling their own potentials..." (p. 117). For
existentialists, however, the salvation from depression
may not be in abandoning motherhood and embracing our "own
selves." Being for oneself, from the HE position, is to
hang up on the conversation with the world. The goal for
HE is not to abandon being for another and in its place
decide to be for our own selves. Either position—
being encapsulated within the Other, or within the self--
it is argued here, risks the negative consequences of
depression. The goal for HE is that a person be able to
have the conversation, that is, that one is able to define
oneself, but that one is also able to find oneself, with
out losing oneself, in another.
The attempt so far in this dissertation is to discuss
the HE perspective that a person is not the result of
intrapsychic mechanisms (psychoanalytic) or idiosyncratic
environmental conditionings (behavioral) or intrapersonal
thoughts (cognitive)? nor is the person the result of
larger sociological forces, but that a person is the result
of one's choices of interactions with the Other. If a
woman chooses to fuse with another, however, she shuts
out part of the conversation, and if the Other— husband,
lover or children— should leave her, then the woman is
left utterly isolated and alone. The critical existen
tial point here is that a woman chooses, for her own good
58
reasons, to fuse with another. Social forces may be power
ful, but the woman still makes the choice.
The next sociological perspective, that is, depres
sion resulting from an inadequate role, will begin to look
at another pole in the existential theory developed here.
Instead of depression resulting from the choice of fusing
with another, and then losing that Other, depression, it
will be argued, could result from the choice to shut
others out, and to be encapsulated within one’s self.
The Sociological Position That Depression
the Result of an Inadequate Role
Sociologists begin by saying that roles all add up to
one's identity and sense of self. They end by saying that
if roles are taken away, there is then a sense that one's
identity is squeezed out of the vacuum of the self. Bart
(1971) diagnosed the depression in menopause as the result
of women who turned motherhood into their identity and
meaning, and who lost their sense of self when their kids
outgrew their home and left. "Personal identity derives
from work," so Powell explained the sociological position
(1970, p. 8). In order to fill up the void in life,
Levenstein wrote, "men work to starve off meaninglessness"
(1964, p. 152).
For the sociologist, work and roles feed meaning into
the absurdity of life that provides no meaningful
59
sustenance. For the existential position that will be
developed here, however, nothing occurs in isolation.
Roles don't exist without the Other. For the existen
tialist there is always the need for the conversation; with
roles, there is always the interaction and relationship
with the Other. We intend a meaning or a communication,
with our action (our role), but that meaning always has an
intention for you and for me. The flow between the self
and Other Sartre called a hemorrhage. We flow into the
Other, and our self is filled with the Other. When Sartre
wrote, "nobody can be vulgar all by himself" (1965b,
p. 189), he meant that "the Other has revealed to me what
I am" (p. 189). The conversation starts with me; that is,
by acting I define myself— "existence precedes essence"
(Sartre, 1967, p. 34). We are doomed to define ourselves
as nothing exists that will free us of that obligation by
deciding for us how we must be. We are "condemned to be
free" (Sartre, 1965b, p. 41) . We must start the conver
sation by choosing to make ourselves be heard and known.
By talking— by choosing, doing and being— we have made
ourselves, but then the Other responds to that self, lets
us know how we are heard, and the conversation flows.
Whenever there is a break in the flow of the conversation,
it is suggested here that depression will be the result.
Bart's mothers, for example, stopped the conversation and
60
the responsibility of defining themselves by only reading
the lines of "shoulds" or the obligations of the Serious
World of Motherhood. The mothers stopped their own con
versation— that is, stopped defining themselves— when
they threw themselves into the arms of their children, and
became the objects of those children. Bart's mothers
became the supermothers of Portnoy's Complaint:
She could make jello, for instance,
with sliced peaches hanging in it,
peaches just suspended there, in
defiance of the law of gravity...
The energy in her I For mistakes
she checked my sums, for holes,
my socks; for dirt, my nails, my
neck, every seam and- crevace of my
body... She lights candles for the
dead... Devotion is just in her
blood...
(Roth, 1967, p. 11)
Being encapsulated'within the Other, and being the
object of others, however, does not necessarily return
the "devotion." The world, unfortunately, as existential
ists see it, runs on its own laws and defies the gravity
of a mother's burden. In being for her children, Bart's
mothers stopped the conversation and let her children and
the Serious World of Motherhood talk for her and define
her. The one sided conversation can be depressing when
the kids are gone. When the kids leave home, the mother
is left with no one to define her. Her project fails.
She could not escape the need to define herself, by
61
attempting to define herself in her children.
Other sociologists feel that you don't need to be a
supermom to be depressed, but just being a "happy house
wife" is bad enough.
Marriage seems to start out making women as effer
vescent as the wedding champagne. The young wives are
"positively euphoric; they are the most likely group to
enjoy doing housework... It appears that marriage is still
considered a woman's greatest achievement, and when she
marries the sigh of relief is almost audible" (Campbell,
1975, p. 38). But the bubbles soon pop, the hangover sets
in and the sigh turns to a groan, if not a gripe.
The sociologist who seems to be most sour on marriage
for women is Jessie Bernard (1972). In her article, "The
Paradox of the Happy Housewife," Bernard spins the para
dox as revolving around marriage making women happy and
then turning around and making them unhappy. Bernard
cites numerous studies indicating that being married is
still an important ingredient in making women happy, and
their overall happiness is dependent on the strength of
the marital happiness. For men, Bernard found the rela
tionship between marriage and happiness was not as strong.
Because "women have put so many eggs in one basket"
(p. 87), Bernard feels that the basket itself becomes
fragile. Women, says Bernard, weave their lives into
62
adjusting to their husbands' life. The strain begins to
wear on women. Although more married women than single
women report themselves to be happy, more married women
than single women are also "bothered by feelings of depres
sion" (p. 8 9), and married women are more likely than
married men to feel a "nervous breakdown is coming on, to
feel 'anxiety' or to be 'immobilized'" (p. 90).
Marriage, Bernard concludes, is a "shock." The shock
is not just waking up to a face smeared with cold cream
and bouncing with curlers, even'on him! The shock is the
short circuit of her self-degradation to the housekeeper,
"an occupation that is classified in the labor market,
and in her own mind as menial and of low status" (1972,
p. 91). She becomes "just a housewife." What a shock!
The shock is not even electrifying, but she's completely
turned off as she stands in the shadow of her husband
whose work outshines her in his "time and attention"
(1972, p. 92). Even if she is in his shadow, she is not
even standing behind a rock; Bernard sees the husband as
not the source of strength in the marriage. "She is often
called upon to be the strong one in the relationship"
(1972, p. 97). For many women "it becomes a full-time
career to keep the self image of her husband intact"
(Bernard, 1973, p. 41). The bride, concludes Bernard, has
been raped of her image of being happily ever after.
63
Instead of investigating why women make the choice to
put all their "eggs in one basket," or looking at why the
wives choose to respond to being "called upon to be the
strong one," or examining why women choose any particular
image of marriage, as existentialists would want, Bernard
chooses instead to smash apart marriage itself. "Adjust
ment to the demands of marriage may greatly impair mental
health... Is it possible that many women are 'happily
married' because they have poor mental health...? We must
make women sick in order to fit them for marriage" (1971,
pp. 94-95).
From the perspective of this dissertation, Bernard's
wives may be choosing to be encapsulated within themselves;
that is, the women that Bernard describes, may be choosing
to be "the strong one in the relationship" and to "put all
their eggs in one basket," and, in bad faith, they com
plain when they crack up. They may be adjusting their
lives to their husbands', but they choose also to hold in,
to not express, to encapsulate, and be "strong," about
their experience of the marriage.
Sociologists, .however, do not look at the choices of
how one marries, nor at how one chooses to see married
life, but sociologists choose to look only at the insti
tution of marriage itself. In examining how marriage
might be "sick," Gove and Tudor (1973) have diagnosed
64
several sources of infection for the wife.
Being married does not fuse the couple into a unity,
but in every marriage, Gove and Tudor splice apart two
marriages— one for him and one for her. The marriage for
her, they conclude, is more depressing than the marriage
for him. Not only do married women have higher rates of
mental illness than married men, but to be an unmarried
woman— single, divorced, or widowed-— drives women sane.
The unmarried female group had lower rates of mental ill
ness than did males (Gove, 1972; Gove & Tudor, 1973).
With a sociological bent to his perspective, Gove
saw mental illness through the role of the everyday house
wife. Like Bernard, he saw the housewife cooped up in
a single role. If the husband gets frustrated in one role,
he can "frequently focus his interest and concern on the
other role" (1973, p. 814). The wife, however, Gove and
Tudor see as having no other sides. Not only is there one
role, but the authors claim that the role is of such "low
status, technically undemanding [and] not consonant with
[her] educational and intellectual attainments," that we
would expect "such women to be unhappy with the role"
(1973, p. 815). The job of the housewife is also "un
structured and invisible". (1973, p. 815) , so that the
housewife can "let things slide." When things do slide,
in their "unstructured way," the housewife can sit and
65
"brood over her troubles, and her distress may thus feed
upon itself" (1973, p. 815) .
The husband, on the other hand, Gove and Turner see
as being structured and supervised and thus forced to
perform. "Having to meet the structured demands should
draw his attention from his troubles and help prevent his
becoming obsessed with his worries" (1973, p. 815). Even
if his wife works, she is more likely to be "discriminated
against in the market place and expected to do double duty
at work and at home." Finally, as Gove and Tudor see
women looking at themselves, women see themselves as ap
pendages to their husband and "perceive their career in
terms of what men will do, whereas men perceive their
career in terms of their own needs" (p. 815). The "un
certainty and lack of control over the future [is] at best
frustrating" (p.'.816).
It seems as if Gove and Tudor have defined the "prob
lem" that Betty Friedan had labeled a "problem that has
no name."
It was a strange stirring, a sense
of dissatisfaction, a yearning that
women suffered in the middle of the
20th Century in the United States.
Each suburban wife struggled with it
alone, as she made the beds, shopped
for groceries, matched slipcover
material, ate peanut butter sand
wiches with her children, chauffered
Cub Scouts and Brownies, lay beside
66
her husband at night— she was
afraid to ask of herself the
silent question— "Is this all?"
(Friedan, 1963, p. 11)
That is all, suggest Gove and Tudor, and Friedan.
"Women previously had a meaningful role" (Gove & Tudor,
1973, p. 816). Before microwaves, "housework required
more time and was highly valued" (p. 816). With the
nuclear family shrinking, and women’s child-bearing years
shortened, Gove sees that the modern housewife is an
anachronism (Gove, 1972).
Sociologists look at the housewife blues through the
haze of roles. Their solution to clear up the blues in
volves diluting the housewife role with other roles. If,
however, a new spectrum is slanted on depression, a new
angle can be seen.
Existentialists feel that we define ourselves not by
our roles, but by our choices, and importantly, by our
interactions with the Other where we find out who we are.
The modern homemaker may be sucked into defining herself
within her children, or allow herself to be defined by
her husband, and in bad faith, not be aware of the nega
tive consequences of those choices. In both of these
situations, the conversation has stopped. In one, encap
sulation with the Other, the mother stopped the conversa
tion by defining herself within her children, and when
67
the children left home, she was lost without a definition.
In the other, encapsulation within the self, the woman
allowed herself to be defined by her husband, but more
critically, keeps her "silent questions" to herself, and
"struggles with it alone." In this position she is shut
within herself. In either position , fusion or isolation,
there is no conversation, and this dissertation contends
that depression ensues from the lack of the interaction
back and forth.
The housewife role, Gove and Tudor, and Friedan
stereotyped, could become depressing, they say, because
it is "unstructured and invisible." The husband, on the
other hand, has to meet "structured demands" which draws
his "attention.from his troubles." For HE, it is not
structure that draws us out from ourselves, but the Other
pulls us out (Ofman, 1981). Rather than structure, it
is the Other that keeps us sane. When the housewife has
no Other--either the Other walked out on her, or she
won't open the door to the Other— her world is shut in,
silently echoing her depression.
Sociologists, however, are fixed on roles in their
paradigmatic view. In order to prove that diluting the
housewife role creates the solution to rinse away the
housewife blues, sociologists have looked at working out
side the house. The studies focus on roles, and from
68
the existential perspective, they have overlooked the
Other standing behind the reciprocal role.
In order to probe where the housewives are hurting,
Maggie Ferree (1976a; 1976b) interviewed 135 working
class women in the Boston area. All of the women were
living with their husbands, had at least one child in the
first or second grade, but had no pre-school children.
Almost half of the women worked outside the home. The
full-time housewives were "more likely to be dissatisfied
with the way they were spending their lives" (1976b,
p. 434). The women who slammed the door on the housewife
role and worked outside the home felt that "despite the
strains of carrying a double role, [she was] happier and
felt herself to be better off than the full-time housewife"
(1976b, p. 439).
The working women were not punching time clocks in
"glamourous, exciting careers" (1976a, p. 76), but they
were assembly lined at jobs such as being a waitress, a
clerk, a typist or a hairdresser. If the jobs were not
"meaningful," some other intangibles gave the women
meaning and happiness. In looking at her data, Ferree
examined the results from the sociological perspective.
She concluded that the regular pay check, feelings of
independence and self-determination, and contact with
the customers gave the women a shot of Self-esteem and
69
a tangible indication of accomplishment. The full-time
wives, however, garnered no recognition and had no cri
terion measure to rate their housekeeping skills. Although
one would not toss out the power of the pay check, neither
should one dismiss the relation with the Other. The
Other, the customers, may have filled a void in the vacuum
of the lack of being with the Other that the full-time
wives experienced.
Ferree does recognize the "obviously not all house
wives feel miserable and worthless" (1976a, p. 78). Those
full-time wives who reported feeling happy and competent,
were not wives who received merit allowances, but were
women who saw their family and friends often, and whose
husbands and relatives were supportive and honored their
housekeeping skills. In Sartre's words, there was the
Other, for these wives, whose "look shapes, sculptures...
and produces" (1965b, p. 2 09) , and who looked at them in
a pleasing reflection. It is the position in this disser
tation, that it is not a particular job, nor a pay check,
nor feelings of self-determination or independence that
relieves one from depression, but, that to be without the
look of the Other, to be alone, or to keep oneself alone,
is to end in depression.
The wives that Ferree studied who were employed had
the opposite experience from when they had stayed at home.
70
At home there appeared to be no "look" from the Other.
They felt as if they were "going crazy staying home, not
seeing anyone but four walls each day" (Ferree, 1976,
p. 78). To be without the Other is like "being in jail"
(p. 78); or, as has been said here, like being without
the conversation.
Loneliness is a torture and depression is the punish
ment.
In her interviews, Ferree did not speak to the middle
class wives, nor to women with pre-schoolers, and she may
have missed hearing something. Having children does not
seem to be a blessed event to mental health. The well
being of mothers with young children is worse than others
in any other situation. These women disagree more with
their husbands, think more often of divorce, and worry
more about having mental breakdowns (Campbell, et al.,
1976), and mothers with children under six are especially
vulnerable to depression (Pearlin & Johnson, 1977). In
looking at mental health data nationally, there seems to
be nothing more depressing than a houseful of young
children (Guttentag, 1975) .
Fitting together the kaleidoscope of data with the
HE view taken here, it looks as if children do not allow
the conversation. Young children cannot, will not, or
maybe even should not, listen to the worlds of others.
Children want to be heard. The mother cannot get a word
in between the chatter and the tantrums. In other words,
women cannot expect, and do not get, a chance for the
existential connection, the reflections back and forth,
with young children.
Kids seem to be particularly depressing for working
class women. In replicating an earlier study by Brown
and others (1975; 1977), Roy (1977) found that working
class women were more likely to be depressed if before
they were seventeen they had lost a parent, if they had
a poor marriage, if they had a non-confiding marriage, if
they had three children under the age of fourteen, and if
they were unemployed. For the middle class woman, only
a poor and non-confiding marriage was related to depres
sion.
Although the studies did not indicate why the vari
ables might be significant, when looked at from the HE
perspective of the Other, some suggestions may be made.
Working class women, more than middle class women, may
be more dependent on their parents for a confiding rela
tionship, and find themselves more alone if the parent
should leave them. Further, the working class mother
may be more likely to feel and be trapped and isolated
at home with children; but, the middle class mother may
be brought more into contact with others when she is
72
involved with Girl Scouts or mothers' rap groups. For
both women, however, if the marriage did not offer a con
fiding relationship, then the world becomes depressing.
The conversation with the Other always involves two
participants. A mother with young children may not have
a conversation because she cannot reveal herself to her
children. A mother without anyone at home may feel like
she's "going crazy" because there is no one there. A
woman could also be without a conversation because if
she is in a "non-confiding relationship" the husband will
not talk with her. There are, however, situations where
the woman chooses not to speak, to "struggle with it
alone."
