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Self-fulfilment or Self-erosion?

Depression as Key Pathology of Late Modernity

Bert van den Bergh

Abstract According to the World Health Organization the mental disorder termed

depression will soon be the second leading cause of disability worldwide. Thiscalamity is frequently referred to as ‘the depression epidemic’. Some stage thisepidemic as the materialization of a fundamental experience of late modern man.French philosopher Dany-Robert Dufour, for instance, in his stirring studies on the‘liberal cultural revolution’, presents the current intensifying discrepancy betweenthe omnipresent incitement to ‘be oneself’ and the extreme difficulty to ‘be a self’as a fatal clash that manifests itself in a rise of the phenomenon of depression.According to Dufour our world today has an increasingly Sadean character.Liberalism, he states, is Adam Smith along with Marquis de Sade. At present theSmithian ‘invisible hand’ has difficulty in guiding the Sadean ‘isolist’ subject insuch a way that the latter can be free from major discontent. On the contrary, so itappears in view of the ‘depression epidemic’ and allied aberrations.

How should we deal with these late modern disorders? If we try to grasp thedepression epidemic as an existential phenomenon, the question arises how we cancome to understand it in a way that is radically different from the prevailing DSM- based one. Since the dominant approach of mental disorders is reductionist, biologistic, highly unphenomenological, we run the risk of losing contact with the phenomenon. How can we avert this? How can we gain access to this keyexperience?

Dufour interprets our current situation as that of an ‘anthropological mutation’.And depression according to him could be seen as a sign of resistance to this

situation. So where then is this fundamental turn leading us? And what does the phenomenon named depression show us? What happens if we, instead of bluntlyattacking it, lend this phenomenon our ears?

Key Words: Depression, mood disorder, late modernity, self-fulfilment,anthropological mutation, attunement, dysrhythmia.

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Self-fulfilment or self-erosion?

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1. Once upon a time...

Glasgow, an evening in January, some years ago. The stage of the populartelevision show Britain’s Got Talent is taken by an unknown woman who does not belong there. Someone from bygone times, without a scrap of stardom potency. Awoman who will never be able to take the leap on which this show is based and onwhich it has its eye: the somersault from average person to media phenomenon.This ugly duckling is called Susan Boyle. She comes from a small village nearEdinburgh, where she lives as a spinster with her cat Pebbles.

Just before the start of her performance Susan discloses her secret dream, adream she has been cherishing since she was twelve: becoming a professional

singer. ‘How old are you, Susan?’ a jury member asks, once she is standing in thespotlight. ‘Forty-seven,’ is the reply. The jury frowns. The audience sniggers. Thisis going to be a laugh.

But then the singing commences. It is – rather symbolically – a song from themusical adaptation of Les Misérables. The song opens – significant as well – withthe line ‘I dreamed a dream in time gone by’ and ends with the sigh ‘Now life haskilled the dream I dreamed’. And exactly the opposite of what is bewailed in thislast line happens right after the sounding of the song’s first words. Susan’s dreamcomes true. The jury swings over, the audience rises. The wasted life, the

unawakened talent, the dull mediocrity, it is all blown away to sweet and splendidstardom. When the last notes of the song have died out, a media personality is born.The inconsequential Susan Boyle is shot to the status of TV star overnight. Nolonger is she just anybody.

This odd little bird, that is you and me. Susan Boyle personifies a late modernEveryman. She is our mirror image and the television is the mirroring dodger.Cloaked in the sheep’s clothing of entertainment a cunning fox incites us again andagain to judge ourselves by a merciless standard. This comes about with a light andgentle touch; we are slyly played to and deftly devoured. When we watch a showlike this, something crucial slumbering in us is addressed: our most personalunredeemed dream. Singing, dancing, top model, top chef, business hot shot, or any‘talent’. Britain’s Got Talent , America’s Next Top Model , Idols, The X-factor , SoYou Think You Can Dance, The Voice, The Apprentice, or one of the many othertalent searches that have been rolling into our living rooms lately. Talent search, ortransformation hunt. Besides the countless talent shows there are the numerous programmes in which candidates are induced to change the shape of something thatis intimately linked to them: their homes, clothes, careers, bodies, even their souls. Become who you think you are, so the message reads. – You can do it, you shouldwant it, you really need to want it. Because what you have been till now is not

enough. Or even less: it is nothing. You are still a nobody. If you leave it at thatyou have failed. Then you are a loser. You should be a winner. You should change.



