A Different Way To Think About Depression

There is a very different way of thinking about depression and I’m amazed that it’s not more widely known about. It doesn’t focus on events from the past or assume that your serotonin levels are out of whack. It’s not some recent flash in the pan (it’s been around for over 60 years) or some miracle cure by some dubious crackpot (it was in fact developed by the founding member of The Washington Institute of Psychiatry). Sadly though, it’s just gone out of fashion.

I was thinking of it recently whilst talking to a Life Change Holiday guest about her long history of depression. She had suffered from serious depressive episodes for many years and at several times had even contemplated suicide.
She had seen numerous counsellors and talked to countless doctors and specialists who prescribed various tablets. Sometimes the pills worked and sometimes they seemed to make things a lot worse, but nothing had ever really helped.

In between describing her depression I also noticed that she often talked about how her life was gradually getting smaller and smaller. Over the years friends had got married and become more distant and the few family members she was close to had also drifted away.

As I sat listening carefully during our counselling session, and concentrating on this person, the name “Harry Stack Sullivan” kept repeating itself in my head. The longer she talked the louder the voice in my head became, “Harry Stack Sullivan” it repeated again, only this time a little louder.

It wasn’t, I hasten to add, a real voice in my head, although it would have been ironic if it had been, as amongst many other things Harry Stack Sullivan revolutionized the way we understand Schizophrenia.

Harry Stack Sullivan

Harry Stack Sullivan was a remarkable man (not least because he mysteriously has the word “stack” in the middle of his name) and eminent psychiatrist, and developed some radical theories in the first part of the last century about what he famously referred to as “difficulties in living.” He hated the term “mental illness” and somewhat bizarrely often found himself arguing against mainstream psychiatry despite being the founding member of a famous psychiatric institute! He is often referred to as the “grandfather” of the anti-psychiatry movement. He was, if you like, a pre-runner to the world famous Carl Rogers who almost single handedly invented Person Centered Counselling.

Although Dr Harry Stack Sullivan was rather retiring and quietly spoken he was not afraid to speak out, which he memorably did in the 1940s against the American military whilst actually serving on the US Advisory Board for Military Recruitment. To everyone’s great surprise and shock he announced that “adult homosexual men should be allowed in to the army” and that they posed “no conceivable threat to the American military” (what on earth did they think they were going to do, dress up in flowery pink uniforms and throw cakes at the enemy). I really like Harry Stack Sullivan. I think he’s a cool dude.

Throughout his life he wrote widely on a range of what would now be known as “counselling issues” but primarily was the main advocate for a school of thought who believed that “mental health” is intrinsically linked to our interpersonal relationships and cultural forces. That depression, for example, was not a product of a faulty personality or a mysterious clinical syndrome, or as he so poetically put it, the product of “unburied shards of a tragic childhood”, but simply a product of something going wrong, or having gone wrong, with our relationships with others (he invented and introduced the term “significant other” to the English language, thanks for that Harry, another cool thing. He also invented the term “parataxic distortion” which seems to be taking a little longer to catch on).

It’s a fairly radical theory now, let alone when he first published it back in the first part of the last century. They must have thought he was nuts (another phrase I’m sure he probably wouldn’t agree with, sorry Harry).

As I listened to our life change holiday guest it became impossible to distinguish between her feelings of depression and her acute loneliness. The more she talked in our counselling sessions, the more it became apparent that both issues where intertwined. The more impoverished her interpersonal relationships became, the more she became depressed, until it simply became a vicious circle.

Sometimes of course Harry Stack Sullivan’s theories (I just love writing his name, it’s the “stack” bit that gets me) do not transpose so easily into real life, but this could have come straight from one of his text books. It was as plain as the little round spectacles on Harry Stack Sullivan’s little round nose.

Of course it’s not so easy to identify these problems ourselves, its always easier from the outside looking in, so to speak, which is often a simple reason why counselling works.

I’m also very happy to report that the person I am writing about went on to make some really important changes in her life and is now about to get married (congratulations). They also gave me permission to write about their story. Thank you.

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Till next week.