In inspecting the ring around the Pink Collar Workers,
Louis Kapp Howe (1977) interviewed women in various low
prestige jobs, including homemaker. The women seemed to
be adhering to the walls of the Serious World, the world
of shoulds. They did not allow their husbands into their
experienced world, because they were trapped behind the
walls of shoulds— of how their world should be, and how
they should be within it. The wives walled themselves
into their world. When asked if she didn't mind if her
husband did not help at home, one homemaker replied:
No, not usually. Although sometimes
at night, well maybe for a few minutes,
I mean, I'll know he's had a hard day
73
too and I'm practically ready to
drop and there's still dinner and
the dishes and getting the kids to
bed, and meanwhile he's sitting on
the couch looking at T.V. So for
a minute, I'll feel like saying
something, but then I'll remember
he's been under a strain, a lot of
money problems, and I'll think, is
it worth it? Basically, I guess,
I'm not the kind to complain.
(Howe, 1977, p. 182)
Confiding translates to complaining. The woman, here,
chooses to become the silent partner in the marriage. She
has signed a contract, it seems, to conform to the obli
gations of the Serious World of Wifehood. In bad faith
she sees no alternatives, and does not renegotiate the
rules of her marriage, even if she's "practically ready
to drop."
As Linda the beautician in Howe's study read the
vows:
My mother taught me it was the
responsibility of the woman to
clean the house, cook and clean
the clothes and everything, and
my mother is that way and I'm
going to stay the way my mother
is. Because I don't believe in
all that garbage and my husband
thinks it's garbage too.
(Howe, 1977, p. 32)
Choices are tossed out as "garbage." "Is it worth
it?"
Being college educated, however, does not necessarily
liberate a woman from wearing the myths of the Pink Collar
74
Workers. The educated housewife who does not have a job
outside the home has a lower sense of well-being than the
less educated woman or the employed woman. The college
educated housewife who stays at home lives in a marriage
that is bound by disagreements, lack of understanding and
companionship (Campbell, 1975). Although the study seems
to cast a view that the lack of a career caused the
college educated woman's marriage to be non-confiding
and disagreeable and lack companionship, by looking with
the existential paradigm, a reverse image is projected.
Perhaps initially, rather than subsequently, the husband
and wife did not confide in each other about the possible
conflicts of staying at home or working, but it was
silently decided that the woman should fulfill the de
mands of the Serious World and stay at home. Ironically,
conflict and assault upon one another could be the re
sult of not allowing ourselves or others to reach out and
touch; discussing the problems in the beginning may have
prevented the blows later.
The women who are unhappy with their position in the
world may have chosen to be the encapsulated within the
self; that is, they operate the world according to some
rigid commandments that have been set; "my mother is that
way, and I'm going to stay the way my mother is." No
matter what the cost. Because the woman seems to idolize
75
the rules, it becomes blasphemous to question them. The
woman follows the rules of the Serious World, and allows
no one to enter her world. She has built walls around
herself with the commandments, and then finds she cannot
get out, or won't break out. The woman, from the HE
perspective, may be unaware of the walls she has con
structed.
Unlike Bart's supermothers who put their world into
their children, and became encapsulated objects within
them, some women have no one in their world, or keep
everyone out of their world, and become encapsulated
within themselves. The supermothers lose the conversation
when they put themselves inside their children, and there
is utter silence when the kids are gone. Other women lose
the conversation when they put themselves inside their
own world, and silence comes when they1re closed inside
themselves.
The HE perspective taken here does not discount the
importance of the sociological vision. Roles do seem to
affect one's sense of meaning and do relate to identity.
When roles are lost, the person does seem to become depres
sed. The perspective taken here, however, adds the com
ponent of the Other; that is, when the Other is lost or
not available, then the person becomes depressed. It is
not the role per se that affects a person's mental state,
76
but instead, for HE, it is the reciprocal partner in the
role that needs to be examined. The role of mother needs
to be looked at from the HE perspective of how a woman
chooses to be a mother to her child, and the role of the
wife needs to be examined from the choices a woman makes
in being a wife to her husband. From the HE perspective
there are consequences to the choice to be the supermom,
or to be the "strong" one in the relationship. A mother
can be left alone if she has put all her identity into
her children. A wife can be alone if she is physically
alone in the house ("not seeing anyone but four walls
each day"), if she is emotionally isolated with small
children around her, if her husband will not participate
in a confiding relationship or if she decides to not
allow another into her experienced world ("I'm not the
kind to complain").
The solution for existentialists would not be to
dissolve the institution of marriage, nor necessarily to
have a woman be involved with other roles. For HE, what
is needed is to have a woman be aware of the negative
consequences of the choices where she might end up alone
without the Other. Hell may be the Other, because once
a choice or a stand is taken, the "Other's look shapes my
body in its nakedness" (Sartre, 1965, p. 2 09). The real
hell, however, in not being undressed, seen, or being
77
made by the Other. The real hell is when there is no
Other to look and reflect back on how I look, or to look
with me at what I see. There is no Other, no conversation,
and only depressing loneliness if I'm inside of the Other,
if I am physically or experientially alone, or if I won't
let the Other inside of me.
78
CHAPTER V
THE FEMINIST PARADIGM OF DEPRESSION IN WOMEN
Although sociologists have pulled out depression as
caused by a woman coming apart as she loses her children,
or a woman falling apart as she gets a husband, feminists
have put depression together as caused by just being a
woman.
What causes women to be feminine is, in Maggie
Scarf's (1979) view, what causes women to be depressed.
"One [explanation for depression] has to do with a trait
considered 'normally feminine'...and that is dependency"
(p. 51). A girl is not encouraged to be self-sufficient,
but "learns to appraise her worth as a function of the
appraisal of others..." (p. 52). Scarf is suggesting
that women learn to become dependent objects of others,
that is, to be encapsulated within the Other. "The
girl, and later woman, gives her highest priorities to
pleasing others, to being attractive to others, to being
cared for, and to care of others" (p. 52). Self-esteem
becomes fused with 'other-esteem, and well-being becomes
the dependent hostage to others. When a woman is over
looked by others, and because she has no resources to
look out for herself, she becomes "hopelessly ineffectual
79
in terms of her capacity for mastery or changing [her life
circumstances]. She may, in a word, become depressed"
(p. 52). The loss of the "love bond" Scarf claims, is
the cause of female depression. Women, however, as Scarf
puts them, are in a double bind; they are taught to bind,
but when that bond breaks, women fall into depression.
"To fail in this relationship is then equated with failure
in everything" (p. 52).
The theme of dependency as the cause of depression
also hums through the lines of Silvano Arieti's writings
(1979). The clinging is wrapped around the "Dominant
Other." "The genesis of the Dominant Other begins in
childhood when the child develops a type of pre-psychotic
depressed personality in which he depends on others for
gratifying his needs... Generally, the person is at first
the mother... Later on the person finds substitutes whose
approval, love and affection are as essential to his well
being as the oxygen he breathes" (p. 57). The Dominant
Other may also be a Dominant Goal, where "in early adoles
cence... to regain the love [of a depriving mother] he or
she must achieve something great in life" (p. 57).
Clearly, although Arieti speaks more of a "he," Arieti
means "she." "Women really are more depressed than men,
and the reason is we still live in a patriarchal society
in which women are raised to be dependent on another
80
person" (p. 58). (It is interesting to note that the
experience of the Other, the one that the woman is depend-
dent and encapsulated within, is not described by these
theorists. System's theorists do examine this relation
ship. See Chapter 6.) After fusion to the Dominant
Other, or the Dominant Goal, any separation becomes a shut
down in the "oxygen" supply, and the woman suffocates in
depression. "When confronted by such events as divorce,
failure, or moving to a new environment, [women] find
themselves in a state of helplessness, which leads to
depression" (p. 92).
If Scarf and Arieti make inferences that women would
do better if they were less dependent, Phyllis Chesler
(1971; 1972) makes her stand clear on it. Freud,
Chesler's mentor and tormentor, had conceived of women as
inferior creatures who were born defective, without a
penis, and this was the "source of outbreaks of severe
depression" (Freud, 1964, p. 252). Chesler swipes at
Freud for his phallocentric view that sees women as
"cranky children with uteruses, forever mourning the loss
of male organs and male identity" (1972, p. 79). Having
abandoned Freud's penis envy, Chesler still picks up on
his intrapsychic mechanism of depression.
Like Freud (and others), Chesler sees depression as
the result of a loss; "women are in a constant state of
81
mourning" (1972, p. 44), but the loss is not phallic, but
for "what they never had, or had too briefly, and for
what they can't have in the present, be it Prince Charming
or direct worldly power" (1972, p. 44) . Like Freud,
Chesler sees the hostility for the loss converted; the
"hostility that should or could be directed outward in res
ponse to loss is turned inwards toward the self" (1972,
p. 44).
In a single round, Chesler flattens "American psychol
ogists and psychiatrists [who] have behaved toward femin
ism [with] nervous laughter, purposeful misunderstanding,
hairsplitting, malicious cruelty, misguided sympathy,
boredom, hostility, condescension, and commercial and
academic capitalism" (1972, pp. 245-246); and she blasts
that such attitudes are carried over to female patients.
She does not take the therapists' superior attitude lying
down, and argues that psychotherapy perpetuates dependency,
the very cause of depression; "For most women, the psycho
therapeutic encounter is just one more instance of an un
equal relationship, just one more opportunity to be
rewarded for expressing distress to be 'helped1 by being
dominated" (1971, p. 260) . ' Being on the couch is sym
bolic of a woman being violated.
An existential therapist would agree with Chesler that
the therapeutic relationship needs to be "reciprocal and
82
mutual" (Ofman, 1972, p. 121). The mutuality, for exis
tentialists, however, is the "mutual quest for the denied
integrity in life" (Ofman, 1972, p. 140). Even as
Chesler has criticized the traditional superior-therapist
attitudes, and HE would agree with her here, there are
points of departure between HE and Chesler and many femi
nists. Unlike HE, Chesler does not see that a woman
suffers from the ways she has chosen to be in the world,
but instead, Chesler views suffering as the result of
social conditions (or conditionings) which result in a
loss and which trigger inner, almost Freudian, mechanisms
that result in depression. Unlike Freud, the endopsychic
mechanisms that Chesler describes are not the result of the
genetic unconscious, but are the result of cultural train
ing. A woman, for Chesler, has not been allowed to ex
press hostility, so the aggression is turned inwards. The
therapeutic escape is not, as HE would have it, to find
the denied meaning of one's choices to be dependent in the
world. Chesler seems to deny women's choices to be depen
dent, and she looks for a new meaningful world. Chesler
stomps for a cultural revolution which would change the
world and how women see themselves. While existential
ists, on the other hand, call for a revolution in the
way women see themselves choosing in the world.
Chesler's contribution is valuable in terms of how
83
she has had us examine the superior position of the ana
lyst, and in having women become aware that being depen
dent could result in depression. For existentialists,
however, the Feminist Revolution may contain a hoax based
on two planks, which are related. The first plank of
feminism is that women should become independent, and
Arieti and Scarf both suggest that independence is a way
for women to detach themselves from depression. For
Chesler, independence is the cadence of the marching wo
men's liberation band. "Women must convert their 'love'
for and reliance on strength and skill in others to a love
for all manner of strength and skill in themselves (1972 ,
p. 298)... Most mother-women give up whatever ghost of a
unique and human self they may have when they marry and
rear children (p. 299)... Women's ego identity must some
how shift and be moored upon what is necessary for her
own survival as a strong individual" (p. 2 99).
From the HE perspective that has been developed thus
far, any effort to have women become a "strong individual"
whose "ego identity1 1 it totally based on "strength and
skill in themselves" could result in depression. Exis
tentialism is based on a fine line between the self and
the Other, but HE insists that the lines be kept there.
For HE, one's "own survival" in an emotional sense, needs
to be connected with another. In a sense, HE would agree
84
with. Scarf,. Arieti and Chesler. Being totally encapsulated
within another, and dependent on the Other, could be a
cause of depression. Instead of taking a step and leaping
into the freedom of creating oneself, in bad faith, or
self-deception, some women seep into the mold of another
and fuse themselves, or encapsulate themselves, within
that Other. Being that object stops the conversation as
one is bound inside the Other. The Other--child, husband
or lover— could take the woman, use her up and toss her
away. Lying in isolation, the woman becomes depressed.
The difference between HE and the feminist position is
that HE sees that these dependent women are responsible
for the choice to be the objects of the Other, while the
feminists seem to see women as innocent victims of cul
tural imperatives. Feminists would, therefore, insist
upon a cultural revolution to change women’s position and
the feminists’ therapeutic goal would be to have the woman
get out of a dependent relationship. The HE perspective,
however, is that one always chooses a position in the
world, and the therapist’s goal would be to have a woman
recognize the reasons for her choice of a dependent
position, as well as the. positive and negative conse
quences of such a choice.
Existentialists would also disagree with the feminists'
perspective that being independent is a guarantee of
85
salvation from depression. In fact, this latter point,
that is, the idea of independence being the answer for
depression in women, is the genesis of the idea behind
this dissertation. From the HE perspective, being totally
independent could be a cause of depression. Being depen
dent, or being encapsulated within the Other, could end in
depression if the Other leaves, but being independent
could also result in depression. Although Chesler taunts
a society where "women are trained to mount the sacrifi
cial altar willingly" (1972, p. 294) , where they chop off
their "unique and human... self" as they are banded into
matrimony and motherhood, but a society where women leap
into the pit of independence is not without its sacrifices
and of ferings. Standing up as a "unique... self" could be
standing out in the cold of loneliness. For existential
ists, we need the warmth of the dialectic, and we need
the flow of the conversation, or the ability to disclose
our inner feelings with the Other. An independent self
could be as tragic as the fused self. By being fused, a
woman decides to attach herself to another, and by being
separate a woman could make the decision not to depend on
anyone. By fusing, a woman could lose the Other and be
come isolated, but by deciding not to fuse, the woman
could begin by being isolated. One plank of feminism
falls under the HE platform; that is, for HE, women are
86
seen as choosing to be dependent and are not solely deter
mined by society, and more importantly, to make the choice
to be independent is not to save a woman from depression.
The second plank which Chesler holds out for women, is
that women will find freedom in a society that exists with
out oppression. In Ches'ler* s. view, women are "trained"
for oppression. With freedom of the means of production
and of reproduction, Chesler feels that women would not
need to mourn the loss of "worldly power." Women would
have cultural and economic clout to allow their hostility
to be expressed rather than be turned inwards. Depression
would lift. Two arguments are struck against this idea.
One is empirical and one is philosophical. Empirically,
depressed women report more hostile behavior to others
(Weissman, Klerman, & Paykel, 1971), and women who improve
their social functioning in terms of reducing social fric
tion, are more likely to become less depressed,
(Rousanville, Prusoff, Weissman, Heraey-Barpn, 1979).
Depressed women apparently are already hostile to others,
and reducing their hostility correlates with reduced de
pression. (See Chapter 2.)
HE also would differ with feminists on a philosophical
point. Chesler would bolt through cultural oppression as
a way of freeing women from depression, but for existen
tialists, freedom is not something that can be fought for,
87
liberated to, or escaped into. We cannot possess freedom
because "freedom possesses the human being" (Boss, 1979,
p. 124). Freedom squirms inside of consciousness. Aware
ness, or consciousness, for HE, is not something to be
raised from some resting place, because consciousness is
not someplace, as a something that could be raised some
where. Nor is consciousness a process that could be put
into an altered or some higher level. Consciousness is a
"nothingness." Consciousness is not a something that can
be objectively determined, but, for HE, it is a way of in
tending the world. We become conscious of something as
meaning something, and as meaning something for each other.
We become conscious of our position in the world, but
that consciousness is not some objective fact, but can
always be changed by some other perspective. Sartre
called consciousness a "nothingness," because he meant
that we can always change our consciousness, or our aware
ness, and thus it is never fixed as a something might be.
Yalom (1980) explains the existential perspective on con
sciousness: "The existential position... regards the per
son not as a subject who can, under the proper circum
stances, perceive external reality but as a consciousness
who participates in the construction of reality... Each
[person] therefore constitutes his (or her) own world"
(p. 23). Freedom is subsumed in consciousness because
88
freedom, for He, is the choice of a way we intend to see
things, in the choice of the way we see ourselves, and in
the choice of a way we intend to be. "The person is that
choice of attitude" (Ofman, 1972, p. 22). Wheelis (1973)
describes freedom as "the awareness of alternatives
and of the ability to choose. It is contingent upon con
sciousness. . ." (p. 15). We are born free to become aware
of the way we intend a choice of being, free to make a new
choice, or free to intend the same choice in a new way.
"Man is free to choose and rechoose...he is self-making...
he gives birth to himself (Ofman, 1976, p. 22). And so
does she to herself. For HE, then, freedom is more than
a cultural condition, but freedom occurs in consciousness.
Although existentialists have fought for cultural freedom
and against oppression, the existential position is that
freedom is more than social rights. For HE, freedom is ^
in the way we choose to look at our way of being, and
freedom is also in the way we can choose a new way of
being or a new way of intending the same way of being.
Freedom also, for existentialists, implies responsibility,
and as Yalom acknowledges, because a person is free in the
existential sense, each "individual is entirely respon
sible for-— that is the [free] author of— his or her own
world, life design, choices, and actions" (p. 9). To deny
responsibility for one's action or choices is to be in
89
bad faith.