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You should want it. You really need to want to win. Thou shalt yearn for the statusof hero. –

The loser who realizes he or she is not a winner is ashamed. The intensifying of

this shame may end in depression. And depression is the phenomenon I would liketo take a closer look at in this essay. The depressions of late modern man, that is,not those of Susan Boyle. Although it is common knowledge that just after herlaunch as a star Susan collapsed under the media pressure and suffered a nervous breakdown, my knowledge of this woman is too limited to be able to statesomething meaningful on her inner life. And the latter, as a matter of fact, is notwhat I am aiming at here. What I intend to connect is Susan Boyle as media phenomenon and depression as key disorder of our times. These times I term ‘latemodernity’. 1 The metamorphosis of this ugly duckling, this obscure Miss Average

– failure becomes celebrity, unfulfilled dream turns into arranged reality, Les Misérables becomes Perfect Day2 – can be linked directly to the paradoxicalexhortation with which the late modern individual is bombarded continuously andmultifariously: be yourself, become somebody else. On all sides this wolfish self-fulfilment regime puts a corroding pressure on us, and it is this corrosion thatmanifests itself today, among other things, as the ‘mood disorder’ called‘depression’.

That is what it is called, but what exactly is it? What do these terms‘depression’, ‘mood disorder’ and ‘mood’ actually mean here? How are these

phenomena generally understood, approached and managed? And how was thisdone in the past? Frequently nowadays the so-called ‘depression epidemic’ isdiscussed and debated. And innumerable are the strategies developed to suppressthis evil. On all sides depression is regarded as a huge social problem. But whatdoes it imply in a cultural respect? What does the global spread of the phenomenondepression – according to the World Health Organization we are dealing today witha true pandemic3 – tell us about the state of our late modern culture? What precisely is ‘disordered’ today? And why has the former concept of ‘melancholy’ been abandoned and been pushed aside by that of ‘depression’, a displacement inwhich the baby of ambivalence seems to have been thrown out with the bathwater?In contrast to ‘melancholy’, which was taken as both vice and blessing,‘depression’ today is considered to be an illness only, an annoying interruptionwhich should be ‘repaired’ as quickly as possible. What kind of culturaltransformation has taken place here?

This essay is an attempt to unfold this question. The aim is to situate the phenomenon of depression in opposition to prevailing approaches. The lattercategorize depression as a ‘mood disorder’, proceeding from a framework thatalready for several decennia all over the world has determined the professionalapproach to mental problems: the Diagnostic and Statistical Manual of Mental

Disorders, better known as DSM4, managed by the American PsychiatricAssociation. What notion of depression is embedded in this framework? How are




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‘mood disorder’ and ‘mood’ understood in the regular psychiatric and psychological professional literature? In what way do these interpretations ‘feed’the phenomenon they intend to grasp? These are questions that have presented

themselves in the light of the growing criticism during the last two decades ofdominating approaches to depression and other contemporary distress in psychiatry, psychology and mental health care. Is the remedy here part of thedisease? Could we and should we get a different outlook on our mental suffering?What does the phenomenon of depression have to tell us if we listen to it with a phenomenological ear? With this latter question as our guide we set off.

2. Heroic melancholy, prosaic depressionSince the start of late modernity, depression has turned into a very hot potato.

Linked to this is the arrival of a new nonfiction genre in our literary world: theautobiography as a personal portrait of a depressive episode. One could name thisgenre the ‘automelangraphy’.5 Well-known examples are Darkness Visible by theAmerican writer William Styron, Prozac Nation by the American journalistElisabeth Wurtzel and The Noonday Demon by the American writer AndrewSolomon. In my country, The Netherlands, twenty four years ago the distinguished psychiatrist Piet Kuiper wrote a much-praised automelangraphy entitled Far Gone.This book set the tone for similar Dutch memoirs, like the following two recentworks: Froggy Goes for a Ride! Or on the Suffering that Is Life by professor of

modern French literature Maarten van Buuren and Pill by comedian Mike Boddé.

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These works are all highly personal accounts of the troublesome victory over acrippling darkness. And in all of them a particular ‘pill’ has a special part in thestory. Styron was prescribed Nardil but re-entered the light because of his state ofisolation in a hospital, Wurtzel obviously used Prozac but in the end needed psychotherapy as well to come back to life again, Solomon experimented for sixyears till he found the right mix of Zoloft, Remeron, Wellbutrin, Zyprexa, Namenda and Ranitidine,7 Kuiper used Tylciprin and started painting, VanBuuren’s turn and return was enabled by Seroxat, biking and the arosen ability togive his ailment a proper name, and Boddé finally discovered Anafranil andthereby rediscovered life. Six examples, and already quite a collection of psychopharmaca.

