Category Archives: General

Existential depression

It’s a question about myself, but I thought it might interest you:

“Sometimes I suffer existential depression in which my thoughts question the validity of feelings. I have thoughts like, ‘How can feelings be a reliable guide to what is right or important to do when they are just my feelings? Does what I do or don’t do really matter in the grand scheme?’ I suppose part of me wants a guarantee that my actions would have some larger or lasting significance or value besides feeling like the right thing to do at the time, but this doesn’t exist as far as I’m aware. I don’t know of any way of dealing with this state of mind besides waiting for it to pass. Is this something you’ve ever encountered?”

What you call existential depression is depression resulting from the defense of self-attack, using existential themes.

Self-doubt and minimization: “How can feelings be a reliable guide to what is right or important to do when they are just my feelings?”

Self-doubt and self-devaluation: “Does what I do or don’t do really matter in the grand scheme?”

Self-doubt and self-devaluation: “My actions have no larger value unless they last beyond my lifetime.”

Underlying messages: 1) “Your feelings are unreliable, so you should hold yourself back”; 2) What you do doesn’t make any difference, so you shouldn’t do anything; and 3) Your actions have no larger meaning, so there is no point to acting.”

These forms of self-attack could be addressed in therapy, so that you recognize these defenses and also find out what feelings are being warded off, and toward whom they belong. These self-attacks are just sneaky cuts to the soul.

But let’s suppose you think this is reductionistic. You might think, “Jon, these are existential realities. Aren’t you reducing existential issues to a psychological category?” The problem with this argument is that there is a beautiful antinomy here, which is missing. That missing antinomy tells us that there is a psychological issue. Without keeping you in further suspense, here is the antinomy spoke by the great teacher Ramana Maharshi:

“Insofar as I am nothing, I am knowledge.

Insofar as I am everything, I am love.”

Therapist as intruder

I gave a lecture recently where I showed work with a fragile woman who expressed fear that I would ask questions she did not want to answer. When I said that was projection, an audience member wondered if it was true. “After all,” he said, “we want to know what is going on in her, and in a sense we are intruders.”

In response, I said that we have no right to intrude on patients’ inner lives. We are here to do therapy, not commit a crime of breaking and entering. I can ask a question but if the patient does not want to answer it, I have to respect her wish not to reveal what she does not want to reveal.

“But we want to know,” he said. I replied, “Actually, no.” Therapy cannot be about my desire, but about her desire. If she desires to explore her inner life, I am willing to help her. This is her life and her therapy. Therapy cannot be driven by my desire but hers. I am just the servant of her desire.

This is not a matter or technique or a way to “trick” the patient into revealing herself. It’s a matter of ethics, our profound respect for her autonomy regarding her life and boundaries. Trying to make a patient talk about what she does not want to talk about is a form of emotional rape. So many of our patients were raped physically or emotionally. They fear we will do the same. So it’s important that we respect their wishes.

Th: “I have no right to ask you to talk about something you don’t want to talk about. I have no right to ask you to do something you don’t want to do. If this is not something you want to do, I have to respect your wishes. After all, this is your therapy, not mine.”

We are listeners, not intruders.