In the existential perspective, women who feel unfree
are in bad faith, deceive themselves of their intentions,
live inauthentically, and ignore the attitude they have
chosen in the world. Like the housewife Joy in Howe's
study (1977) who "maybe for a few minutes" thought of
asking her husband to get up off the couch and help put
the kids to bed or wash the dishes, but chose to ask her
self, "is it worth it?" and said nothing, because she was
not the "kind to complain" (p. 182). The housewife had
expressed her freedom in the silent question and was free
not to ask. She was also free to look at her asking as
a complaint. From another choice of consciousness, she
would have been free to see her asking for help as a
right. A woman, because of the freedom of consciousness,
is free to see herself as "I'm trapped by the Other," just
as she is free to see herself as, "I'll be caught by the
Other." The choice of any perspective is inherent in the
freedom of consciousness to make out of the nothingness
a somethingness for and with another.
A belief in existentialism is not to deny the credos
of social equality, ERA, woman's rights or abortion, but
to allow for the basic tenets of freedom to be understood
in terms of consciousness. Society may have taught women
to be dependent, but women have also made the choice to
90
accept to be "trained." Freedom comes in the conscious
ness of the choices one makes, and in one's choice of
viewing one's position. Chester's call for social power
for women so they may become independent and be able to
unleash their hostility, may not be liberating from depres
sion. Chesler sees men as free, independent and possess
ing "worldly power," and yet, some men may choose to see
this position as not free, but as trapped within the need
to appear powerful. Women, who follow Chesler's call,
could, in bad faith, begin to make a project out of being
independent to avoid being dependent. A woman could be
safe from the rupture of emotional bonding if she never
set the seal of a bond, but without the Other, HE sees
that there is a slow tearing of one's existential self.
Who is to say that a slow tear is less painful than a sud
den rip?
For existentialists there needs to be the ebb and flow
between the self and the Other. These tides between the
self and Other create the conversation. Without being,
sharing and experiencing with another, loneliness seeps
into the Heideggerrian hyphens of a being-in-the-world,
and cracks begin to swell in the emotional life of the
person. We cannot be the completely free and independent
self because we need the Other, just as we cannot be the
completely fused and dependent self because we may lose
91
the Other.
From the HE perspective developed here, the Feminist's
vision may have focused women on the dangers of being de
pendent and fused, but HE would insist that the opposite
pole of being independent and standing without the Other
could be as emotionally dangerous as being totally depen
dent. In the effort to abandon dependency, feminists also
need not destroy the security women have found in "sister
hood. 1 1 In the past, women have also been immunized against
stress related mental and physical illnesses, partly be
cause of their ability to disclose their feelings, and
emotionally depend upon their community of family or inti
mates. HE could also argue that it is more than cultural
conditionings that caused women to be dependent, but that
women may also have chosen, for good reasons, to be
dependent. Finally, HE would argue that even in a society
that attains social equality, a person would still need to
be reminded of the HE position that one is always free,
and always has been free, because freedom exists in one's
ability to be conscious of one's choices in the world, to
be able to rechoose and to take different perspectives
on one's way of being.
92
CHAPTER VI
THE SYSTEMS VIEW OF DEPRESSION
Systems theory produced a paradigmatic shift in the
models of psychology as it has striven to see that we
exist not as isolated intrapersonal units, but within a
conglomerated interpersonal whole. No part of any system
is seen as containing irreducible properties, but each
segment is recognizable only within the interrelated
field. According to General Systems Theory, all systems—
living organisms, cultures, or economic systems— seek to
maintain themselves in a homeostatic pattern, but can
also adapt to environmental influences by feedback mech
anisms within themselves. Marital, family or any inter
personal system is programmed as being analogous to a
cybernetic system in which causality is fused in a cir
cular loop, rather than being diagrammed in a linear
formula. Our natures, according to this perspective, are
not fixed, but are the result of learned responses to
forces in the life space. A complex behavior pattern
repeats itself and forms an interlocking feedback process
within the system as a result of the reinforced res
ponses linking the system. What is significant about
93
human systems, note Allman and Jaffe (1978), is that a
person is relatively free from reflex, instinctual or a
fixed response pattern, but humans are unique in their
qualities of self-awareness, or consciousness, and in
their ability to think, reason, and reflect. Each partner
in the system obtains a reinforcement value for the other,
and for the system, but the reinforcement value could be
come secondary and derived from the eventual perceptions
and expectations of the other.
Although the idea that our behavior is part of con
sciousness, rather than instinct or reflex, seems congru
ent with HE thought, one can draw lines of departure be
tween HE and the systems model. The systems theorists
seem to see consciousness as linked into the person's
ability to be aware of what would reinforce some behavior
in the other, for oneself, or for the system. For exis-
tentialists, consciousness is the ability to be aware and
to look at one's choices, as systems theory would have it,
but those choices, for HE, are potentially free from re
inforcement, and not all choices are seen as being made
with the intention of being rewarded by others. For HE,
consciousness is self-awareness of one's projects and
intentions, but, because "we are the agents and the cause,
we are free" (Ofman, 1976, p. 19), and no system can
deny the potential of freedom. Embracing a moderate and
94
realistic existential position, Wheelis explains; "We must
affirm freedom and responsibility without denying that we
are the product of circumstance, and must affirm that we
are the product of circumstance without denying that we
have the freedom to transcend that causality to become
something which could not even have been previsioned from
the circumstances which shaped us" (1973, p. 88).
In depression, systems theory projects a person as
being part of a homeostatic mechanism where the system not
only maintains the depressed behavior, but depression also
serves to regulate the family interaction. The therapeu-
tic intervention in the systems perspective is symptom
focused and designed to disrupt, disconnect, or jam the
characteristic behavioral maneuvers within the looping
transmission. Instead of giving Freudian structural inter
pretations regarding the ego, id and superego, or tracking
the irrational cognitions, the systems therapist seeks
to relabel or decode the behavior to give it meaning in
terms of problematic, yet homeostatic, pathology.
Depression for systems theory is not the result of
psychoanalytic converted anger, nor the result of dis
torted thoughts about the environment, nor is depression
the sole result of the sociological influences; but, de
pression is seen as the interaction within the system,
where the depressed person is an integral part of that
95
system, and not separated as the identified patient, nor
the innocent and non-participating victim of a sick en
vironment. Studies do show that depressed women report
more hostile behavior towards their spouse and children
than nondepressed matched controls (Weissman, Klerman &
Paykel, 1971) , and women who are able to effect an im
provement in their marital relationship and reduce social
friction, and their expressed hostility, do improve their
depression (Rousanville, Prusoff & Weissman, Heraey-Barpn,
1979). Expression of hostility may have less to do with
depression than classical psychoanalytic thought would
suggest. (See Chapter 2.) The depressed person also may
have a more accurate, rather than a more distorted, per
ception of one's environment. Depressed patients do rate
themselves as less socially competent than nondepressed
controls, but this discrepancy is congruent with judges'
ratings (Lewinsohn, Mischel, Chaplin & Barton, 1980) . De
pressed subjects were also found to be more realistic in
their recall of negative feedback than nondepressed sub
jects who underrated the amount of punishment they had
received (Nelson & Craighead, 1977) . If anything, a
nondepressed person tends to distort one's vision of the
environment in the light of positive hues, while a de
pressed person sees things clearly, if darker.
What systems theorists are trying to suggest, by
96
calling attention to these studies which contradict the
psychoanalytic and cognitive theories of depression, is
that it is not the "patient," nor the environment alone
that needs to be altered, but rather, the person with the
others and vice versa, the entire system that is pathologi
cal and needs treatment. Like the computer based model,
the output cannot be corrected unless the input is also
examined, and depression cannot be treated without the
context of the interaction of the person with the others
and the circuit flow between them. In looking at the
family dynamics, system theory is constructed upon a
behavioral framework as it explains that transactions
within the system are linked in terms of reinforcement.
The theory of depression follows this outline.
In the system's model, the depressed behavior is
understood and ordered in the context of the feedback re
inforcing mechanisms, and the resulting patterned res
ponses. Coyne (1976) fitted depression into a self-
perpetuating interpersonal system. With the behavioral
slant to systems theory, Coyne saw the depressed person's
complaints as a personal strategy designed for contol to * ■ "
increase support from the environment, or to inhibit
negative responses from others. The support, however, is
nongenuine and ineffective in ceasing the depressed com
plaints, and ironically increases the depressive's
97
behavior. The depressed person is seen as trapped within
a feedback loop. The depression recycles through the in
put of the system, and each time the output reproduces a
more persistent pattern. Those in the environment of the
depressed person, initially try to provide reassurance to
reduce the aversive complaints of the depressed person;
but, while the complaints are receiving positive rein
forcement from the attention they demand, at the same time,
those giving the support are learning to avoid the noxious
and negatively reinforcing depressed person. There results
a powerful double bind that strengthens the ties of depres
sion. The depressed person, according to Coyne, is com
plaining to achieve control. The complaints are met with
opposing personal maneuvers designed to reduce the aver
sive depressed behavior by providing support or reassur
ance, but the depressed person is also met with rejection
and avoidance. The power of partial reinforcement is
significant, as the depressed behavior and complaints
increase to achieve more support, but the increase in com
plaints serve as a further negative reinforcement to
others who begin to reject the depressed person. The de
pressed person makes the others feel guilty for rejection,
but this guilt may actually begin to provoke aggression
(Jacobson, 1954). The family withdraws from the depressed
person, and interaction with the others is more and more
98
initiated by the depressed (Liberman & Raskin, 1971). Be
fore support erodes completely, the spouse continues to
provide the partial reinforcement; "He or she become frus-.
trated, confused, (and, importantly) overly solicitous,
or angry, or withdraws emotionally" (Rush, Shaw & Khatami,
1980, p. 105). Eventually, however, support slips away
altogether (Coates & Wortman, 19 80. Coyne, 1976).
Existentialists and system theorists share certain
theoretical outlines, but HE and system theorists are
severed on some philosophical points. Existentialists
would agree that we need to examine the relationship with
the Other. "The other holds the secret— the secret of
what I am," wrote Sartre (1965b, p. 209). Being, for
existentialists, cannot be comprehended without the look
of the Other. We are understood, says HE, in the context
of another. Saying that we are understood with another,
is not to say that the Other has formed me for, as Sartre
reminds, "...I am revealed to myself as responsible for
my being, I lay claim to this being which I am" (196 5b,
pp. 2 09-210). Existentialism is based on freedom where
each being is seen as freely creating one's own essence,
while systems theorists seem to box a person within rein
forcement theory which seems to deny choice outside of
reward and puishment. HE says, "I choose how to be and I
understand those choices with another"; while systems
99
theory says, "The whole shapes my being, and my choices
are only understood in terms of reinforcement." Depres
sion from the systems perspective is looked at in terms
of behavior that provokes or is designed to elicit a pos
itive response, but is partially reinforced, and at the
same time is an aversive stimulus which results in avoid
ance and emotional isolation. Existentialists look at
depression in terms of projects and choices. Depressive
complaints, for HE, could be the result of a project to
control the Other, but it also could be the negative con
sequence of other failed projects. For this dissertaion,
depression is seen as the result of isolation. Either
the woman tried to become the Other and lost the Other;
or, she chose an isolated position— -she made the choice
to stay at home and "not seeing anyone but the four
walls," or she chose to stay within a non-confiding rela
tionship, or she chose to isolate herself and not express
her existential experience within the relationship. (See
Chapters 4 and 5.) From the systems model, Coyne sees
that depression is exacerbated as support is undercut,
while the position advocated here would say that depression
is caused when the person is isolated. For HE, pathology
is loneliness, and van den Berg reminds; "loneliness is
the central core of his (or her) illness, no matter what
his (or her) illness may be" (1972, p. 105).
ts
ts
100
A valuable component of systems theory is in the in
spection of the whole unit rather than one part. Systems
theory does focus attention on the relationship to the
Other. In the therapeutic modality of systems theory, the
therapist examines the symbiotic emotional system where
each part is reinforced and fires and maintains the system
in the feedback loop. HE, on the other hand, tends to
work with a person to find the "denied integrity of one's
choices" (Ofman, 1976, p. 140). One's project, or one's
basic set of choices, will be repeated in any context and
does not need, therefore,.to be only examined within the
family or social system. For HE, the person's basic
choices can be separated and seen in action apart from
any specific system, while systems theory sees that the
behavior is only displayed within the system that rein
forces the pathological dynamics and maintains the system
itself. The project to fuse or to isolate, for HE, could
be seen, therefore, within the family, or it could be ob
served with the therapist or in any other context, while
systems theory would see the depression maintained by and
in the system and maintaining the system.
System therapists seek to alter the behavioral symp
toms within the system, but the HE therapist sees symptoms
as the expression of the person's individual project, and
"the symptom is the person" (Ofman, 197 6, p. 39). To
k*'-"
101
alter the symptom of depression would not alter the per
son ' s project, or the negative consequences of suffering,
because, as Ofman concluded for existentialists, "if unity
of consciousness is posited, and if symptoms are not ac
cidental invasions or results of an unfortunate set of
conditioning sequences, something else will arise to take
the place of the infirmity she suffers in order to express
in some way the cosmology she pursues. The behaviorist
cure alters only one expression of the way in which the
person freely chooses to see herself" (Ofman, 1976, p. 93).
HE looks at the individual choices or projects that may
result in isolation and loneliness, while systems theory
would inspect the system that produces via reinforcement,
the isolation of the person.
System theory, however, does remind existentialists
of Wheel'is'1 less stringent position; that is, "Being the
product of conditioning and being free...do not war with
each other. Both are true." We are free, responsible and
also determined by our conditionings, but, reminds Wheelis,
coming back to existentialism, and away from any similari
ties to systems theory's behavioral origins, "What des
troys the behaviorist's argument is not the evidence
marshaled to demonstrate that we are controlled by envir
onment— that is utterly convincing— but the use of that
evidence to destroy freedom" (1973, p. 88). The moderate
102
position taken here is that we are all to some degree con
ditioned by the system that contains us and that we con
tain, but we are also capable of executing choices that
are free of conditioned determinants. Systems theory is,
therefore, similar to HE in that it stresses the relation
ship of the Other, but it differs from HE, in that exis
tentialists would argue that the relationship is poten
tially free from being totally determined within the
system.
Because system's therapists see depression as output
of the dysfunctional system, the family, marital dyadic
relationship, or any symbiotic group is examined to assess
the problematic input. Existential therapists, on the
other hand, because they see the expression of the per
sonal project as transcending any group context, and
symptoms as contained within that project and not within
a response pattern inherent in and to the system, can
justify the examination of the project in individual
therapy. However, existentialism might benefit from an
inspection of depression and the depressed person's pro
ject within a group context, where the projects can be
seen as reproducing themselves with others. The project
to fuse or to isolate might be more clearly seen by the
therapist and by the person within the group setting
rather than in individual therapy.
103
Systems theory thus adds the component of the rela
tionship to and with the Other. This perspective adds
much to the previous isolated paradigmatic visions, and is
more in line with the HE view. HE and systems theory are
at variance Over how much power the system has in deter
mining the person's behavior. Systems theorists seem to
say that the system creates and maintains the depression,
while HE would argue that the person still maintains a
choice to continue or to change one's project. Although
HE might argue that the person brings the project into
play within any group, and the project would be displayed
with the client and the therapist as a dyad, and the
entire system need not be examined, the treatment of de
pression may be more effective within a group context,
than with individual therapy.
104
CHAPTER VII
THE EXISTENTIAL PARADIGM OF DEPRESSION
For existentialists, meaningfulness has been the net
used to rescue a person from the swamp of depression.
Meaninglessness, however, always lies embedded in the ab
surdity of existence and is uncovered in the muddying
question of "why." Camus slipped into the absurdity:
Get up in the morning, the streetcar,
four hours at the office or factory,
eat, streetcar, four hours work, .eat,
sleep— and Monday, Tuesday, Wednesday,
Thursday, Friday, and Saturday in the
same rhythm— this path is followed
easily most of the time. But one day
the ■''why* rises up...
(Camus, 1955, p. 27)
Camus did not hear the absurdity as bubbling up from
the world, nor as coming out of ourselves, but the absur
dity is a silent echo that comes back empty when beings
confront the irrational world with a demand for reasonable
coherence. There is no answer there; there is no meaning
coming from the world itself. "The absurd is born of that
confrontation of the human appeal and the unreasonable
silence of the world" (Camus, 1955, p. 45). Even if the
world calls back no meaning, Camus shouts back that life
is not meaningless. Instead Camus grabs the absurdity by
10 5
its neck, revolts before it, and refuses to let the ab
surdity wrap its hands around him and drag him into its
muck. Accepting that there is no transcendent, essential
reasonable meaning to the world, Camus was freed to create
a new meaning, and to tear down old "barriers" of meaning.
"To the extent I order my life, and thereby prove that I
admit that it has meaning, I erect barriers between which
I confine my life" (1955, p. 82). The absurdity can yield
a freedom to find meaning, to pursue it, and to run for it
in passion.
Thus I derive from the absurd three
consequences which are my revolt, my
freedom, and my passion. By sheer
activity of consciousness I transform
into a rule of what was an invitation
to death— and I refuse suicide.