One of the most successful works written on the use of psychopharmaca in the battle against mood disorders is Listening to Prozac by the American psychiatristPeter Kramer. This book, published in 1993, six years after the introduction ofProzac, explores the status of the successful novel SSRI8 antidepressants. Is Prozaca medication or a drug, or both? Could we use these ‘mood brighteners’ to alter our personalities and become ‘better than well’?9 We are on the eve of a revolution inmedical thinking, says Kramer: ‘We are entering an era in which medication can be

used to enhance the functioning of the normal mind.’10 This message fell in thebooming nineties in extremely fertile ground. A new promising concept was added



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to the psychiatric dictionary, ‘cosmetic psychopharmacology’. No joke intended;Kramer was deadly serious. We now have means, he declared, of ‘making thehesitant decisive’, change their defective condition into one of ‘assertiveness and

optimism’, or in other words into a ‘self-assured state’.11

The success of Listening to Prozac made Kramer start a grand tour around theglobe to explain his ideas and elicit responses of all kinds of audiences. Whatstruck Kramer during this tour – so he reports in a more recent work on the phenomenon of mood disorder, Against Depression – , was a certain kind ofreservation that emerged regularly when people in the audience started to askquestions. ‘What if Prozac had been available in van Gogh’s time?’ 12 Thisquestion, raised in all sorts of variants by all sorts of people, made Kramer realizethat the tradition of ‘heroic melancholy’ was still very much alive. This tradition,

rooted in an ancient Greek text fragment, Problemata XXX.I , involves aninterpretation of depression, or melancholy, in which the pathological is linked toexcellence. The first lines of this (in)famous fragment – until recently attributed toAristotle himself, but today believed to be written by one of his epigones – go likethis: ‘Why is it that all men who have become outstanding in philosophy,statesmanship, poetry or the arts are melancholic…?’.13 Against Depression is anattack on both the disease and the tradition that tends to glorify it. Our highestvalue is at stake here: ‘Depression is the opposite of freedom.’14 And the oppositeof this opposite is ‘a resilient mind, sustained by a resilient brain and body’. 15

Instead of recognizing this, Kramer continues, we made melancholy into somethingextraordinary and in doing so evaded the heart of the problem. The outcome of thisdenial was ‘two thousand years of therapeutic impotence’.16

According to Kramer this romanticizing view is still the undercurrent in ourevaluation of depression today. His renunciation of this superstition has three parts:‘What it is to us’ – the ambivalent and false understanding of depression as asuperb illness; ‘What it is’ – the truth about depression, being a plain disease;‘What it will be’ – the vision of a world without this darkness. So Against Depression is a tripartite work along the lines of the Confessions by Augustine:digression, conversion and profession. ‘How glorious it will be to free ourselvesfrom depression’, so the closing sentence of the book reads.17 In trying to convertus, Kramer replaces the refuted heroizing tradition by another one. Robert Burton’sclassic Anatomy of Melancholy, published very successfully in the first half of theseventeenth century, had a similar utopian spirit as Kramer’s battle text. In theextensive prologue of his work Burton presented four centuries ago ‘an Utopia ofmine own, a new Atlantis’ where industriousness is the iron rule: ‘I will not have a barren acre in all my territories (…) I will suffer no beggars, rogues, vagabonds, oridle persons at all’.18

Secular Father Kramer is preaching to the already converted. Today the utopian

inspiration proclaiming melancholy or depression to be a sin and an evil more thanever has taken the upper hand. Naming melancholy ‘depression’ is only one sign of




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this dominance. Today we look at depression the Kramerian way. ‘Heroicmelancholy’ belongs to the past, prosaic despondency is our present-day burden. A plain disease, nothing more and nothing less.19 A ‘mood disorder’ that can be fixed.

An annoying interruption of productivity and mobility that should be eliminated.Via SSRI’s – the novel anti-depressants – or other pills, via deep-brain stimulationor nervus vagus irritation20, or via other similar technical tools. Burton’s utopia isour reality. Idle persons do not belong here.

3. Depression epidemicThe calamity of the global spread of depression is often referred to as ‘the

depression epidemic’. A study by the very same title was published in The Netherlands four years ago by the Dutch philosopher and psychologist Trudy

Dehue. The book caused a great deal of controversy, especially because Dehuedemonstrated in detail, and convincingly, how the combined action of pharmaceutical industry, science and media nurtures a particular interpretation ofand way of dealing with mental disorders – in this case depression. Thiscollaboration (or plotting), however, is not Dehue’s main explanation of thedepression epidemic. The subtitle of her study indicates what according to her isthe root of the problem: On the Duty to Control One’s Own Destiny. It is theimperative of self-determination, or taken somewhat broader, the ethos of self-realization that puts such a pressure on the late modern subject that he is

increasingly liable to the opposite of what is wanted and needed: show oneself as astrong, motivated, purposeful, enterprising, flexible and communicative individual.Depression involves the flip side of these late modern virtues. A constellation inwhich everybody is held fully responsible for his own lot, turns unhappiness moreand more into a shortcoming, namely in one’s duties of vigorous self-fulfilment.

