Emotional Experience in Depression: A Philosophical Study is a three-year AHRC-DFG funded project lead by Matthew Ratcliffe and Achim Stephan. Its aim, quite simply, is “to provide the first ever detailed, systematic philosophical study of the nature and role of altered mood, emotion and feeling in depression.”

The Phenomenology of Depression, organised principally by Durham-based research fellow Ben Smith, was the second four-day workshop associated with the project. As with its predecessor “Emotional Experience in Narratives of Depression” the programme brought together some of the leading lights in this fascinating and thoroughly interdisciplinary field.

The prospect of trying to capture in any kind of satisfying way the complexity of the ideas discussed in the last week is a task too daunting to contemplate. Equally, I feel as though I could wax lyrical about this workshop for hours and still not come close to conveying the intellectual excitement generated by the formal presentations and sustained throughout our informal discussions. My intention here is a far more modest – to offer some reflections on the various ways in which the concept of depression was addressed.

Despite, or perhaps because of, working on schizophrenia for so long, I’m always struck by the very different ways in which these two broad categories of experience are discussed and described. For all that schizophrenia is characterised by paradox (a case so convincingly and comprehensively argued by Louis Sass in Madness and Modernism), and despite the variety of ways in which its phenomenology and aetiology are explained, there is, still, a tacit agreement, at least in philosophy of psychiatry circles, that we know roughly the order of experience we are trying to describe. In this we are helped by wider trends: after all, schizophrenia is a term seldom used to refer to moods, emotions, or everyday experiences; while its existence is disputed, few would argue that the persistence of the diagnosis is a result of “overmedicalisation”; and hardly anyone seems voluntarily to seek out a diagnosis of schizophrenia as a framework for interpreting and addressing their distress.

Can the same be said of depression, that we agree, roughly, on the kind of experience or set of experiences to which the term refers? Judging by this workshop, my answer would have to be no.

As the project rationale itself makes clear, standard DSM-IV-TR/ICD-10 diagnostic criteria are hopelessly inadequate when it comes to the task of describing subtle as well as stark differences in depressed people’s experience of, for example, changes in their sense of time, self, free will and capacity for action. Notwithstanding workshop participants’ shared commitment to exploring these differences, in meeting to discuss ‘the phenomenology of depression’ it became abundantly clear that speakers were addressing (whether implicitly or explicitly) distinct and perhaps even incommensurable characterisations of depression.

Louis Sass and Elizabeth Pienkos, for example, presented in their paper a detailed account of the finely grained differences between disturbances of self-experience schizophrenic and affective psychoses. For them, the focus was on suffering at its most severe; disturbances registered not only at the level of identity, behaviour, and emotion, but more fundamentally at the level of ipseity.

In his powerful close-reading of this seventeenth-century print by Giovanni Castiglione, Wayne Martin, by contrast, drew our attention to a form of experience mysteriously entitled inletabilitas. Appearing in no other known artistic works, and translated variously as a form of melancholy, grief and imperviousness to joy, inletabilitas is, according to the motto of the drawing, a virtue. The image and, in turn, the experience it portrays, was revealed in Martin’s careful analysis as an early modern palimpsest encoding theological, mythical, and philosophical perspectives on melancholy. The idea that this experience, or something like it, can be imbued with an intense spiritual and intellectual significance was also pursued by Mark Wynn’s reading of Dark Night of the Soul as a theological case of depression.

The range of perspectives on depressive experience was further expanded in papers reported on recent qualitative and quantitative studies. Perhaps unsurprisingly, differences between and among anonymous survey respondents in Outi Benson and the SANE Research Team’s study of The Experience of Suicidal Feelings; south London psychiatric in-patients participating in Gareth Owen’s study of decision-making capacity; and the psychically distressed adolescents in Tom Csordas’s NIH-funded project Southwest Youth Experience of Psychiatric Treatment were easily as striking as the similarities.

So what relationship, if any, is there between the experiences of post-partum depression in a fifteen-year old girl in the south-west United States in 2010, the “typus melancholicus” so beloved of German phenomenologists, and sixteenth-century Carmelite friars enduring the long dark night of the soul? Depression as a mood, emotion or feeling; depression as a diagnostic identity; depression as a virtue, a potential pathway to union with God; depression as disease, disorder, illness: does the use of the same word in each case point us towards or away from what is important?

It was neither the business nor the ambition of the workshop to resolve these questions, but it is to the great credit of participants and organisers that they were posed.

1 Comment

A Follow-up Workshop on the Phenomenology of Depression – Thursday 22 September 2011 | Centre for Medical Humanities Blog · August 16, 2011 at 5:15 pm

[…] You are invited to attend a half-day workshop, on Thursday 22nd September, as part of a three year research project Emotional Experience in Depression: A Philosophical Study, funded by the AHRC and DFG. This event follows on from The Phenomenology of Depression: A Workshop. […]

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