(Camus, 1955, p. 89)
Like Camus, Sartre saw us born swaddled in the swamp
of meaninglessness that threatened to dump us into the void
of depression. "In anguish I apprehend myself at once as
totally free and as not being able to derive the meaning
of the world except as coming from myself" (Sartre, 1965,
p. 129). When smothered by the question of "why" that
begins to pull us into the void, Sartre found safety by
clinging to "engagement." In Sartre's play, "The Flies,"
Orestes finds meaning in activity. Even walking and
having to carry the burden of being his mother's murderer
was better for Orestes than walking aimlessly and
106
wandering close to meaninglessness:
The heavier it is to carry, the better
pleased I shall be; for that burden is
my freedom. Only yesterday I walked
the earth haphazardly, thousands of
roads I tramped that brought me nowhere,
for they were other men's roads... Today
I have one path, only, and heaven knows
where it leads. But it is my path.
(Sartre, 1955, p. 10 8)
Orestes ran into a message on the path. There is no
absolute meaning. He alone had to create it. There is
no one "path," but by walking (acting) our path (our
essence) is made. To Zues, Orestes confesses the truth of
existence.
Suddenly, out of the blue, freedom
crashed down on me and swept me off
my feet— and there is nothing left
in heaven, no right or wrong, nor
anyone to give me orders... I am
doomed to have no law but mine...
Every man must find out his own
way.
(Sartre, 1955, pp. 121-122)
Without the leap into action and engagement, existen
tialists see us being sucked down by the question of
"why," stumbling into the void of meaninglessness and
falling, therefore, into the pit of depression. Salvatore
Maddi described the trap of "existential neurosis" where
the walls are padded with "meaninglessness" or a "chronic
inability to believe in the truth, importance, usefulness
or interest value of any of the things one is engaged in
or can imagine doing" (Maddi, 196 7, p. 313). Maynard
107
Boss describes those trapped; "Melancholics can discover
no thing of worth in their existence... They will complain
monotonously that nothing in their lives works anymore"
(Boss, 1979, p. 219).
For existentialists, depression is the result of the
absurdity of existence where life is potentially meaning
less. Without any inherent values preordained for us
in our existence, and without a belief in a religion or
other cosmologies that would have provided some guidelines,
life seems to be, at times, without meaning. With no
meaning, existentialists see that we are subject to de
pression. Engagement and action, like Oreste1s journey,
are the safety nets that are flung by existentialists to
save beings from the void of meaninglessness and depres
sion. Because we are burdened by freedom, however, each
being must stitch one's own meaningful net.
Unlike Sartre, Victor Frank! insists that we do not
invent a meaning, but we must discover it. "Meaning is
something to be found rather than given. Man cannot in
vent it, but must discover it" (Frankl, 1966a, pp. 21-28).
The existential analyst is "not to give meaning to the
patient's life. But it may well be his task to enable the
patient to find meaning in life. And in my opinion, mean
ing is something to be found rather than to be given"
(Frankl, 1966b, p. 253). Frankl, however, is not pulled
108
by the burden of freedom in a nontheistic universe cramped
in a void, but he fills the "existential vacuum" with a
God who has created a meaning that we are to discover and
rest upon. Even with a God intruding into the void,
however, Frankl, like Sartre and Camus, maintains that;
"Man's primary concern is to find and fulfill meaning and
purpose in life" (1966b, p. 258).
If meaning dissolves the cause of depression, then for
existentialists, the cause of depression is found in mean
inglessness. In the existential framework, women are
boxed in depression by meaninglessness. In middle-age the
box gets tighter as the void of meaninglessness gets
larger. Women become depressed, writes Ernest Becker
(1963) because "they do not have enough reasons for satis
fying action, and when they lose their one apparent reason
upon which they predicate their lives— their femininity—
their whole action world caves in" (Becker, 1963, p. 358).
Even as existentialists have probed being through the
vacuum in the world by saying that we must create or find
our own personal meaning, they have dropped us by saying
that there is no meaning to hang onto. Even "action" or
"engagement" remain a path that is undefined by existen-
tailists. Sartre had promised to reach out with a volume
on ethics, which was to reveal what action was to be
truly meaningful. Ironically, however, he died, and the
10 9
meaning he had to give went with him. The guide through
the void, however, remains somewhere in engagement.
Existentialism is largely infused with European
blood, where engagement or action could be spilled against
Nazi occupation, or in concentration camps. When crossing
the Atlantic, however, engagement immigrated and was bred
with the American ideal of progress and individualism. If*
progress is no longer to be consumed in one's own work,
then work is now consumed in the engagement of one's own
progress, one's own self-actualization. Maslow displayed
the mark of humanistic mixing with existentialism; "The
human being is so constructed that he presses toward fuller
and fuller being..." (Maslow, 1962, p. 147). Psychologist
George Back and Laura Torbet indict the humanistic notion
of "self-actualization"; "the psychiatric community has
unwittingly colluded in this one-sided quest for self-
actualization, convincing people that the answer to their
problems lay in 'doing their own thing.' Psychiatrists'
and therapists' offices are filled with men and women
seeking sanction for their noncaring, self-actualizing
pursuits... People coming to therapy desperately seeking
love and closeness are often derided for their 'neurotic
dependency,' [and] told to be self-sufficient" (Costing,
1982, p. 147).
Engagement has become mutilated into self-involvement.
110
Sartre did begin with the self: "Man is nothing else than
his plan; he exists only to the extent that he fulfills
himself; he is therefore nothing else than the ensemble of
his action, nothing else than his life" (Sartre, 1965a,
p. 47). Or she than her life.
The self, however, is found with the Other. Con
sciousness in itself is a nothingness, and does not exist
without objects of which to be conscious. Others become
objects, and I not only see them, but they also see me. By
the sight of the Other, I cannot only know who I am, but I
know that I am. The reflection goes on as long as we stand
before the mirrored Other. "No one can be vulgar all by
himself," wrote Sartre (1965b, p. 189), just as no one
can be anything all by him or her self.
Meaning then, cannot just come from personal action
unconnected to the Other, which is something that some
existentialists, it seems, have been overlooking Camus'
Dr. Ricour did not just battle the plague, but he tended
the sick. Sartre's Orestes did not just walk the world,
but he opened the eyes of the Argos to the despair and to
seeing that "Life begins on the far side of despair"
(1966, p. 123). Women are not just depressed because they
have lost "reasons for satisfying action," but they become
depressed because the dialectic has been squeezed out of
the action. There is no one to act for or with.
Ill
In the humanists effort to fulfill one1s own potential
and to discover peak experiences, the Other has been
dropped out. Engagement, for HE, cannot be self-involve
ment. Self-actualization without the Other is only a
masturbatory pleasure wrapped up and around oneself, and
only a temporary relief. The self is only found— actual-
ized--with the Other. Alone the self stands as a halluci
nation (van den Berg, 1972).
In order to understand depression, not only must
meaning be defined by engagement, but engagement and action
must be defined with the Other. It is the balance with
the. Other that existentialists fit meaninglessness and
depression.
This chapter has attempted to point out how existen
tialists have looked at depression, and what may have been
overlooked. For HE, depression is the result of meaning
lessness. We are thrown into a world inhabited without
meaning or direction. If we fail to find that meaning
for ourselves, and if life seems pointless and absurd, then
we are subject to existential depression. One way exis
tentialists have suggested to overcome the absurdity,
which could lead to meaninglessness, and therefore depres
sion, is through action and engagement. Being based on
freedom, however, HE has never defined what form of action
or engagement is meaningful. It is almost as if by just
112
acting or engaging, we would escape depression. One pos
sible explanation for not defining what a meaningful
engagement would be, is that HE believes that each person
defines oneself, and for anyone else to be defining what
is a meaningful type of engagement would be defining what
should be one's essence, and would thus violate and vilify
HE's philosophy that "existence precedes essence," and that
we are free and condemned to create our own essence.
The other pole of HE, is that even as we freely define
ourselves, we are also understood and find ourselves with
the Other. If one follows the argument, that we are dis
covered with the Other, then meaning and engagement must
also be connected to action and engagement with the Other,
and not just individual isolated action for and with
oneself. Existential writers seem to find escape from
depression when they, or their characters, are connected in
action and engagement with the Other. It is the focus of
this dissertation that when we lose the conversation with
the Other--when our action is separated from the Other, or
when we choose to isolate our experience from the Other—
then the result is depression. If such a position is ac
cepted, then the modern (and humanistic) notion that advo
cates "individual growth" or individual potential," or the
feminist idea of creating a "unique... self," is contrary
to HE philosophy, if it is taken as disconnecting our
113
relationship to the Other, and further, such a position
might result in isolation and, thus, depression. To advo
cate the position that stresses individualism as meaning
a separation from the Other, is, according to this author,
potentially dangerous, as it might lead to depression.
It is the intention of this dissertation to place
meaningfulness into the relationship with the Other, and
to remind the HE therapist that existentialism,
larly evident in HE philosophy, and existential
plays, is not only based on freedom, choice and
bility, but that HE also has strong ties to the
that a loss of the Other, or a choice not to be
with the Other, could be a cause of depression.
as particu-
fiction and
responsi-
Other, and
connected
114
CHAPTER VIII
A NEW PARADIGM; DEPRESSION AS THE RESULT
OF ONE'S CHOICE OF BEING
The Paradox of HE— Being free of anything
to create our being; and/ yet our being
only known with the Other.
An enigmatic paradox, wrapped around two poles, exists
in existentialism. One pole is grounded in the well known
foundation of existentialism; that is, existence precedes
essence. "Man is nothing else but what he makes himself,"
held Sartre (1965a, p. 36). "Man's essence is his exist
ence," repeated Tillich, pulling even farther away from
Platonic idealism by being tethered to the pole of freedom
in existentialism with the statement, "no essence can be
affirmed" (1961, p. 9). Existentialism turned the Platonic
pillar of essence preceding existence upside down. For
HE, existence creates our essence. In subjectivity, or
freedom, a person chooses and creates his or her own plan.
The freedom to choose one's being creates a vacuum of
nothingness in the world where one is sucked into the trap
of the responsibility for one's choices.
The hole in one's being, however, is never ultimately
patched up, and one's essence finally resolved. Instead,
the hole remains, and is covered by a thin film of
115
nothingness. One's essence slips around the choices one
makes in an effort to harden the film of one's being. We
try to establish an essence once and for all time, but,
instead, we must continue forming our essence with our
choices.
Existentialists, is seems, have turned Descartes'
"cogito ergo sum" around and squeezed him out. For exis
tentialists, the credo is, "I am, therefore I think, I feel,
I choose, and I exist; and, I am responsible for my choices
and my existence."
The paradox is found in matching the pole of existence
creating essence with the other, less well remembered,
pole of existential grounding. Even though choices define
one's being— I am, therefore, I exist--I also can be blind
to my being. Even without an essence, there does remain a
person's "basic set of choices that make up what is called
a 'project' or basic cosmology (or personal myth) to
which all the lesser decisions and elections are intimately
related" (Ofman, 1976, p. 2 3). Even as I am weaving my
project, however, I can be blind to how it looks. The
blindness is peered into by Ofman; "Each person has in
vented and built and seems committed to a basic way of
engaging his (or her) priorities in his (or her) world,
and this may be either explicity known to him (or to her)
or not" (1976, p. 24). Each person "invents" his or her
116
pattern, but it seems that it takes another to reveal it to
us. This does not imply that the Other sees into our myth
better, or more deeply, than we do, but that it takes
another to help us see our pattern and to look with us to
uncover where our choices clash, and to help us see the
negative consequences of our project. Because existen
tialists do not hold faith in any unconscious, the project
could not be said to be unconscious, but it is simply
there, waiting to be looked at and become aware of by us.
The paradox is thus uncovered in the two poles: We
must define ourselves by our choices; and, yet, we can be
blind to the very choices. No one else defines our being;
but, it takes another to help us discover that being.
I define myself, and yet, as Sartre wrote, "I am
possessed by the Other." The Other's look "shapes my
body...produces it as it is, sees it as I shall never see
it. The Other holds the secret— -the secret of what I am"
(1965, p. 209). We are without a mold, but we create that
mold by our choices. The mold, however, never remains
set, and is shattered with each new choice. Ironically,
we can be blind to the very mold we try to hold together.
The look of the Other defines the mold, and "shapes my
body."
Without the Other to help shape, sculpt, and define
us, our existence becomes porous and spreads into
117
"illness. " "Loneliness is the central core of illness, no
matter what his (or her) illness may be. Thus, loneliness
is the nucleus of psychiatry," screams van den Berg (1972,
p. 105) at the silence of the isolation of living without
the Took of the Other. In the isolation a person "halluci
nates ... objects of his own" (p. 107). One of the "objects"
could be a person's own description of one's self. With
out the Other, our selves can become hallucinated objects;
objects seemingly real, but created within the imagination
of our deprived isolation. We need the look of the Other
to see ourselves in reality, and to see ourselves clearly
without hallucinations. The Other can help to illuminate
our blindness to ourselves. without the Other's illumina
tion, we hallucinate ourselves in our blindness. Again, we
need the look of the Other to see our chosen selves more
clearly, or we begin to distort'ourselves and our projects.
Before we experienced the reflection of ourselves
upon the look of the Other, we defined ourselves as wholly
subjects, totally free, and forming and outlining the
world and ourselves; but, the look of the Other backs us
to the wall of the world, and forces us to realize that we
are objects to others. "...I discover that my being or
not being an object depends not on me, but on the Other,"
wrote Sartre's disciple, Hazel Barnes (1959, p. 59).
Forced down by the look that can make me an object of the
118
Other, the only way out seems to be to "enter with him (or
her) in perilous conflict in which I try with my own look
to make him (or her) so completely an object that he (or
she) cannot look at me in return" (Barnes, 1959, p. 59).
The Other possesses me by looking at me. Sartre also des
cribes the struggle, where the Other possesses me, and
since the Other, "is the key to [my being an object], I
attempt to lay hold of the Other so that he (or she) may
release to me the secret of my being" (1965, p. 208).
Even as we need the Other to define us, we fight to lay
hold and capture the Other so that we can get and keep
the secret of who we are.
There are, however, ways, out of the "perilous con
flict, " or the fight with .the Other to maintain our sub
jectivity and keep from being totally defined by the
Other.
For existentialists, the beginning of any round re
volves in choices. After being thrown down the hole of
existence, one has to grab onto one's essence by choices.
The responsibility for defining one's self, and for one's
choices is awesome. In bad faith, or self-deception, one
way out of the hole in one's being, and the responsibility
for oneself, is to fuse with the Other. By attaching our
selves to another, we not only give up the conflict with
the Other, by giving in to the Other, but we feel we can
119
escape from the absurdity of life where choices must be
made, where responsibility has to issue from those choices,
and, yet, where there is no ultimate value to any choice.
Instead of letting the Other illuminate who we are, we
let the Other be who we are. The trap is that the choice
to give our choices up to the Other, still remains a
choice, and all choices have potential negative conse
quences. The danger is that the Other may turn away, not
look, and no longer be there to define us, and then one's
essence is seemingly lost. Being encapsulated within the
Other, does not remove us from choices; it simply dangles
us before the tenuous hold of the Other. We could be
dropped like any object, by the mere blink of the eye of
the beholding Other.
Another way out of the conflict would be to avoid the
look from the Other, remain in the illusion that we are
total subject, and that we can exist without the look
from the Other to shape and define us. Instead of looking
with the Other for the outline of ourselves, we avoid the
look. We continue to define our world, and ourselves as
subjects of it. It seems as if the struggle with the
Other is over, because we separate from the Other. We try
to encapsulate ourselves within ourself, and shut the
■Other out, and not allow the Other to look with us at our
being. Without the illumination from the Other, however,
120
we remain blind to ourselves, hallucinate ourselves, re
flect specters of our being, and remain unable to fully
see the negative aspects of our choices.
There is, in fact, no exit. We need the Other. We
define ourselves, and the Other helps to read back that
definition.
There exists a fight. For some it is a struggle to
dominate the Other by avoiding the Other1s look and be
coming encapsulated within ourselves. For others, or at
other times, we feel the pressure to submit to the Other
and become the object of the Other and encapsulated within
the Other. The only authentic way out of encapsulating
within the self, or within the Other, is to embrace the
struggle with the locked awareness that while each person
is outlining the Other, at the same time, each person is
trying to escape that outline; or, each person may be
trying to merge into the outline of the Other. In this
chasing of and by the Other, there comes the realization
that there can be a "reciprocal and fluid ['relationship]— -
an exchange...[where]*we can be two gods together,
neither one losing, neither one winning, each nourishing
the other" (Ofman, 1976, pp. 12 3-124) .
The struggle is "fluid" where each one is trying to
avoid being total subject over the Other, and at the same
time, each one resisting the pull to be the object of the
121
Other. In looking at the exchange, Buber (1958) referred
to the relationship as the 111-Thou1 1 encounter. "I affirm
the person I struggle with; I struggle with him (or her)
as his (or her) partner. I confirm him (or her) as oppo
site to me as him (or her) who is over against me"
(Buber, 1965, p. 79).