At the end of The Depression Epidemic, in response to a kindred study on thestate of despondency in late modern culture – The Loss of Sadness by the Americansocial scientists Allan V. Horwitz and Jerome C. Wakefield – Dehue states that it isnot so much the loss of sadness that we have to contend with, but ‘a ban ondeliberation’.21 This remark raises some important questions: What kind ofdeliberation is meant here? What kind of subjectivity is linked to this key attitudeor condition? And if this attitude or condition is changing or deteriorating, in whatway then is this connected with a change in subjectivity as such? Regrettably, these pressing questions are not answered nor raised by Dehue, because the scope of herwork does not allow it.

The subtitle of the above-mentioned study by Horwitz and Wakefield points toa culprit of the ‘loss of sadness’: How Psychiatry Transformed Normal Sorrow into Depressive Disorder . The main source of this metamorphosis, according to the twosocial scientists, is a conceptual confusion:



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We argue that the recent explosion of putative depressivedisorder, in fact, does not stem primarily from a real rise in thiscondition. Instead, it is largely a product of conflating the two

conceptually distinct categories of normal sadness and depressivedisorder and thus classifying many instances of normal sadnessas mental disorders.22

This study does an excellent job in unfolding and analysing the American professional and social context in which and by which ‘sadness’ transforms into adifferent thing.23 It falls short, it seems to me, by evading the cultural context ofthis transformation: late modernity, its history and its major concepts and specificexperiences of subjectivity. For if indeed the pandemic of sadness according to

certain psychiatric or psychological criteria cannot be taken as depressive disorderin the strict sense, then still there is this global discontent with late moderncivilisation, a discontent we had better take seriously.

Somebody who is definitely doing this and has been doing it already for morethan twenty years now, is the French sociologist Alain Ehrenberg. In 1991 he published the first volume of a trilogy in which the contours of late modernsubjectivity are marked. The third volume of this trilogy, entitled La Fatigue d’ÊtreSoi, or The Weariness of the Self , is entirely devoted to the phenomenon ofdepression.24 On the first page Ehrenberg presents the two leading questions of his

study: ‘Why and how has depression asserted itself as our main inner misery? Inwhat way is it revealing with regard to the mutations of individuality at the end ofthe 20th century?’25 These questions are answered via an extensive exploration ofthe French context around the phenomenon of depression.26

Depression, Ehrenberg states, is the pathology of a society with a newnormativity. Since the fifties of the former century economic competition, sportingrivalry and consumption are the moulds that shape the subject, his lifestyle and hismode of self-realization. Traditional bonds and fixed values no longer make up the basis from which the individual develops. One needs to rely on oneself and has toexpand, be successful, excel and display oneself as a happy consumer. Wetherefore live in postneurotic times: the late modern subject is no longer destined by prohibition, conflict and guilt but by summons, shortcoming and shame. It is theethos of self-realisation and responsibility that moves him. What is expected fromhim is not restriction and sublimation but mobilisation and expression of his passions. He must show initiative, motivation, determination, purposefulness,versatility and communicability. And depression in this context appears as exactlythe opposite, as failure in what is being called for. Being depressed means not being able or willing to have a project, be enterprising, assertive, on the move. Itmeans being unwilling or unable to realize oneself. Depression, in Ehrenberg’s

words, is ‘the disease of responsibility’, or ‘the fatigue of becoming oneself’. 27




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What happened in psychiatry in the course of the previous century correspondsto this transformation of normativity. Gradually the reference to conflict – whichsince the end of the nineteenth century underpinned the concept of the subject –

subsided and made way for a model of failure or weakness. Concerning depressionthe symptoms of sadness and distress pulled back in favour of weariness. In a waythings were reversed: one no longer is weak because one suffers, one suffers because one is weak. Lack of initiative became the principal defect of the depressed person. And the new anti-depressants that were launched in the seventies andeighties of the twentieth century, and became highly successful in the nineties, theaforementioned SSRI’s, aim at reverting this, at restoring the enterprising spirit ofthe disheartened. Prozac, writes Ehrenberg, ‘is not the pill of happiness, but that ofinitiative’.28

The rise of the SSRI’s in the nineties went hand in hand with a(neuro)biological turn in psychiatry. The idea, taken root in the eighties, that mentaland behavioural disorders could be treated solely with biological remedies, becamethe norm. ‘Sick nerves today are a neurochemical imbalance’, Ehrenberg recapssharply.29 This changing norm, the boom of these new medications, the decline ofthe model of conflict, all this was highly facilitated by a decisive change of theDSM in 1980. The third edition of the Diagnostic and Statistical Manual of Mental Disorders – the worldwide starting and focus point of mental health care – turnedaway from the underlying causes of mental disorders and focused completely on

connection, frequency and duration of symptoms. This bias, which Horwitz andWakefield deem to be a decontextualisation of mental suffering,30 resulted in a blurring of the borders between normal and pathological forms of distress, e.g.normal sadness and depressive disorder. This blurring of course was eagerlysaluted by the pharmaceutical industries and incorporated in their policies. A tellingfact with regard to this is the working title Ely Lilly chose for the project ofdeveloping the molecule that later was named Prozac: ‘a compound in search of itsillness’.31

