Abstract
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, emphasizes diagnosis and statistically significant commonalities in mental disorders. As stated in the Introduction, “[i]t must be admitted that no definition adequately specifies precise boundaries for the concept of ‘mental disorder’ ” (DSM-IV, 1994, xxi). Further, “[t]he clinician using DSM-IV should ... consider that individuals sharing a diagnosis are likely to be heterogeneous, even in regard to the defining features of the diagnosis, and that boundary cases will be difficult to diagnose in any but a probabilistic fashion” (DSM-IV, 1994, xxii). This article proposes that it may be helpful for clinicians to study narratives of illness which emphasize this heterogeneity over statistically significant symptoms.
This paper examines the recorded experiences of unusually articulate sufferers of the disorder classified as Major Depression. Although sharing a diagnosis, Hemingway, Fitzgerald, and Styron demonstrated different understandings of their illness and its symptoms and experienced different resolutions, which may have had something to do with the differing meanings they made of it.
I have proposed a word, autopathography, to describe a type of literature in which the author's illness is the primary lens through which the narrative is filtered. This word is an augmentation of an existing word, pathography, which The Oxford English Dictionary, Second Edition, defines as “a) [t]he, or a, description of a disease,” and “b) [t]he, or a, study of the life and character of an individual or community as influenced by a disease.” The second definition is the one that I find relevant and which I feel may be helpful to clinicians in broadening their understanding of the patient's experience.
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Notes
Hawkins, Reconstructing Illness, 24.
Howbsbawm, The Age of Extremes: A History of the World 1914–1991, 530.
Hawkins, 24.
Lifton, Death in Life Survivors of Hiroshima, 3.
Hemingway, “Soldier's Home,” in In Our Time, 71.
James, The Varieties of Religious Experience, 137–139.
Hemingway, Selected Letters of Ernest Hemingway, 1917–1961, 153.
Quoted in Turnbull, Scott Fitzgerald, 244.
Hemingway, “Indian Camp,” in In Our Time, 15–16.
Ibid, 19.
Ibid, 19.
Baudelaire, Paris Spleen, 99.
Lynn, Hemingway, 36.
Quoted in Jamison, Touched With Fire: Manic-Depressive Illness and Creativity, 228.
Hemingway, “A Clean Well-Lighted Place,” in The Complete Short Stories, 288–291.
Ibid, 290.
Ibid, 291.
Ibid, 290.
Hemingway, Selected Letters, 407.
Hemingway, Complete Short Stories, “To Have and Have Not,” 238.
Hemingway, For Whom the Bell Tolls, 468.
Ibid., 338–340.
Crowley, The White Logic, 155.
Fitzgerald, The Crack-Up, 75.
Meyers, Scott Fitzgerald: A Biography, 263.
Crowley, The White Logic, 144.
Fitzgerald, The Crack-Up, 70.
Ibid., 72, 77.
Ibid., 78–79.
Ibid., 69.
Hundert, Philosophy, Psychiatry, and Neuroscience, 170.
Fitzgerald, The Crack-Up, 70.
Caramagno, Flight of the Mind, 92.
Myers, Scott Fitzgerald, 272.
Fitzgerald, Letters of F. Scott Fitzgerald, 562.
Styron, Darkness Visible, 84.
Ibid., 78–79.
Ibid., 23.
Camus, The Myth of Sisyphus, 3, 11.
Styron, 23.
Ibid., 23–24.
Berman, “Darkness Visible and Invisible,” 77.
Cowley, Writers at Work: The Paris Review Interviews, 272.
Styron, 41.
Ibid., 65.
Ibid.
Ibid., 46–47.
Caramagno, 92.
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Moran, S.T. Autopathography and Depression: Describing the ‘Despair Beyond Despair’. J Med Humanit 27, 79–91 (2006). https://doi.org/10.1007/s10912-006-9007-8
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DOI: https://doi.org/10.1007/s10912-006-9007-8