It is in this ideal relationship, that we struggle and
come into an authentic awareness of our own myth, and the
choices that make up our existence, and the negative con
sequences of those choices. The ideal relationship where
each struggles in the encounter can be shattered in many
ways. For this dissertation, if one breaks off from the
Other and encapsulates within one's self, or if one gives
in to the Other, and encapsulates within the Other, then
the fluid exchange stops flowing. In the ideal relation
ship, in the engaged encounter, or in the conversation,
we struggle to find out who we are by disclosing and re
vealing to the Other how we see ourselves and how we see
our world, and we let the Other in to point out what we
may not be seeing.
We do define ourselves by our choices, and yet we do
need the help of the Other to see those choices. Our
essence is never ultimately settled. We are tempted to
stop the responsibility of defining ourselves and we are
tempted to flow into the Other and become encapsulated
122
within the Other. We are also tempted to avoid the Other's
look, and become encapsulated within ourselves. These
projects, which are attempts to avoid the responsibility
of defining oneself, or the responsibility of seeing our
selves defined, can end in tragedy. We can be cut off
from the Other, or we can start by cutting off. The re
sult would be isolation, a conversation within ourselves,
and loneliness. Talking to ourselves we hear nothing; by
ourselves we cannot see ourselves clearly. Our words
bounce off the fluid world, and poke holes in it. We need
the Other to get a grasp on ourselves. The world begins
to ooze in the depression of isolation. Thinking that we
could have beaten the world in its own game, by being
fused with the Other, or by avoiding the Other, we find
that we have, and are, lost. No one hears us.
It is the purpose of this dissertation to remind
existential therapists of the paradox of HE. It seems as
if HE therapists do consistently remember one pole of
existential grounding; that is, that we are free and res
ponsible for our own existence. The other pole is less
well seen and remembered; that’is, that we need the Other
to see ourselves clearly, to avoid the isolation where we
hallucinate who we are, to help us see the negative con
sequences of our choices, and to nourish ourselves.
In the next section, the two positions will be
123
reviewed, and then the negative consequences of the project
to avoid responsibility of defining ourselves by encap
sulating within another will be explored. The following
section will investigate the negative consequences of the
project of avoiding the Other, and encapsulating within
the self.
The Two Positions
The paradox of existentialism is the dance of exist
ence. How can one freely choose for oneself, and yet be
known only by the Other? How can one be free and indepen
dent without being isolated from the Other? How can one
be known and dependent with Others without being fused
with them as objects? Inside the paradox, it is suggested,
lies the rhythm of depression. Being all subject and en
capsulated within the self, or all object and encapsulated
within the Other is an attempt in bad faith to glide
through existence. But if existence and meaning for HE
come from the dance and engagement with the Other (see
Chapter 7), then being an isolated leader, or being a fused
partner, only results in solitary gyrations. Meaning comes
from the flow, the back and forth, the finding and defin
ing, between the dancers. Either position, encapsulated
within the Other, or encapsulated within the self, will
stop the dance, and may eventually, it is suggested here,
124
cause the person to slip into depression.
The rest of this chapter will look at examples of
either position— encapsulated within the Otheror encap
sulated within the self— as possible causes of depression.
The novel The Mandarins, by Simone de Beauvoir, was se
lected to illustrate both positions, because it uses two
female characters who exemplify both positions, because
de Beauvoir is an existential author, and because she is
also a woman author. In addition to the novel, empirical
studies as well as other data will be examined to correlate
with both positions.
Being Object and Encapsulated Within the
Other as a Cause of Depression in Women
In the dance of existence, men have traditionally held
the position of the leaders; women have followed. Simone
de Beauvoir looked at the choreography in the Second Sex;
"She is defined and differentiated with reference to man
and not he with reference to her; she is incidental, the
inessential as opposed to the essential. He is subject;
he is absolute— she is Other" (de Beauvoir, 1952, p. xix).
Women have, in fact, been encouraged, by society, to be
the object, and to be encapsulated within the Other. The
position of being an object to the Other, however, is
still a choice.
Women have danced in time with the bad faith of being
125
object. The position of being an object and encapsulated
within :v the Other, is chosen, and the chosen position is
often denied. Dancing through the pirouettes another
spins is really a way to avoid taking a step on one's own.
Because of the anguish of choosing for one's self, it is
often easier to be fused with the Other. The Other no
longer helps to reflect ourselves more clearly, but we
cling to the Other to avoid looking at ourselves at all,
and becoming aware of our projects. Being fused is one
attempted way out of the responsibility of defining our-
sel'.ve s.
In her novel, The Mandarins (19 79) , de Beauvoir puts
Paula in the position of the fused partner of Henri.
Paula, like all Other appendaged women, in bad faith,
could not see that she tried to give up responsibilities
for herself as subject, by meshing herself through
another's life. Instead, she feels she sacrifices her
life for the Other. "...I realized that Henri required
it of me...1 know my sacrifice is necessary, not only for
his happiness, but for his work, his mission" (p. 192).
Once having sacrificed her subjectivity, however, Paula
can look at Henri as rising out of her blood; "...it was
I who made Henri. I created him as he creates characters
in his book..«" (p. 195).
Feeling that she created Henri, Paula can delude
126
herself into seeing that she is Henri. "You speak as if
Henri and I were two distinct beings...we're one single
being...it's strange, you know, to lose yourself abso
lutely in another" (p. 195) . It's not so strange; mothers,
lovers, wives and The Faithful, do it all the time.
Togetherness becomes the life blood, when existence is
hooked up with the essence of the Object. The subject, or
freedom, goes out into the Object. It's a painfully flay
ing experience to discover that what a woman thought she
had sacrificed herself into creating, so that she could
live in and through that person, is actually another being
whose existence is freely determined by that Other.
From Pinnochio to Christ, once it's human, for HE, then
it no longer has another creator to determine its exist
ence. For existentialists, only existence creates essence,
and not some other cosmology or guide to being. For
Paula, when Henri no longer desired her, she did, not exist.
If her "sacrifice" was not to find herself reborn in him,
then she was willing to give it all up. If not pursic acid,
"— then how shall I live" (p. 445) .
Perhaps society has encouraged women to fuse with
another. Some women, as Durkheim (1951), Powell (1971)
and Bart (1971) explained, have fused themselves with
their children. (See Chapter 4.) They find meaning in
life when they are not only engaged with their children,
127
but fused with them. Arieti (1979), Scarf (197 9), and
Chester (1971; 1972), also have noted that women may be
come dependent and fused into the dependent love bond.
(See Chapter 5.) The loss of children, or the loss of the
love relationship, results not only in the loss of the
Other, but the loss of self as well. The loss of the self,
as fused into the relationship, seems to result in depres
sion.
HE does recognize that there is always some transfusion
with the Other. Once we have chosen to include another in
our world, then it is not the same world if the Other
leaves it. The world changes color when the Other has
faded out. The body, for HE, illuminates our world, and
when that world is darkened without the Other, then the
body suffers in the shadows. If the Other was a part of
our world, then if the Other is gone, so also would be that
part of our world. In some vain effort to fill up the
changed and vacated world again, ingestive behaviors in
crease for the bereaved. Alcoholics increase their drink
ing, and pill popping and cigarette smoking increases
(Klerman, 1979). For others, the body cannot survive.
Data from England and Wales found that widowers death rate
increases by more than 14 0 percent during the first 4 to 6
months after the death of the spouse. "Humans react vig-
ourously with the total body, to the disruption of the
128
attachment bonding" (Klerman, 1979, p. 38).
To escape the metastasis of the growing gloom, beings
could, with intentionality, depress the world. Sartre
explains the intentionality of consciousness where, "to
bring that change about [in the world], we can act upon
ourselves, only * dim the light' and withdraw the press of
the world: depress ourselves" (1948, p. 65). Depressives
suffer more loses and separation than any other stressors
(Klerman, 1979). For a woman, when children leave home,
she dances alone, and often falls down— suicides and
divorces rise (Powell, 1970) . Bart's (1971) mothers tell
of the world with the loss of children that mirrors
Paula's loss of Henri.
I loved, and loved strongly and
trusted... I deserved something,
but I thought if I give to Others,
they'll give to me. How could
they be different... I don't want
to be alone, and I'm going to be
alone... My children will go their
way... I'll still be alone, and I
got more and more alone.
(Bart, 1971, p. 116)
Women have been more vulnerable to the bad faith of
waltzing themselves around the pole of being an object of
Others and become encapsulated within the Other. A
"woman gives her highest priorities to pleasing Others, to
being attractive to Others, to being cared for, and to
carrying for Others" (Scarf, 1979, p. 52). For Scarf, the
12 9
depressed woman is one who has lost something with which
her world was fused; the loss of a love bond.
Although divorce is a traumatic break for men and
women (Weiss, 1976), women usually suffer longer
(Hetherington, Cox & Cox, 1976). Because women have put
so much of themselves into the myth of "until death do us
part," and fused their lives into the Other, the disrup
tion of the marriage is "perceived not just as a loss of a
relationship, but as something closer to a total loss of
self" (Miller, 1976, p. 93) .
Although HE would agree that we all would suffer a
loss, and the world would not be the same, if the the Other
should leave, not all beings, however, suffer the loss of
self when the Other is gone from one1s world. It is sug
gested here that only when, as Paula, you lose yourself
totally into another that identity is snuffed out when the
Other turns around without you. A comparison study
(Farberow & Reynolds, 1971) of male suicides, between
those whose death was precipitated by a disruption of
.interpersonal relationships, compared to those whose sui
cides were not, found that those in a dyadic crisis were
more dependent. They clung to the Other in varied
spheres— indirectly by asking the spouse to take care of
child-rearing responsibilities, or directly by asking to
be taken care of by the mate. The loss of a significant
130
Other early in life may predispose another to suicide
(Palmer, 1947). Once the hole in the world is experienced,
perhaps there may be a death grip upon the remaining Other.
An iron bond, however, where one is fused to the Other,
may snap by its own weight, catapulting the Other into
depression.
Bonding itself, however, is not the problem, but it is
only when the bonding becomes fused and meshed and there
seems to be no existence without the Other, that the loss
of the Other results in prolonged depression. The solu
tion for depression does not come from dissolving all
bonds, and dancing alone as Chesler (1972) seems to have
directed: "Women's ego identity must somehow shift and be
moored upon what is necessary for her own success as a
strong individual" (p. 2 99) . As will be suggested later,
the dissolving of bonds in the attempt to be "moored
upon" oneself as a "strong individual" could also result
in depression. Bart (1971), too, advocated that women
work on "actualizing their own selves, fulfilling their
own potentials," where as existentialists suggest that our
own self is only realized, seen and known with others.
Since Durkheim's work, and perhaps before, it was
noted that being unmarried, or without having social con
nections, throws one into anomie. The person "moored"
upon oneself flounders, and often sinks. The unmarried
131
person is twice as likely to be susceptible to depression
than the married person (Pealin & Johnson, 1977). More
over, vulnerability to depression increases the more the
married person is socially isolated. Being in a new
neighborhood, not belonging to a voluntary association,
and not having one's friends nearby isolates a person, and
makes one prone to depression. Even going to work reduces
depression, perhaps because it puts the newly unmarried
person into some contact with others (Tcheng-Laroche &
Prince, 1979). Being without a partner creates a break in
the world that depression may fill up, but having others
to fill in the gap, reduces the possibility of losing
the self in depression.
One turn of bad faith lies in putting one's being
into the arms of the Other, not to be partnered, nor to
see oneself more clearly, but to be tied to the Other to
avoid looking at oneself, and deciding where to go, and to
avoid determining our own essence. The conversation be
tween the partners has already stopped when one is fused
within the Other, but there is even more silent. If
the leader-other waltzes off, as when children leave home,
or if the Other changes partners, as in separation of a
love relationship, or if the Other should die, then the
person who had attempted to fuse is left alone. In bad
faith one deceived oneself into believing that the Other
132
will always dance in time with us, and that the Other will
always be there to lead us without our taking a step.
Choosing to be the fused and encapsulated object-of-Others,
puts us into one stand where the world can become depress
ing with each new beat and each different step of the
Other.
Encapsulation in the Self as a Cause
of Depression in Women
In being the object of the Other, the partner fused
with another. Instead of the choice to fuse and become
encapsulated within the Other, the partner could choose to
be alone and insulated within the self. Perhaps the
choice to be encapsulated within the self, is made to avoid
the pain of losing another. In this sense, the poles could
be said to attract; that is, the more one is likely to fuse
with the Other, and then lose the Other, perhaps, the more
likely that person would be to close off and fuse within
the self. Perhaps the choice to encapsulate within the
self is made because, like the woman in Howe's (1977)
study who felt she was "not the kind to complain," a woman
decides to insulate herself and keep her feelings inside.
Perhaps a woman would choose to remain in a non-confiding
relationship, where there is no Other to hear her feelings.
Perhaps, women, like men, are feeling the cultural pres
sure to be strong, not to fuse, and become "moored upon"
133
themselves as Chesler (1972) advocated. However the choice
is made/, the balance with, the Other is delicate. For HE,
we do create our essence, but we need the Other. The
choice to be encapsulated within the self, and to avoid
sharing and disclosing one's feelings, may avoid the
struggle with the Other and having the Other define one;
but, yet, the negative result is that the person then ends
in loneliness, and "loneliness is the central core of
illness, no matter what his (or her) illness may be"
(van den Berg, 1977, p. 105).
De Beauvoir's (197 9) character, Anne, spun around the
opposite pole from Paula. As Paula tried to escape defin
ing herself by vacuum packing her being into another's
skin, so Anne attempted to slough off the Other, and be
free of that Other's definition. Anne, a psychiatrist,
in bad faith, fooled herself into believing that she
needed no one to find herself, because she knew every dark
recess of herself. She wrapped herself up in the myth
that she had packaged up and analyzed the ingredients of
who she was--"If someone asks who I am, I can always show
my case history" (p. 35). Knowing who we are, however,
for HE, is not done by telling a case history; but one is
only known in the someone who asks.
In an effort to prove her subjectivity, and her free
dom from others, Anne attempted to break loose of the
134
defining morality and role that had wrapped her life in
the cushions of "kid gloves." She attempted one affair,
but it fizzled. Perhaps, de Beauvoir is saying that be
cause Anne stood alone, encapsulated, and powerful, she
was unable to feel passion with another. Passion is, after
all, a dialectic— the ultimate intercourse, back and forth,
subject and object, give and take, defining and finding
with the Other.
Being alone, insulated and omnipotent, Anne paid a
price for her project. She was free of others, yet iso
lated from feeling the passion with Others. In another
continent, almost another world for Anne, in America, Anne
had swung into the opposite pole in an affair under a neon
Schlitz sign. With Lewis, Anne fell into the object side
of the dilemma, and became fused with another; "as soon
as you love someone, you're no longer free" (p. 475).
Freed of isolation, Anne found herself trapped in another.
In the end, Anne chose to return home, to put back
her "kid gloves," to live within her roles. But as Anne
returned, she unpacked a depression. She held up her
future, and saw that the seams of her life were coming
apart. She recognized that she could not control the
whims of existence, and age and her "facticity," or the
facts of one's life, would limit what she wanted— success,
love, passion. Anne was bit with the pain of existential
135
reality. She was, however, encapsulated within herself,
feeling the pain of existence and unable to reach out of
her insulated position. Almost as if to be released of
her depression, and to execute her ultimate subjectivity,
she thought of suicide.
In dancing around the opposite pole from fusing with
another, Anne swung to the side of the "unique" individual,
and she stood by the pole of being free and yet encapsu
lated within herself. Being powerful, in control, and en
capsulated, however, also ends the conversation. Instead
of being the encapsulated object within the Other and, if
the Other should leave, suffering the loss of the Other,
and hence, the loss of the self, here, on this side of the
dilemma, Anne initiated the isolated position. She trans
lated being strong and independent to being isolated and
keeping to herself. Feeling the pain of existence, how
ever, she could not reach out. In either position, there
is a dead end in the conversation beteeen the self and
Other. On one side, we can put ourselves into another,
and not hear ourself; or, on the other side, we can put
ourselves into our self, and avoid hearing from the
Ot:he r.
By listening to the non-conversation, or the lack of
communication between the self and Other, one can, it
seems, hear a cause of depression. Sociologists and
136
feminists have talked about the housewife who is hung on
the apron strings of depression (Friedan, 196 3? Gove,
1972; Gove & Tudor, 1973). The unstructured role, lack of
visibility, one role source of gratification and low
status, were heard as the causes of female depression.
Not all housewives, however, sing the blues, and by listen
ing into the conversation, more lines are heard. Brown
and others, (1975; Roy, 1978), found that the lack of
employment, three or more children under the age of four
teen living at home, and the absence of a confiding rela
tionship were factors predisposing housewives to depres
sion. These factors may also inhibit the conversation.
Working would bring a woman into the possibility of a
daily conversation, having fewer younger children at home
would allow women the freedom to seek the conversation
with others, and a confiding relationship hears the con
versation. The conversation, or letting one into our self
seems to make or break a being's world. Ferree's (1976)
interviews with working-class women found working women
were happier than those at home, and those women who had
previously stayed at home spoke of "going crazy staying
home; not seeing anyone but four walls all day" (p. 78).