4. A Sadean world

The subject which the present globalising constellation puts in the limelight asincarnation of the good life, is an individual full of self-confidence, energy,flexibility, alertness, in short, an enterprising subject. This alleged sovereignindividual, however, appears to suffer more and more from episodic, recurring andchronic depression. And from dependence and addiction. And stress, burn-out andchronic fatigue. Or the opposite: restlessness and hyperactivity. Sovereignty, insum, seems hard to find these days. And paradoxically the individual as individualis more or less ruled out in the dominant, symptom-oriented and neurobiology-minded approach of mental disorders. One wonders why. What kind of contrariety

is involved here?



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The French philosopher Dany-Robert Dufour has formulated quite an extensiveand stirring answer to this question. In his studies32 on ‘the liberal culturalrevolution’ he links the depression epidemic to the intensifying discrepancy

between the omnipresent incitement to ‘be oneself’ and the extreme difficulty to‘be a self’. Having a sustainable identity is hard nowadays, according to Dufour, because there is no guiding frame of reference any more, no Grand Narrative, or put in Lacanian terms, as Dufour sometimes does: ‘no figure of the Other’.33 Nosuch founding figure has any real validity in late modernity. We are on our own,completely. An ‘anthropological mutation’ has taken place.34 The late modern or postmodern subject35 has become a self-referential being, exhorted to createhimself, without a real basis to take the plunge.

Exchanges are no longer valid insofar as they are guaranteed bysome higher power (either transcendental or ethical); they arevalid by virtue of the direct relationship they establish ascommodities. Commodity exchanges are, in a word, beginning todesymbolize the world. (....) Human beings no longer have toagree about transcendent symbolic values; they simply have to goalong with the never-ending and expanded circulation ofcommodities. 36

This pliability, cloaked as self-fulfilment, makes us go adrift. The formermodern subject, who had a critical and neurotic nature – two characteristics thatcomplemented each other perfectly according to Dufour 37 –, transformed into acreature that smoothly fits in with the flows and pulses of the global market.Dufour speaks of ‘a precarious, acritical, psychotisizing subject’ and specifies thelatter term as follows: ‘by “psychotisizing” I mean a subject that is open to allidentity fluctuations and thereby is susceptible to all commercial bifurcations’.38 This late modern subject imagines himself to be free, because he experienceshimself as self-referential, self-determining, self-realizing. But the only thing infact that is really free, says Dufour, is the ‘divine market’,39 in the sense that itsworshipped dynamics in the end are decisive. The global market of ‘totalcapitalism’ destroys institutions and reshapes procedures ‘in such a way as to produce individuals who are supple, insecure, mobile and open to all the market’smodes and variations.’40 ‘Neo-liberalism’ and ‘consumerism’ as terms to describethis late modern context are inadequate because they tell only a part of the story. Itis ‘producerism’ as well: the modern professional is supposed to be a flex-worker, a position which matches with the pliability of the trendwatching consumer. Andsecondly, the ‘neo’ is an intensification of something that goes way back to AdamSmith, and even further, to Blaise Pascal.

Liberalism, states Dufour, means primarily a liberation of the passions.41 Andthis liberation started on puritan soil. It was Pascal who halfway through the




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seventeenth century started to tamper with the classical Augustinian hierarchy of Amor Dei and Amor sui, divine love and self-love. In a letter written in 1651 Pascaladmits the following on self-love: ‘It was natural to Adam, and just in its

innocence; but it became criminal as well as intemperate due to his sin.’42

Thissmall concession started a development of gradual revaluation of self-love, makingthe puritan more and more ‘perverse’, that is inverting the original hierarchy. Viathe Jansenist Pierre Nicole and the Calvinist Pierre Bayle we arrive at the Calvinist physician and economist Bernard de Mandeville and his famous Fable of the Bees of 1714, the text in which private vices are declared to bring public benefits.Liberation of the passions produces affluence, their restriction brings on misery.Half a century later economist and theologian Adam Smith followed inMandeville’s footsteps43, made them acceptable, and via his Wealth of Nations

founded liberalism and its religion of the free market guided by a divine ‘invisiblehand’. Private vices, i.e. private interests, should have a free hand, because theylead to public happiness. Amor sui is the main road to glory.

