Mourning or Melancholia

Philosophy, Psychiatry, and Psychology 16 (3):245-247 (2009)
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Abstract

In lieu of an abstract, here is a brief excerpt of the content:Mourning or MelancholiaJ. Melvin Woody (bio)Keywords“objective correlative”, depression, grief, cognitive-affective dissonanceIn a celebrated and controversial critical essay, T.S. Eliot faults Shakespeare's Hamlet on the grounds that the playwright has not provided sufficient “objective correlative” for the moods of his melancholy Dane. For lack of the “complete adequacy of the external to the emotion” that he finds in Shakespeare's other tragedies, Eliot judges that “the play is almost certainly an artistic failure” (Eliot 1921, 101, 98). Dr. Bailey's explanation of Colin's melancholy provokes parallel critical reflections. When his initial expectation that he will discover the cause of depression in traumatic battle experiences in Iraq proves groundless, he finds that cause, instead, in the very absence of traumatic experiences. I cannot but wonder whether the lack of opportunity to prove heroic provides an adequate objective correlative for Colin's mood.To be sure, persistent sadness cannot be regarded as pathological if adequate reasons for sadness also persist. There lies the difference between mourning and melancholia. As Freud remarks at the outset of his comparison of the two, “although grief involves grave departures from the normal attitudes to life, it never occurs to us to regard it as a morbid condition and hand the mourner over to medical treatment.” Even though the mourner displays almost all the same symptoms as melancholia, where there is a recognizable objective correlative, we look upon any interference “as inadvisable or even harmful... because we know so well how to explain it... this attitude does not seem to us pathological” (Freud 1963, 165). Neither the absence of battlefield trauma nor the lack of heroic opportunities seems sufficient occasion for Colin's sadness. But (perhaps) that very explanatory insufficiency justifies regarding his plight as pathological, as a case of melancholia rather than mourning and therefore as warranting psychiatric interference. Insofar as that is true, the self-criticisms engendered by his trauma-free stint in Iraq might best be regarded as an effect rather than cause of his depression. Freud found this sort of “fall in self esteem” that “finds utterance in self reproaches and self revilings” to be the singular feature that distinguishes melancholia from mourning.” In the clinical picture of melancholia, dissatisfaction with the self on moral grounds is far the most outstanding feature” (Freud 1963, 167, 169).Anyone who has dealt with depression will recognize such feelings as standard symptoms. The DSM- IV cites “feelings of worthlessness or excessive or inappropriate guilt” as one of the defining criteria of a major depressive episode and “low self esteem” as a diagnostic criterion of dysthymic disorder.Freud speculated that the melancholic's attacks upon himself actually aim at an abandoned but internalized love object. But he acknowledged [End Page 245] that his speculation was based on “a small number of cases the psychogenic nature of which was indisputable,” and that some cases of melancholia suggest more somatic causes. Recent psychiatry has veered sharply toward somatic causes and cures, although the psychogenic nature of depression associated with traumatic stress is generally acknowledged. But in the absence of trauma and stress, as in Colin's case, a somatic account seems more plausible than supposing that the depression is triggered by that very absence.The contrast between somatic and psychological sources of depression threatens to prove distracting, however. We are not faced with a simple either/or here, and however we sort out the genetic, environmental, somatic, and psychological sources of depression in any given case, the depression itself is always a profoundly incarnate experience. Moreover, what seems of especial pertinence to this case, the loss of self-esteem and feelings of worthlessness and guilt seem to prevail regardless of the particular balance of causes of the depression and can, therefore, be regarded as characteristic symptoms rather than explanatory causes of the mood. And the blackness of melancholy typically extends well beyond such negative self-judgments to cast a shadow on the depressive's whole world and future.Epistemology and pathology converge in the clinical diagnosis of depression. Depression seems pathological insofar as it seems unreasonable in light of the circumstances as we apprehend them. Of course, the person who is depressed...

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J. Melvin Woody
Connecticut College

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