Those who' did stay home, and were happy, reported that
they were supported and respected by their social network.
(See Chapters 4 and 5.) Working, then may not be the
137
critical factor in releasing women from depression, as
some sociologists or feminists would have it. The research
on depression needs to be more focused on the social sup
port system, or a woman's "immediate social context, on
individuals and their households, and on how they get
caught up in a crisis or difficulty, try to cope with it
and the resources they have for this" (Brown & Harris,
1978, p. 293). It seems to be the conversation, or the
having or allowing others into our world, to define and to
find us, that frees one from depression.
It is this connection to the others, or allowing the
connection, that is essential. Those who suffer trauma,
greater life strains, and chronic hassles are more likely
to display greater levels of depressive symptomatology
Brown & Harris, 1978; Pearlin & Schooler, 1978). Recently,
however, greater attention is being paid to the "conversa
tion." The trauma of loss— loss of a child or spouse, a
divorce or changing jobs— has traditionally been looked at
as the source of depression. If however, there was not a
total encapsulation within that Other who was lost, and
there are additional Others, or there are allowed to be
Others in one's social network, then the vulnerability to
physical and mental illness is reduced (Caplan, 1981).
Survivors of any disaster, where one can lose one's family,
one's belonging and/or one's home, are subject to
138
depression. However, those with a social support system of
family or friends seem to fare better. "Support systems
are absolutely critical. People who are isolated will have
the most difficult time adjusting," wrote Frederick Ahearn,
co-author of "Handbook for Mental Health Care of Disaster
Victims" (Sweeney, 1983). Those with a social support
system are less likely to display depressive symptomatol
ogy, and the support is a buffer against the painful whims
of existence (Brown & Harris, 1978; Billings & Moos, 1981,
1982), — and existence, according to HE, is absurd and
tragic anyway.
Just as the body illuminates the shadows cast over
the world with the loss of the Other's being (see above),
so the body can reflect the choice not to communicate with
another. Regardless of age, relatively isolated people—
defined as those without some combination of marriage,
friends, church or informal club affiliation— had a mor
tality rate 25 times higher than those with such strong
social bonds (Forman, 1982). Even men in their fifties
who would have been considered high risk to mortality
because of a very low socioeconomic status, but who scored
high on an index of social-networks, outlived those men
who had a higher status, but who scored low on social-
network scores. A commitment to a stable and continuing
social-network, seems to reduce the emotional effects of
139
stress (Pines, 1980) . HE would add that having a social-
network could be a choice; one chooses, or refuses, to
have the conversation, or the relationship with the Other.
A friendly conversation, however, is not the same as
a confiding one, at least not for depression. In a com
parison study between hospitalized depressed and non
depressed women, Winfield (1979) found no differences in
the number of people with whom the women lived, nor in the
estimates of friends or acquaintances in each group. The
deficiency for the depressed women lay in the silence of *
their conversation? that is, they perceived fewer close
social connections. Importantly, for this dissertation,
it was not the lack of available connections, but the
ability, or the choice, to open their innermost lives,
that was crucial. Chatting is not what Barrett (1978)
meant by a conversation. The encounter needs to be en
gaged to the core of existence. Winfield suggested that
women would benefit from "particular training in social
skills which would foster intimacy" (p. 338). The exis
tentialist therapist, however, would view any such
"training" in intimacy skills as violating; "...any
manipulation of another's behavior violates him (or her).
It matters not at all whether such manipulation is re
quested by the patient [nor] whether it is for his (or
her) own good...any effort at change or interchange, no
140
matter how minimal, seeks to include some degree of influ^
ence, control or manipulation" (Ofman, 1976, p. 98). In
HE, however, the search is always for the good reasons for
one's project, and the HE therapist would struggle with
the woman to look at her good reasons for not choosing to
confide, and also at the negative consequences of such
encapsulation.
Much published psychologist, Dr. George Bach suggests
that, programs in schools, churches, community organiza
tions and elsewhere develop a "caring network, an inter
connected system of family, friends, intimates and commun
ity that is needed to restore those now absent feelings of
belonging" (Gosting, 1982, p. 147). It seems, however,
that the availability of such a "caring network" is only
part of the difficulty in establishing a relationship.
As Winfield's (1979) research indicates, having a network
does not mean that one will choose to disclose oneself to
that network. Rather than just advocating the establish
ment of a social network, what is important for the HE
therapist is to examine the choices in not availing
oneself and disclosing oneself to one's network.
Even as the HE therapist would not "train" a woman
in "intimacy skills" it is critical that the therapist be
aware of the negative consequences of insulation and en
capsulation within the self. Research does indicate that
141
a non-confiding relationship, lack of social bonds, and
perceiving that the Other will not be interested in one's
own intimate and personal concerns, does contribute to
depression. There is not always the loss of the Other
that leads to depression, but one may either choose to
stay within a non-confiding relationship, or choose not to
confide with those within one's social-network. Social and
emotional isolation seems to cause depression, rather than 1
just be a symptom of depression. The HE therapist, like ,
r
HE in general, does not seek .change, but explores with the I
woman her valid reasons for not sharing the conversation. J
In the end of The Mandarins, Anne, while contemplat
ing suicide, heard the others looking for her. She was
snapped into the world of Others by seeing that her sui
cide would not have been an escape, because her death
would not belong to her alone. Others would define and
live out her death. They would experience it, and not
she. Anne reflected back upon the existential imperative
that we are defined in life with Others, when Anne saw
that her death would be defined by them. She chose to
live with Others and recognized the dialectic of choosing
for oneself, but seeing that the self is defined by
others. Anne returned to the "struggle" where we define
our being, but find that being with another.
We exist with another. No matter how much we would
142
like to be in charge of our subjectivity, we are still de
fined with another. On the other side of the dilemma, no
matter how much we would like to give up the need to de
fine our existence, and live as the object of the Other, we
do create ourselves by our choices. Our essence, for HE,
revolves in the dance of the dialectic conversation. The
choice to be an object and fuse with the Other appears to
save one from the anguish of defining oneself, but the
loss of the Other results in the loss of self. The other
choice, to keep one *s experience inside oneself, appears
to avoid the risk of being defined with Others, but it is
isolating, and when the pain of existence presses in,
there is no Other to reduce the pressure, and the isola
tion caves in on the person. Either position— encapsula
tion within the Other, or encapsulation within the self—
could result in the lack of the conversation and loneli
ness, the "central core of illness."
143
CHAPTER IX
SUMMARY, CAVEATS, PREVENTIONS, PREDICTIONS
AND RECOMMENDATIONS
Summary
At this point, a review of the chapters might be
helpful. Chapters 2 through 8 were used not only to high
light other theoretical perspectives on depression, but
also to pinpoint certain existential specifics.
The psychoanalytic theory (Chapter 2) was used to
describe HE's position that depression relates not to
intra-psychic mechanisms, but to our projects and the
failed denouement of the choices made by us with our world
outside. Depression, for HE, is the result of the "frus
tration in our projects" (Ofman, 1976, p. 83), and these
projects relate to our interpersonal world and not to
intra-psychic spheres.
The behavioral theories— lack of positive rewards,
learned helplessness, and illogical cognitions (Chapter
3)— were used to emphasize that although we are conditioned,
we cannot use these same principles to deny freedom: "We
must affirm freedom and responsibility without denying
that we are the product of circumstance, and we must af
firm that we are the product of circumstance without
144
denying that we have the freedom to transcend that causal
ity to become something which could not even have been
previsioned from the circumstance which shaped us"
(Wheelis, 1973, p. 88). According to HE, we choose our
way of being, and are not just conditioned beings. Our
projects have negative consequences (negative rewards, if
you will), and yet we persist in those projects, and we
deny the negative consequences of our projects. We are
able to change those projects, however, if we choose to do
so. For HE, "human dignity requires the recognition that
a symptom expresses the way a person chooses life" (Ofman,
1976, p. 92). For HE, we are not depressed because we
have inadequate rewards or negative reinforcement from the
environment, as Lazarus (1968) would See depression, but
because of the choices we freely make. Although the theory
of learned helplessness (Seligman, 1972'; 1974) may provide
a model for depression in animals, HE would contend that
humankind is not just an animal of a different degree, but
we are beings of a different kind (Ofman, 1981). For
women, helplessness may mean something to the person; it is
a means of communication. For HE, all behavior is symbolic
and communicates a message about the person, and to another
person. Helplessness means something to the person, and
it is a means of communicating to the other person.
"Emotionality illuminates that person's engagements, and
O
145
commitments" (Ofman, 1976, p. 77). Helplessness illumi
nates the person*s commitment. HE would not imply that a
person*s behavior should change, but merely that a person
needs to examine one's own commitments and choices. "The
person must see that the symptom is his (or her) unique
way of expressing the truth of him (or her) for him (or
her)...HE is less interested in the solutions to specific
problems than in the assumption of total humaness" (Ofman,
1976, p. 94). HE follows Nietzche's dictum that a person
always "acts rightly," and would also add that a person
sees rightly, and thinks rightly. For HE, there can be no
erroneous or illogical cognitions as Beck (1967; 1974;
1976) assumes, and a woman would always see, act and think
correctly according to her own perspective. In contrast
to behavioral views, HE sees that a person chooses a way
of being that has negative consequences, but which makes
perfect sense according to her own world view.
The sociological view (Chapter 4) was examined in a simi
lar way as was the behavioral paradigm. Instead of looking
at idiosyncratic conditionings, however, sociologists
examine social imperatives. Society may be conditioning
women into certain roles, and the loss of those roles— as
when children leave (Bart, 1971)— or an inadequate female
(housewife) role result in depression (Friedan, 1974; Gove,
1972; Gove & Tudor, 1973). Existentialists would add,
146
however, that a woman chooses roles for her own good
reasons. A woman may be pressured by society to fuse her
identity, and her self, with her children, and find mean
ing with her children. The loss of her children, and her
role, may therefore result in the loss, not only of her
role, but also the loss of her identity and of her self.
A changing society also, for sociologists, has resulted
in a less meaningful role of the housewife (Friedan, 1974;
Gove, 1972), and the meaningless role may cause depression.
In examining the housewife blues, various factors have
been analyzed as resulting in depression for women. The
lack of daily adult interaction (Ferree, 1976; Guttentag,
1975), *a non-confiding relationship (Brown, Bhrolchain,
& Harris, 1975; Brown, Harris, & Copeland, 1977; Roy,
1977), and the lack of structure and status (Gove & Tudor,
1973), are some of the components that are attributed to
depression. When a woman, however, is engaged with her
spouse, and has the support of a social network, depres
sion seems to be alleviated (Ferree, 1976). Existential
ists would suggest, and argue with sociologists, that not
only does a woman have the option to choose to be a house
wife, but that she also chooses to adhere to other role
prescriptions— she chooses to stay in a non-confiding rela
tionship, chooses to see confiding as "complaining" (Howe,
1977), and chooses not to confide in her social network
147
(Winfield, 1979). Existentialism would see that a woman
is making choices to either encapsulate within her child
ren, or to withhold within herself, rather than seeing as
a sociologist that either position as the one-way dictates
of society.
The feminist perspective (Chapter 5), like the socio
logical view, also sees depression as the result of social
conditions. Feminists trace depression back to a woman's
subordinate and dependent position upon a man (Arieti,
1979; Chesler, 1971, 1972; Miller, 1976; Scarf, 1979).
Like the mother in the sociological perspective who fused
within her children, the feminists see a woman as fused in
a dependent love bond. The breaking of the love bond is
the breaking of the self. The position taken in this dis
sertation would agree that if a woman encapsulates within
another, she risks losing her self, if the Other should
leave her. HE would add that not only does society con
dition women into becoming dependent, but women also
choose to accept that conditioning, and choose to fuse
with the Other. HE would also disagree with the solution
that feminists prescribe. A cultural revolution is urged
by feminists for women to obtain "worldly power" and thus
no longer need to be dependent, and for women to be
"moored upon" themselves (Chesler, 1972). For existen
tialists, it is not a cultural revolution that is needed,
148
but a psychological one. For HE, women need to become
aware that they have the freedom to choose, and because of
the freedom of consciousness, they have the freedom to
look at their situation and see it as they choose to view
it. "Dasein is at once the meaning giver and the known...
the person constitutes the world" (Yalom, 1980, p. 23). A
housewife can see herself as united in marriage, or tied
down to a man. More importantly for this dissertation,
the position of being moored upon oneself, as is suggested
by feminists, could also result in depression. We need
the connection to the Other, and the feminist call to be
independent, may also result in depression if the woman
shuts out the Other. In the cry to independence, femi-
ists need to be careful not to abandon women's historical
connection to community or to the newer concept of "sister
hood, " which have offered women a protection against iso
lation and insulation within the self.
The system's view (Chapter 6) was used to collaborate
with the existential idea that depression needs to be
examined within the social context. Unlike the systems
theory, which is behavioral in nature, and sees maladap
tive behavior as actually adaptive to the system in which
it exists and which it maintains, existentialists look at
choices and see a person chooses to be a particular way
within an interpersonal context. For HE, the pattern of
149
behavior stems from one's choices and is not system speci
fic. The personal project is carried into any relation
ship and the basic choices may be independent of any
specific homeostatic system. The systems therapist would
examine the system in action and the therapist's inter
ventions would be designed to disrupt or to jam the char
acteristic patterns of the system's members. Existential
therapists would justify individual therapy, on the other
hand, because, for HE, a person's project is carried with
that person into any encounter and is, therefore, dis
played in the room with the therapist. Existential thera
pists, however, might benefit from the use of a group
setting to see more clearly the projects--to fuse with
another, or to encapsulate within the self— and to iden
tify with the person the choices that may contribute to
depression.
Thus far the existential paradigm (Chapter 7) has
said only that "meaning" saves one from depression. Mean
ing, however, has not been adequately defined. Perhaps
existentialists have felt that any definition of meaning
would limit the freedom of each being to define meaning,
and existence for oneself. Existential writers have
pointed to engagement as giving meaning. Again, however,
engagement is not defined, and it almost seems as if just
action could save one from depression; women are
150
depressed, suggested Becker, because "they do not have
enough reasons for satisfying action" (1963, p. 358).
Perhaps in the United States, which stresses individualism
and personal achievement, action by itself would seen suf
ficient to provide meaning, but in Europe, the home of
existentialism, it appears, at least in plays and novels,
that meaning is provided by engagement with the Other.
It is this back and forth, the "conversation" (Barrett,
1978) with the Other that appears to save one from depres
sion .
In Chapter 8, the two positions were defined and the
novel, The Mandarins by Simone de Beauvoir, an existential
female author, and empirical data were used to explain and
verify the positions. If one encapsulates within the
Other, and then loses the Other, the result could be the
loss of self, and depression. On the other hand, encap
sulation within the self, is a separation from the Other,
and when the person suffers existential pain', and is
unable to reach out to another, the result could also be
depression.
For HE, then, depression is an interpersonal (rather
than an intra-psychic) event, and results from one's
personal choices (rather than ideosyncratic, social or
system conditionings), and the choices refer to the en
gaged meaning in relationship to the Other.
151
Loss has been the benchmark of theories of depression.
Existentialists would add certain elements of choice that
relate to loss--the choice to fuse with the Other may re
sult in the loss not only of the Other, but also of the
self; or, the choice to shut off from the Other is initi
ating the loss from Others. For HE there needs to be the
delicate balance, the conversation, the flow between de
fining ourselves alone and finding ourselves with the
Other. To encapsulate within the Other or to encapsulate
within the self is to risk depression.
Caveats
The purpose of this dissertation is to provide an
existential model of depression. Although depression may
be a tangled mass of many causes (Miller, 1982), and a
variety of inherited, nutritional, chemical, metabolic,
environmental and personality factors may be the contribu
tory or sole causes of depression, as yet, no existential
framework has been developed as a theoretical structure
for understanding depression in women. Yalom (198 0) has
noted that a therapist needs a theoretical orientation, a
"belief system":
First, a belief system provides
therapists with a sense of
security for the same reasons
that explanation is useful to
patients. By allowing the
152
therapist to control, and
not be overwhelmed by a
patient*s clinical material,
a belief system enhances a
therapist's self-confidence
and sense of mastery and
results in the patient's
developing trust and con
fidence in the therapist—
an essential condition of
treatment. Furthermore, a
therapist’s belief system
often serves to augment his
or her interest in a patient...
it provides therapist and
patient with a joint, pur
poseful project...which brings
them together and keeps them
cemented to one another while
the real agent of change, the
therapeutic relationship,
■germinates and matures.
(Yalom, 1980, p. 190)
The attempt in this dissertation was to provide such
a "belief system," by using existential concepts in formu
lating a perspective on depression in woman.
Whatever the theoretical orientation, however, a
therapist needs to be watchful of other causes, and not
follow any dogmatic maneuver in a narrow tunnel-vision.
With an eye towards the existential perspective developed
here, the HE therapist also needs to allow one's peripheral
vision to be open to other causes of depression.
One warning, therefore, appended to the existential
paradigm is the precaution not to overlook other causes,
and simply to diagnose depression as the result of encap
sulation within the self or within the Other.
153
Another prescription is administered not only to the
therapist but to social policy makers as well.