But there was a final liberalizing step to be taken and this was done in a veryradical way by the libertine writer Marquis de Sade. He made the perversion, that isto say the reversal, complete by staging, in literary space, the experiment ofradicalising certain basic elements of liberalism, leading to the Sadean notion of‘isolism’, an utmost extreme combination of egoism and hedonism. Showingimmediately what the key thought is, Dufour starts his The Perverse City with the

following revealing parallel quotation:Give me that which I want, and you shall have this which youwant. 44

Give me that part of your body which is capable of giving me amoment's satisfaction, and, if you desire, amuse yourself withwhatever part of mine that may be agreeable to you. 45

The first line is by Adam Smith, the second is De Sade’s. ‘Liberalism means Smithtogether with Sade,’ Dufour states provocatively.46 Today the infamous Marquishas us firmly in his grasp: ‘we live in an increasingly Sadean world.’ 47

In 1929, of all times, the year of the economic world crisis, something happens in New York that Dufour marks as the moment at which the Sadean spirit really camemightily upon us.48 As a promotion of cigarette consumption a titillating parade ofseductive smoking women takes place near Central Park. It is a real spectacle. The press are invited. The whole thing is devised by father of spin Edward Bernays,next of kin of Sigmund Freud, whose ideas Bernays uses, together with mass psychological views of Gustave LeBon and Wilfred Trotter. The new thing is that it

is news. Actually the event is plain advertising, but it is designed as news. And theassociation which draws the attention is that of cigarette enjoyment with sensuality



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and liberation: the unconventional, sensuous women smoke their torches of freedom. ‘The entire new capitalist spirit of consumption can be told from this inaugural act of Bernays’, Dufour writes. And: ‘Capitalism could only recover from

the big crisis of 1929 through democratizing pleasure, through becoming Sadean,or rather, taking into account the prevailing Puritanism, crypto-Sadean.’49 Afterthis inauguration there is no stopping the new spirit. By means of the pin-up,among other things, the sensualised consumption is mobilized. Everywhere‘perversion lessons’ are being taught, i.e. skilfully wrapped instructions foruninhibited gratification of desires. And eventually television takes a key part inthis Sadean ‘education’: the entertainment industry as disciplining agency.However, the puritan foundation remains. Dufour speaks of a double bind ,‘accelerating and slowing down at the same time’.50 Enjoy abundantly, but

consume moderately.The smoking Amazon grew into a solitary Marlborough man. Our contemporaryworld is monadic; we are a collection of islands in an ocean of commodities. Theglobal market releases us, but not to set us free. It ties us to our roles of consumerand flex-worker. It initiates and stimulates the production of ‘individuals who aresupple, insecure, mobile and open to all the market’s modes and variations’.51 Itsummons us to ‘be ourselves’, but tempts us do to the opposite by offering all sortsof artificial identities. I dreamed a dream in time gone by. Don’t let this happen toyou, so is the warning that is constantly thrown at us. – Don’t have your dream

killed. Make your wishes come true, exploit your talents, get the most out ofyourself, even though it might be hidden. Do it quickly, do it now. Realize yourself,and enjoy! – The promise is great, the pressure is huge, and the possibilities offered by the market are countless. We are in danger to become playthings. The latemodern individual, writes Dufour, hovers between megalomania and its opposite,depression:

This subject is increasingly trapped between a latent melancholy(the depression we hear so much about), the impossibility ofspeaking in the first person, the illusion of omnipotence, and thetemptation to adapt a false self, a borrowed personality or eventhe multiple personalities that are made so widely available bythe market.52

With regard to this melancholy or depression, however, Dufour is ambivalent andambiguous. On the one hand he suggests that the depression epidemic might be‘one of the most evident signs of resistance of the subject to the economy of thegeneralised market’,53 yet without explaining what kind of resistance this might be,and on the other hand he presents depression as nothing more than a shadow of

perversion: ‘The depressed person is a subject that doesn’t get round to becoming perverse’, or rather, ‘The depressed person is a pervert that ignores himself’.54 Now




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what might it be, crypto-resistance or semi-perversion? Or is it both at the sametime? If so, what exactly do these two involve?55 We should turn to the phenomenon of depression itself to find a more precise answer to the question of

what it involves.

5. Dysphoria and dysrhythmiaDo we experience the ‘end of psychotherapy’, as the Flemish psychoanalyst

Paul Verhaeghe maintains in his homonymous book?56 For the moment this seemsto be a premature statement. Is psychiatry as one of the humanities, to use thewords of the Dutch psychiatrist Antoine Mooij, in danger to be elbowed out by thesame discipline in its medical shape?57 That already seems to be a fait accompli.Currently the dominating approach of mental disorders is one that desubjectifies the

subject, or deindividualizes the individual, by taking the sufferer as a kind of ‘black box’, displaying certain external features that count as symptoms, which are to becounteracted by giving medicine, administering electroshocks, inserting electrodes,or by applying other technological tools. And the ‘talking cure’?58 Still there is talk, but it seems to be a matter of minor importance, the start up and halting of atechnocratic mechanism. This far-reaching expropriation corresponds with the‘total mobilization’ of late modern globalizing capitalism. One is made loose, i.e. pliable and versatile, and this way made receptive to the vagaries of the globalmarket, as flex-worker and as trendfollowing consumer. And all this comes about,

paradoxically, under the guise of ‘self-realization’. The English sociologist NikolasRose, analysing this masquerade, uses therefore Foucaultian terms like ‘regime ofthe self’, ‘technologies of the self’ and ‘technologies of subjectification’. Theconcepts of autonomy, responsibility and self-fulfilment, says Rose, aredisciplining agents; they function as tools for the ‘conduct of conduct’. 59 In otherwords, the social control of behaviour occurs not in spite of but exactly viaindividual self-determination.60