The delicate balance and the relation to the Other is
the fulcrum of this dissertation. A teetering to either
side— too much of an encapsulation within the Other, or
too much of an encapsulation within the self--throws off
the scale and destroys the balance. Most theoretical per
spectives see loss as the cause of depression. For
Freudians it is the loss of ego; for behaviorists, it is
the loss of rewards, the loss from the "personal domain,"
or the loss of personal power; for the sociologist it -is
the loss of a role; for feminists it is the loss of
worldly power; for system theorists it is the loss of pos
itive communication within the system; and, for existen
tialists it is the loss of meaning. For this disserta
tion, loss is also significant. If one fuses with the
Other, then loss of the Other can also be the loss of self.
On the other side, if one encapsulates within one's own
self, then the person initiates the loss from the Other.
The existential therapist stresses choice and res
ponsibility, but just as there is the prescription to
examine other causes of depression, so must there be a
prescription against attributing depression solely to
choice. Depression is the negative consequence of one's
chosen project, which is not to say that a person
154
willingly chooses to be depressed, and it would be callous
of the HE therapist to point an accusing finger at the
woman dictating that she has chosen to be in such a pain
ful position. Instead there must be a mutual search, and
the HE therapist with the woman, must look together for
the choices that result in the negative aspect of depres
sion, but the search must not overlook what positive con
sequences she gains from these choices. The therapist is
thus warned not to insinuate that a woman chooses to be
depressed.
Another warning rises from the position of choice.
The theoretical orientation developed here stresses the
need to allow the Other into our existence, without fusing
with that Other. Research does lock arms with the concept
that we need the Other. The National Mental Health Associ
ation (Fischer, 1983) has hopped on the band wagon as well
and has initiated a national campaign with the platform
that stresses that we would be physically and psychologi
cally healthier and live longer, if we developed social
relationsships. Likewise, the California Department of
Mental Health is advocating a "friendship can be good med
icine" public education campaign with the hope that the
development of a social support caring network could re
duce the state health care costs, particularly the $569
million in annual state mental health care (Gosting, 1982).
155
But even as the HE therapist sees the negative con
sequences of the choice to isolate, it is important for
the therapist and policy makers not to be blind to other
realities. One warning is issued by Dr. Irwin Ruben,
co-chairman of the Public Information Committee of the
Southern California Psychiatric Association who argues
that "caring is not a replacement for professional psychi
atric help" (Gosting, 1982). In addition, there are
warnings to be made. The choice to be alone with young
children may result in depression because there is no
existential communication with other adults (Guttentag,
1975), however, a woman may not see how she is able finan
cially to leave her children for a day and seek a confid
ing relationship— and such a relationship may take more
bonding time than just an afternoon off, one day a week.
Even if the choice to stay within a non-confiding rela
tionship is correlated with depression (Brown, Bhrolchain,
& Harris, 1975; Brown, Harris, & Copeland, 1977; Roy,
1977), a woman may not see how she could support herself
and her children outside of the marriage. The choice to
open herself up in the relationship and "complain" or
reveal her feelings, as the woman in Howe's study (1977)
would not do, may be therapeutic, but it may risk the
balance of the marriage and to tip the relationship into
the side of divorce. The freedom to seek others and
156
reveal oneself to them, may save one from depression
(Winfield, 1979), but such intimacy with the Other, may
seem, not just emotionally, but economically difficult
for some women. Opening oneself up for a social relation
ship, may appear to be a financial burden to many women.
"Money makes it possible to entertain, to travel, to
telephone, to exchange gifts, and to provide others with
aid," and warns Carole Fischer, a sociologist at U.C.
Berkeley, "personal ties" may be a way to "cut costs and
stay well," but, "for some economic minded politicians,
private social support is a tempting substitute for public
action" (Fischer, 1983, p. 78)'.
This dissertation is not meant to replace a social
policy of essential economic realities with the hot tub
psychology of the remedy of the hug. Community reorgani
zation may be needed. Bach (1982) has suggested that
schools, churches and community organizations develop
"caring networks" to restore lost feelings of belonging.
Likewise, Weissman (1974), in discussing the depression
and suicide problem of the young, has suggested that "pri
mary prevention should be viewed in a social-historical
perspective... The strengthening of family and community
supports, the developing of meaningful work, a continuity
of relationships, and a new look at institutions... are
recommendations that are not easy" (1974, p. 745). The HE
157
therapist, as well as politicians, must be mindful of
economic realities, and not simply diagnose depression as
the result of the choice not to seek out others, not to
disclose oneself to one's mate, or not to get out of a.
non-confiding relationship, and then dictate that a woman
either find someone else to communicate with, or begin to
divulge her feelings to her unreceptive mate, without con
sidering the woman's consequences for such choices. When
such caring networks are available, however, some women
will choose not to disclose themselves to the Other
(Winfield, 1979), and the HE therapist would need to in
vestigate that choice.
Not only must biochemical and psychological factors
be examined, but social and economic ills need to be
looked at as well. What is intended here is for the
therapist to be aware of the project to fuse with another,
or to close within oneself, and to also look at social and
economic realities of the woman's world. The therapist
would point out the projects, but the therapist also needs
to look at the good and valid reasons for a woman's fusing
or withholding from others. The existential therapist
searches with the woman to look at the reasons she would
choose to stay in a non-confiding relationship, choose to
stay at home "with no one but the four walls all day," and
choose not to confide her feelings with the Other. Not
158
only would the HE therapist look at the negative conse
quences of those choices, but also validate with the woman
that she does not need to rechoose, but that all her
choices do make sense for how she views her world, and any
different choice would have attending negative consequences
as well. What is essential is to validate her choices
rather than to dictate that new ones need to be made.
Validation does not lead to change, but change is not the
goal of the HE therapist. Validation would allow the
woman to feel that her choices do make sense for her, and
that she is free to make other choices, with other con
sequences, if she wants to rechoose.
The warnings issued, therefore, include the need for
the therapist to consider.various components that may con
tribute to depression, the prescription against dictating
that a woman chooses to be depressed (and that she could
simply choose to not be) and the warning against the HE
therapist prescribing that a woman either seek confiding
relationships outside her marriage, or that she begin to
confide with her non-confiding spouse, or that she leave
her children during the day, without considering the eco
nomic and social realities or interpersonal consequences
of such decisions for many women. The HE therapist is
warned, finally, not to dictate change for the woman, but
to affirm her choices, and the only "stake" the HE
159
therapist needs to have, as Ofman writes, is "the client's
assumption of responsibility for [her] engagement in the
world...and the explicit awareness of the person's basic
way of being-in-the-wprld" (Ofman, 1976, p. 25).
Predictions and Preventions
Traditionally, women have found meaning through the
"feminine" role (Chesler, 1972). Unlike men whose suicide
rates climb after retirement, the white female rates
have risen at the time her children leave home. "The
identity of the white woman is built on the wife-mother
role," notes Powell (1970), in his study of suicide, and
when her children grow up and leave home, her structure
collapses and "she is rendered obsolete, with a resulting
rise in both suicide and mental disorder rates" (p. 4 5).
Powell's findings are catalogued and referenced by Bart
(1971) and others (Belknap and Friedham, 1949).
Another dimension of woman's fusion within the Other
is in the passive dependent attachment to men. "She is
defined and differentiated with reference to man and not
he with reference to her; she is incidental, the inessen-
ial as opposed to the essential. He is subject; he is
absolute— she is Other," is how Simone de Beauvoir (1952,
p. xix) outlined and enclosed the woman's relationship
within men. "Women are really more depressed than men,
160
and the reason is we still live in a patriarchal society
in which women are raised to be dependent on another per
son," so Arieti explained the etiology of dependency and
depression (1979, p. 92). Such a dependent and fused
position is linked to depression when the link snaps and
the woman is dropped out of the relationship. "To fail
in this relationship is then equated with failure in
everything," wrote Maggie Scarf (197 9, p. 52) of the near
soap operatic view of women.
A final fusion in the trilogy of the female role is
the grafting of her identity onto a cultural youthful
image. A loss of youth brings with it the wrinkles of
depression. Because "they do not have enough reasons for
satisfying action...when they lose their one apparent
reason upon which they predicate their lives— their femi
ninity— [women's] whole action world caves in," noted the
existential writer Ernest Becker (1963, p. 358).
For women, depression has been traced through the
etiologic imbroglio of loss of her fused identity— fusion
into her children, within a love relationship, and with a
youthful image. In existential terms, the woman defined
her existence and her essence within her children, her
lover, and being young, and the choice to encapsulate
brought with it negative consequences of depression if
children or lovers should shut the door, or when youth
161
dries up. The positive aspect is that a woman could escape
the anguish of defining herself as she slipped into the
Serious World— the world of shoulds— where behavior was
decided and dictated for her. Hazel Barnes describes the
ease with which one is tempted to turn around the axis of
the Serious World.
[Beings] cannot bear the realization
that all values [one] lives by,
[one's] purposes, one's projects are
sustained by [one's] own free choice;
[one] finds it too great a strain to
accept sole responsibility for [one's]
life. Therefore [one] takes refuge
in the belief that somehow the exter
nal world is so structured that it
guarantees the worth of objects, it
provides specific tasks which have to
be done, it demands of each person a
definite way of living that is the
right one. Whether God, Nature, or a
transcendent society is responsible,
the order of things is absolute. It
is the serious world.
(Barnes, 1959, p. 48)
Traditions, however, are changing. Economic factors
have made it necessary for women to work; technological
advances have made the housewife nearly a bored anachronism
in a microwaved and permanent pressed home, while these
advances allowed her the time to work outside the home, and
social liberation has followed both economics and technol-
ogy to provide an ethic to allow women the credos to leave
the home and to begin working in paid employment.
By working, women may have become less subject to the
162
depression resulting from fusion. A woman's life may be
less enwombed within her children, entwined with a love
bond, or glued into being youthful. She may develop other
reasons for "satisfying action." Chesler's (1972) call
for women's "worldly power" may build up women's defenses
against fusion. By making her own living, a woman may
find identity outside of her children, and not need the
dependent or alluring relationship to promise her economic
security.
Having "worldly power," however, is not a force
against all depression. The feminine force of liberation
has been a pressure against fusion. In the effort to have
women be swayed away from being dependent, however, the
pendulum may swing too far and plummet women into the op
posite side. Instead of the centripetal force that caused’
women to be fused with another, the centrifugal force may
slam women into isolation. Chesler may be right in saying
that "Women must convert their 'love' for and reliance on
strength and skill in others to a love in all manner of
strength and skill in themselves" (1972, p. 298). The
problem, however, is that women may hear this message as
reading that women need to depend totally upon "strength"
within themselves, to the exclusion of the Other. The
code to be strong has been given to men, and has been
translated into being isolated, in the existential sense
163
of withholding, from others. Ironically, at a time in soc
iety when men appear to be breaking down emotional barriers
and letting others into their existence, women may start to
construct walls. It is predicted that depression rates of
women may drop off from where they have been highest; that
is, during menopause, an event that marked the decline of
youth, an experience that was perhaps linked to the proba
bility of not finding the hoped for love bond, and a time
when women began to lose their children. Economic security
may provide women with an identity and sense of self away
from children, her lover or her youth. As a women becomes
economically secure, however, the threat of the whims of
existence may impinge on her from another side. The threat
of failure of her new career, the excommunication of re
tirement, or national economic insecurities, may surface
at the time that the threat of her failed feminine role
subsides. If the woman carries with her the accoutrements
of being strong, as meaning holding feelings in, and a
separation from the Other, then the threat of depression
may result from encapsulation with the self.
What is needed is for the pendulum to maintain its
balance within a narrow range. Even as there is a filling
with anguish to define"" ourselves, for existentialists,
there remains this need. To some extent we need to be
"moored" upon ourselves, and find "all manner of strength
164
and skill1 1 .there, but, on the other hand, we also need the
Other to read back to us our definition, to look with us
at our choices that cause us pain, and to listen to us as
we experience the onslaughts of existence.
In his study of minorities, immigrants and the poor,
Arron Antonovsky, looked at the balance that allowed
people to avoid the fall into physical or mental illness.
The "generalized resistance resources" were characteris
tics of the person, or the environment, that allowed ef
fective management of the facticity of one's existence.
Knowledge and intelligence were resources that allowed
people to see different ways of dealing with problems, and
the ability to choose the most effective means. A strong
ego was also a vital resource. Finally a commitment to a
stable and continuing social network was essential (Pines,
1980). Although under a different name, Antonovsky's
"resistance resources" are the same factors, that are
suggested here as preventions against depression. A strong
ego could be translated into the ability to define one's
essence, without fusion into another. The commitment to a
social network is the ability to allow Others to struggle
with us, and to let them see us, where each can be "two
gods together, neither one losing, neither one winning,
each nourishing the other" (Ofman, 1976, p. 123). This is
the need to define oneself without encapsulation within the
. 165
self, but with a relationship with the Other. Although
existentialists would not support a therapist showing the
alternatives— "such pointing out would imply that the per
son does not know the circumstances in his (or her) own
life, that the therapist knows the patient's circumstances
and opinions better" (Ofman, 1976, p. 159)--the therapist
could act as a companion, similar to the resource of intel
ligence or knowledge, that would search with the person to
look at one's project, and "help the client see the mean
ing and integrity of his (or her) life, that he (or she)
is doing what he-(or she) wants, but chooses to ignore the
negative consequences of these wants," (Ofman, 1976,
p. 159), and also point out that a person is free to re
choose. Like the person's resource of intelligence or
knowledge, the therapist helps the person to "consider the
available options" while keeping in mind that "it is the
patient--not the therapist— who must generate and choose
among these options" (Yalom, 1980, p. 331)
For the existential paradigm described here, the
woman who is able to define herself alone without fusion
within another being or within the serious world, but
allows the look of another (including allowing a therapist)
to look with her at herself and at her choices, and allows
the Other to look at and share her existential pain, this
woman would be the best able to survive depression.
166
Recommendations to the HE Therapist
The foundation of HE therapy rests upon affirmation.
The person is affirmed for the "validity of his (or her)
position" (Ofman, 1976, p. 161), without the underlying
pressure to change. The only change is in the awareness of
the choices we make, and for the person "to attend to the
situation of his (or her) life as he (or she) structures
and construes it...and to help the client see the meaning...
of his (or her) life, that he (or she) is doing as he (or
she) wants, but chooses to ignore the negative consequences
of these wants" (Ofman, 1976, p. 159).
For depression, the perspective taken here, is that
the woman could choose for her own reasons, to fuse or to
isolate from another. The choice to fuse is made when the
woman resists defining her own essence, and finds it easier
to fuse within the existence of another. The choice to
isolate is made when the woman resists having another see
herself and finds it easier to feel omnipotent and encap
sulated 'within the self. The negative consequences result
when the fused person's self is wrenched away when the
Other separates; or, on the other side, if existence be
comes painful, and the isolated person needs the Other,
but has become unable to reach out, or has shut the Other
out, and then suffers alone. We need to define ourselves
alone, and, yet, we need the Other with us.
167
The HE therapist needs not only to validate the
reasons why a woman would choose to fuse or to isolate, but
also to look with her at the consequences of these choices.
An HE view of the nature of humankind, would contend
that the person's project is a commitment*which "each per
son has invented and built" and "the basic way of organiz
ing his {or her) priorities in his (or her) world..."
(Ofman, 1976, p. 24). The project would, therefore, be
played out in any context. The systems theorist (see
Chapter 6), on the other hand, sees the system as causing
and maintaining the behavior of the individual and the
system itself. The entire system is diagnosed as the
patient and needs to be treated. For HE, however, the
person's project is a freely chosen (system free) choice,
and can be seen in any context, and is not system depen
dent. HE therapy can, therefore, justify individual
therapy.
Any project, however, "may be either explicitly
known...or not" (Ofman, 1976, p. 24). Not only could the
woman be blind to her project, but the therapist as well
may be far sighted to one's self, and be unable to re
flect back on one's project in a clear perspective. If the
HE therapist's project is in a symbiotic relationship to
the client's, then both might be blind to either one's
personal myth. This may be a particularly dangerous
168
possibility if the woman's project is to fuse, and the
therapist's project is the need for adulation. The woman's
need to fuse would be trapped within the therapist's need
for idealization, and both would be imprisoned within each
other's symbiotic projects (Temerlin & Temerlin, 1982).
Although it is critical and incumbent upon the therapist
to be able to see one's own project, so that it does not
interfere with seeing the client clearly, one possible
means of getting a clearer view of one's self and of the
client would be in a group setting.
While group therapy has not been recommended for the
depressed person (Bartlett, 1982), and Yalom (1975) notes
that "undesirable candidates include ...depressives,"
(p. 220), perhaps the project to fuse or to isolate might
be more visible in the group setting.
In the treatment .of the depressed in the group ther-
aPYf psychologist Robert Neimeyer, of the University of
Rochester, described the "typical client" as a "50-year-
old woman with a wide range of interpersonal problems,
problems in communicating with her husband [and] a woman
who has lost significant people in her life..." (Bartlett,
1982, p. 3). In the existential terms defined here,
Neimeyer's "typical client" could fall into the positions
of encapsulated within the Other or within the self. In
discussing the problems in "interpersonal therapy," it
169
seems that Neimeyer is coming close to the two positions.
The interpersonal therapy deals with
four problem areas and makes this the
focus of treatment. The areas are...
(1) conflict or disputes (the constant
arguments)...[which] typically involves
a spouse. The second (2) is far broader
and includes people with poor social
skills, people who have difficulty
making friends and then keeping them,
people who cannot seem to open up in
relationships. The third (3), grieving,
can be actual or symbolic. It may
center on the death of loved one, but
it can involve loss of a valued work
setting. The fourth (4), role transition,
is most typically the empty nest syndrome,
when a woman's efforts at being a mother
are no longer needed..."
(Bartlett, 1982, p. 3)
The HE therapist would not attempt cognitive therapy
as Neimeyer suggests, because an HE therapist believes that
a person does not distort the world, but sees it clearly
(see Chapter 3); nor, would the HE therapist attempt to
teach "intimacy skills" as Winfield (1979) suggested (see
Chapter 8), but would have the woman look at the choices to
fuse with the Other or to defuse within the self, and per
haps, the therapist and the woman together would get a
better view of these choices within the group setting.
Conclusions
The model developed here was not an attempt to answer
all questions regarding the etiology of depression in
women. Rather the paradigm of seeing depression as the
result of fusion with the Other, or within the self, was
170
suggested as a framework for the existential "belief
system" that could assist the HE therapist (Yalom, 1980).
No change in the project is suggested by the HE therapist,
but the woman and the therapist would search together for
the valid reasons to choose to fuse within the Other, or
to escape within the self, and also look at the negative
consequences of such choices. Nothing else is needed.
171
REFERENCES
Abraham, K. .Notes on the psychoanalytic investigation
and treatment of manic-depressive insanity and allied
conditions, 1911. ; In Selected papers on psycho
analysis . London: Hogarth Press, 1949.
Allman, L., & Jaffe, D. Abnormal psychology in the life
cycle. New York: Harper and Row, 1978.
The American Psychological Association. Diagnostic and
statistical manual of mental disorders (3rd ed.).
Washington, D.C.: Author, 1980.
Arieti, S. Root of depression: The power of the dominant
other (Interview). Psychology Today, April 1979,
pp. 54; 57-58; 92-93.
Ascher, E. A criticism of the concept of neurotic de
pression. American Journal of Psychiatry, 1952, 108,
Barnes, H. . Humanistic existentialism. Lincoln:
University of Nebraska Press, 1959.
Barrett, W. The illusion of technigue. Garden City, New
York: Anchor Books, 19 78.
Bart, P. Depression in middle aged women. In V. Gormick
&B. K. Moran (Eds.), Women in sexist society. New
York: Basic Books, 1971.
Bartlett, K. Psychologist using group therapy in treat
ment of depression. Los Angeles Times, December 5,
1982, Part 1-B, p. 3.
Beck, A. Depression, clinical, experimental and theoreti
cal aspects. New York: Harper and Row, 1967.
Beck, A., & Greenberg, R. Cognitive therapy with depressed
women. In V. Franks & V. Burtle (Eds.), Women in
therapy: New psycho-psychotherapies for a changing
society^ New York: Brunner/Maze 1', 1974 .
172
Beck, A. Cognitive therapy and emotional disorders. New
York: International University Press, 1976.
Becker, E. Social science and psychiatry: The coming
challenge. The Antiock Review, 1963, 2_3, 353-365.
Belknap, I., & Friedham, H. Age and sex categories as
sociological variables in the mental disorders of later
maturity. American Sociological Review, 1949, 14,
367-378.
Bernard, J. The paradox of the happy marriage. In V.
Gormick & B;. Moran (Eds. ) , Women in sexist society.
New York: Basic Books, 19 71.
Bernard, J. The future of marriage. New York: Bantam
Books, 1973.
Bibring, E. The mechanisms of depression. In P. Greenacre
(Ed.), Affective disorders. New York: International
University Press, 1953.
Billings, A.. G. , & Moos, R.. H. Psychosocial theory and
research on depression: An integrative framework and
review. Clinical Psychology Review, 1982, 2, 213-237.
Blaney, P. Contemporary theories of depression: Critique
and comparison. Journal of Abnormal Psychology, 19 77,
8J5 (3) , 203-223.
Bonime, W. The psychodynamics of neurotic depression.
American Archives of Psychoanalysis, 1975, 4^(3),
301-326.
Boss, M. Existential fundamentals of medicine and psychol
ogy . New York: Jason Aronson, 19 79.
Brown, G. W. , Bhrolchain, M. N., & Harris, T. Social class
and psychiatric disturbances among women in urban
population. Sociology, 1975, 9_, 225-254.
Brown, G., W. , & Harris, T. (Eds.). Social Origins of
depression: A study of psychiatric disorder in women.
New York: Free Press, 1976.
Brown, G. . W. , Harris, T. , & Copeland, R. Depression and
loss. British Journal Of Psychiatry, 1977, 130, 1-18.
173
Buber, M. I and thou. New York: Charles Scribner's
Sons, 1958.
Buber, M. The knowledge of man. New York: Harper
Torchbooks, 1965.
Bugental, J. The search for authenticity. New York:
Holt, Rinehart and Winston, 1965.
Bugental, J. (Ed.). Challenges of humanistic psychology.
New York: McGraw-Hill, 1967.
Burton, R. The anatomy of melancholy. East Lansing:
Michigan University Press, 1965.
Campbell, A. The American way of mating: Marriage si,
children maybe. Psychology Today, May 1975, pp. 37-4 0;
42-43.
Camus, A. a The myth of Sisyphus and other essays J.
O'Brien, Ed. and trans. New York: Knopf, 1955.
(Originally published, 1942.)
Caplan, G.M. Mastery of stress: Psychosocial aspects.
American Journal of Psychiatry, 1981, 138 (4) , 413-420.
Chesler, P. Patient and patriarch: Women in the psycho
therapeutic relationship. In V. Gormick & B. K. Moran
(Eds.), Women in sexist society. New York: Basic
Books, 1971.
Chesler, P. Woman and madness. New York: Avon Books,
1972.
Coates, D., & Wortman, C. B. Depression maintenance and
interpersonal control. In A. Baum & E. Singer (Eds.),
Advances in environmental psychology (Vol. 2).
Hillsdale N.J.: Lawrence Eribaum, T98 0.
Coyne, J. C. Toward an interactional description of
depression. Psychiatry, 1976, 39_, 28-40.
de Beauvoir, S. The second sex (H. M. Parchley, Ed.
and trans.). New York: Vintage Books, 1974.
(Originally published, 1949)
de Beauvoir, S. The mandarins (L. M. Friedman, trans.)
South Bend, Indiana: Regency/Gateway, Inc., 1979.
(Originally published, 1954)
174
Durkheim, E. Suicide: A study in sociology. Glencoe,
111.: The Free Press, 1899/1951.
Farberow, N., & Reynolds, D. Dyadic crisis suicides in
mental hospital patients. Journal of Abnormal
Psychology, 1971, 7_8, 77-85.
Ferree, M. The confused American housewife. Psychology
Today, September 1976, pp. 76-80.
Ferree, M. Working class jobs: Housework and paid work
as sources of satisfaction. Social Problems, 1976, 23,
431-441.
Fischer, C. The friendship cure all. Psychology Today,
January 1983, pp. 74; 78.
Foreman, J. Friendship bonds: Crucial for man's survival.
Los Angeles Times, March 25, 1982, Part V, p. 22.
Frankl, V. Logotherapy and existential analysis - a
review. American Journal of Psychotherapy, 1966a, 20,
252-260.
Frankl, V. What is meant by meaning. Journal of Existen
tialism, 1966b, 7_, 21-28.
Frazier, E. F. The Negro in the United States. New York:
Macmillian, 1957,
Friedan, B. The feminine mystique. New York: Dell,
1974.
Friedman, A. Hostility factors and clinical improvement
in depressed patients. Archives of General Psychiatry,
1970, 23_r 524-537.
Freud, S. ■Analysis terminable and interminable. In
J. Starchey (Ed. and trans.), Standard edition of
psychological works of Sigmund Freud (Vol 23). London:
Hogarth Press, 1964. (Originally published, 1937.)
Freud, S. Mourning and melancholia. In J. Richman
(Ed.), A general selection from the works of Sigmund
Freud. New York: Liverwight Publishing Corporation,
1957.
Goodwin, D. W., & Guze, S. B. Psychiatric Diagnosis (2nd
ed.). New York/Oxford: Oxford University Press, 197 9.
175
Gosting, K. Take two aspirin and call a friend in the
morning. Los Angeles Magazine, May 1982, pp. 139-140;
142; 147-148.
Gove, W. R. The relationship between sex roles, marital
status, and mental illness. Social Forces, 1972,
51 (1) , 34-44 .
Gove, W. R., & Tudor, J. F. Adult sex roles and mental
illness. American Journal of Sociology, 1973, 78,
812-835.
Guttentag, M. Women and mental health. In L. Cater, A.
Scott, & W. Martyna (Eds.), Women and men: Changing
roles. Palo Alto, Calif.: Aspen Institute for
Humanistic Studies, 1975.
Haigh, G. Learning theory and alienation. Psychotherapy:
Theory, Research and Practice, 1965, _3, 147-150.
Hetherington, E. M., Cox, M., & Cox, R. The effects of
divorce. Paper presented at APA meeting, Washington,
D.C., 1976.
Howe, L. K. Pink collar workers. New York: G. P. Putnam
& Sons, 1977.
Jacobson, E. Transference problems in the psychoanalytic
treatment of severely depressed patients. Journal of
the American Psychoanalytic Association, 1954, 2,
295-606.
Karasu, T. Psychotherapies: An overview. American
Journal of Psychiatry, 1977, 134 (8) , 851-868.
Kardener, A., & Oversy, L. The mark of oppression. New
York: W. W. Norton, 1951.
Keen, E. Three faces of being. New York: Appleton-
Century-Croft, 1970.
Kendell, R. E. The classification of depressive illness.
Maudsley Monographs, No. 18. London: Oxford
University Press, 1968.
Klein, M. A contribution to the psychogenesis of manic
depression. In Contributions to psychologies, 1921-
1945. London: Hogarth, 1948. (Originally published,
1935.)
176
Klerman, G.L. The age of melancholy? Psychology Today,
April1979, pp. 36-42;88.
Kovacs, M., & Beck, A. T. Maladaptive cognitive structures
and depression. American Journal Of Psychiatry, 1978,
135.(5) , 525-533.
Kuhn, R. The structure of the scientific revolution (2nd
ed.). Chicago: University of Chicago Press, 1962.
Laing, R.D. The politics of experience. New York:
Pantheon, 1967.
Lazarus, A. Learning therapy and the treatment of depres
sion Behavioral Research and Therapy, 1968 , 6_, 83-89.
Levenstein, A. Why people work. Changing incentives in a
troubled world. New York: Collier Books, 1964.
Lewinsohn, P., Mischel, W., Chaplin, & Barton, R. Social
competence and depression: The role of illusory self-
perceptions. Journal of Abnormal Psychology, 1980, 89,
203-212.
Lewis, A. Melancholia, a historical review. In The state
of psychiatry: Essays and addresses. New York:
Science House, 1967.
Liberman, R. P., & Raskin, D. E. Depression: A behavioral
formulation. Archives of General Psychiatry, 19 71, 24,
515-523.
Maddi, S. The existential neurosis. Journal of Abnormal
Psychology, 1967, 7_2, 311-325.
Maslow, A. Toward a psychology of being. New Jersey: Van
Nostrand, 1962. /
Miller, J. B. Toward a new psychology of women. Boston:
Beacon Press, 1976.
Miller, N. Depression takes root as a way of life. UCLA
Alumni News, 1982, pp. 3-4.
Nelson, R. E., & Craighead, W. E. Selective recall of .
positive and negative feedback, self-control behaviors
and depression: A controlled study. Archives of
General Psychiatry, 1969, '2_1, 753-757.
177
Ofman, W. Affirmation and reality. Western Psychological
Services, 1976.
Ofman, W. Seminar, University of Southern California,
Spring, 1981.
Palmer, D. M. Factors in suicide attempts, a review of
25 consecutive cases. Journal of Nervous and Mental
Diseases, 1941, 93^, 421-442.
Pearlin, L. J., & Johnson, J. S. Mental states, life
strains and depression. American Sociological Review,
1977, 42, 704-715.
Pearlin, L.J., & Schooler, C. The structure of coping.
Journal of Health and Social Behavior, 1978, 19_, 2-21.
Pines, M. Psychological hardiness: The role of challenge
in health. Psychology Today, December 1980, pp. 34;
36? 39-40; 43-44? 98.
Powell, E. The design of discord. New York: University
Press, 1970.
Rado, S. The problem of melancholia. International
Journal of Psychoanalysis, 1928, 9^, 420-438 .
Rohrbaugh, J. B. Women: Psychology's puzzle. New York:
Basic Books, Inc. 19 79.
Roth, P. Portnoy's complaint. New York: Random House,
1967.
Rousanville, B. J., & Weissman, M. W., Prusoff, B. A., &
Heraey-Barpn, R.L. Marital disputes and treatment
outcome in depressed women. Comprehensive Psychiatry,
1979, 20^, 483-490.
Roy, A. Vulnerability factors and depression in women.
British Journal of Psychiatry, 19 78, 133, 106-110.
Rush, A. J.., Beck, A. T. , Kovacs, M. , & Hollon, S. Compar
ative efficacy of cognitive therapy and pharmacotherapy
in the treatment of depressed outpatients. Cognitive
Therapy and Research, 1977, _1, 17-37..
Rush, A. J., Shaw, B., Khatami, M. Cognitive therapy of
depression: Utilizing the couples system. cognitive
Therapy and Research, 1980, A, 103-113.
178
Sartre, J-P. The emotions: An outline of a theory. New
York: Philosophical Library, 1948.
Sartre, J-P. The flies. In No exit and three other
plays. New York: Vantage Books, 1955.
Sartre, J-P. No exit. In No exit and three other plays.
New York: Vantage Books, 19 55.
Sartre, J-P. Being and nothingness. New York: Philo
sophical Library, 1956.
Sartre, J-P * The philosophy of Jean Paul Sartre * R.D.
Cumming, Ed. . New York: Vantage Books, 19 65.
Sartre, J-P* The humanism of existentialism. In Essays
in existentialism. New Jersey: The Citadel Press,
1967.
Scarf, Maggie. The more sorrowful sex. Psychology Today,
April 1979, pp. 44-45; 47-48; 51-52; 89-90
Seligman, M. Learned Helplessness. Annual Review of
Medicine, 1972, 2j3, 407-412.
Seligman, M. Depression and learned helplessness. In
R. J. Friedman & M. M. Katz (Eds.), The psychology of
depression: Contemporary theory and research.
Washington, D.C.: Winston-Wiley, 19 74.
Shaw, B. F. Comparison of cognitive therapy and behavior
therapy in the treatment of depression. Journal of
Consulting and Clinical Psychology, 1977, 45_, 543-551 .
Singer, E. Key concepts in psychotherapy. New York:
Random House, 19 65.
Syfers, J. Why I want a wife. In A. Koedt & S. Firestone
(Eds.), Notes from the third year: Women's liberation.
New York: Notes From The Second Year, Inc., 1971.
Sweeney, J. Coping with disaster— many can't. Los
Angeles Times, January 14, 1983, Part I, pp.l; 22-23.
Tcheng-Laroche, F., Prince, R. Middle income, divorced
female heads of families. Canadian Journal of
Psychiatry, 1979, 2_4 (1), 35-40.
179
Termerlin, M. , & Termerlin, J. Psychotherapy cults: An
Iatrogenic proversion. Psychotherapy: Theory,
Research and Practice, 19 82, 19_ (2), 131-141.
Tillich, P. Existentialism and psychotherapy. Review of
Existential Psychology and Psychiatry, 1961, 1, 8-16.
van den Berg, J. A different existence. Pittsburgh, Pa.:
Duquesne University Press, 1972.
Yalom, I. The theory and practice of group psychotherapy
(2nd ed.). New York: Basic Books, 1975.
Yalom, I. Existential psychotherapy. New York: Basic
Books, 1980.
Warheit, G. Life events, coping, stress, and depressive
symptomotology. American Journal of Psychiatry, April
1979, 136(43), 502-507.
Weiss, R.S. The emotional impact of-marital separation,
Journal of Social Issues, 1976,32, 135-145.
Weissman, M. M., .Klerman, G. L., & Paykel, E. S. Clinical
evaluation of hostility in depression. American
Journal of Psychiatry, 1971, 261-266.
Weissman, M. The epidemiology of suicide attempts, 1960
to 1971. Archives of General Psychiatry, 1974, 30,
737-746.
Whellis, A. How people change. New York: Harper & Row,
1973.
Winfield, H. R. Social support and the social environment
of depressed and normal women. Australian and New
Zealand Journal of Psychiatry, 1979, 13, 335-339.

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Creator Spencer, Henrietta Cecil (author)

Core Title The development of the existential model of depression in women

Degree Doctor of Philosophy

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