What should be, within this context, the line of approach of psychiatry andother assistance? How can we get to the heart of the message which depression asexperience has to deliver? And in what way does this experience differ from theone that for ages was conceived as ‘melancholy’? Whatever happened to the latterexperience? What happened to the ambivalence of deep despondency? When wetry to get access to the phenomenon of depression, we should keep, I think, thetradition of ‘heroic melancholy’ at the back of our minds. Evaluating this traditionthe Kramerian way – which to my mind is, as I already stated above, the dominantview today – is a capital mistake. First of all because this tradition is a multiformone: there is no such thing as the tradition of melancholy. Secondly, the richness ofthis multiformity does not allow us to claim that we understand it completely; onthe contrary, there is much to be discovered, much to be interpreted and

reinterpreted. And thirdly, there is the real possibility that indeed melancholy attimes was ambivalent, that means partly positive, opportunity, disclosure. And,



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most importantly, perhaps depression today could be, at least sometimes, two-facedtoo. Taking this possibility into account does, however, not mean opting for areglorification of depression and melancholy. Antipsychiatric reversals of

normality and madness should be avoided. What we need to do is let the phenomenon speak for itself. What does it have to say? What does it have to tell ustoday? What does it report us about our position in these late modern times?

Depression is labelled as ‘mood disorder’, but what exactly is a ‘mood’?Traditionally, we take depression as an internal affective state, a state of disorder. Itis the opposite of freedom, Kramer says.61 And freedom then is understood asresilience, being motivated, showing initiative, having an enterprising spirit. Thesequalifications could be questioned. Does sanity mean above all possessing thosequalities? And is the way these traits are emphasized and exercised today free from

insanity? Are we, late modern subjects, perhaps too decisive, enterprising andversatile, and do we lack deliberation and consideration? And as for the otherdefinition, depression as an internal state of disorder: is that the most fundamentalinterpretation of this phenomenon? In my view it is not. To conclude this essay Ishall therefore briefly turn to the thought of the Belgian psychiatrist JacquesSchotte62, as an inspiring example of an alternative understanding of mood andthereby of mood disorder depression.

In his view on mood and pathology Schotte bases himself, among other texts, onthe famous study Classical and Christian Ideas of World Harmony. Prolegomena

to an Interpretation of the Word ‘Stimmung’ by Leo Spitzer.

63

The German word‘Stimmung’, mood, is close to ‘Abstimmung’, attunement, and this latter concept isthe starting point for Schotte’s reinterpretation of mood. Being in a mood means being tuned in one-way or another. It is not so much an internal state but a way ofrelating to or being in the world. It is an ac-cordance with the environment orambiance, and so the possibility of a dis-cordance. ‘Environment’ is understoodhere as the ancient Greek periechon64, which means something like ‘theencompassing-bearing’. It is not an extension of us; we take part in it, we participate. Sphere of the thymos, the ‘heart’, ‘breast’ or ‘soul’, in German: dasGemüt .65 A basic, primordial level, to which the term ‘relation’ does not apply; itconcerns an affective being-in-the-world before any subject-object opposition. Theaffectivity at stake here is a pathos in the original sense: ‘first passions of the soul,through which this soul starts to appear in the world, to the others, and via these toitself’.66 An attunement or distunement that takes place at a pre-intentional, pre-subjective, participative level, ‘a level of global psychic functioning to which evensuch terms as “object” and/or “subject” are inappropriate, because of their “face toface” dualistic-opposing nature’. A sphere, in other words, ‘of feeling or a unifiedsensing prior to any perception (which is always facing ob-jects)’. An aesthetic lifesphere, in the ancient Greek sense of aisthesis: feeling, sensation, Empfinden. 67

The being at issue here is not a subject yet but a pre-subject; a pré-moi participatif , a participating pre-ego: ‘Presubject feeling-itself moving and so living-




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itself dying, participating rhythmically in the coming-and-going of nature and oflife.’68 The basis that is found by this presubject is that of the movement of takingand being taken, holding and being held in the periechon, ‘with which he can find

himself more or less in a “Stimmung ”, that other word for “harmony”´.69

Correspondence that involves a continuous adjustment:

‘in a sort of reciprocal interiority of ‘self’ and a world constituted by others as well, who together with this ‘self’ (re)findthemselves already on their way in the coming-and-going and thegeneral anonymity of a primary participation’.70

It is se trouver in the double sense of the French word: be somewhere and find

oneself. Schotte refers here to a term Heidegger uses in Being and Time: Befindlichkeit , translated by the way by Stambaugh as ‘attunement’.71 Primordialsphere of contact, referred to with the word ‘rhythm’: in the mood acorrespondence is executed with the environment ‘according to the tone of asituation and according to the rhythm of an exchange which already on thiselementary-primordial “level” can realize themselves as harmonious or, on thecontrary, be analyzed as more or less disharmonious’.72 Correspondence that must be realized, so it involves as it were a ‘task’ that must be acquitted, and during thisdischarge problems might occur: the participation can be in dis-cordance, the

Stimmung can turn into a Verstimmung , a mood disturbance or dis-tunement.These mood disturbances are in Schotte’s eyes basic problems since they touchthe basis of human existence. ‘Pathoanalysis’ thus means investigating the humancondition through the prism of psychiatry, which means, first of all, gaining aninsight into the movement of human existence. Mood disorders should beconsidered as ‘moment of this movement’.73 The ‘feeling presubject’ has problemswith ‘participating productively-receptively in the global ambient coming-and-going of nature and life’.74 Schotte’s use of dense language is an attempt to findwords that do justice to this sphere of primordial interwovenness. ‘Environment’for instance suggests a separation that has not yet happened; inside/outside, passivity/activity, receptivity/productivity, be tuned/tune in, and so on, convergehere, in this dimension of the basic rhythmicity of life, of its primordial movementor emotivity. A presubjective, preintentional movement and involvement.Derangement of this arrangement means dysphoria or distunement, a disturbance ofthe productive-receptive, tuned participation in ‘the steadily ongoing gravitation oflife’75, or the ‘primordial dialectics of feeling and moving’76.

Being in tune or being untuned, that’s the question. Mood disturbances are thevia regia to the sources of human existence, says Schotte, and on that roaddepression is the king to follow. All specific symptoms of mood disorders relate to

the primordial, presubjective level, he writes, and this goes especially fordepression:



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‘weariness, heaviness and pressure, slackening of all functions ofresonance as well as exchange: of the “dialogue” with the

entourage or rather with the milieu, in the whole indivisibility oftheir vital, social and “personal” sense, at the basic prepersonallevel of all possible “personation”’.77

Inability to enjoy, or even worse, to be inter-es-ted, and along with that aheightened dependency with regard to the entourage in order to maintain aminimum of co-movement, which strengthens the tendency to ‘recover’ with thehelp of drugs.

Schotte opposes ‘pure, basic depression’ to melancholy.

78

The first according tohim is a simple and universal condition, the second a very complex and typicalWestern one. He even calls melancholy ‘the most complex – heterogeneous – stateof all, due to the additional contribution of psychotic moments or specific “ego-disturbances” on “top” of the neurotic ones already combined with the depressivenucleus’.79 Melancholy is Western because it is linked to the Western idea of personal responsibility and connected feelings of guilt.80 Depression by contrast, asthat ‘nucleus’, can be regarded as:

‘the structurally “simplest” and therefore properly basic type of psychiatric disturbance’, and therefore ‘as the most ubiquitouslyimportant one of the whole of psychiatry in the practice ofmedicine in general, and as having played therefore its frequent paradigm-role in the history of psychiatry’.81

The key distinction for Schotte with regard to depression is consequently notendogeneous/exogeneous or major/minor but simple/complex. Depression is presented as a third category, next to neurosis and psychosis, and severalcombinations of these two with depression are possible, leading to all sorts ofcompound pathological phenomena. A third category, but in fact, underlinesSchotte, it is the first82: it leads directly to the basic movement of life. Three maincharacteristics are pointed out by Schotte: anhormia, lack of drive or zest,anhedonia, lack of interest or pleasure, and arrhythmia, disturbance of the rhythmof life.83 There is a strong suggestion in Schotte’s text that this arhythmicity ordysrhythmicity is the root or the source of the other two. Schotte points in thatdirection when he writes about the temporal dimension as ‘the true primordialdimension of all living functioning’.84 And when he speaks of the primordialsphere of contact, referred to with the word ‘rhythm’: in the mood a

correspondence is executed with the environment ‘according to the tone of asituation and according to the rhythm of an exchange’.85 And the presubject he




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portrays pithily as follows: ‘Presubject feeling-itself moving and so living-itselfdying, participating rhythmically in the coming-and-going of nature and of life.’86 Could it be that our highly demanding, hyperdynamic late modern culture more and

more, and increasingly intense, brings about a disturbance of that basic ‘rhythm’?Is it in the end this primordial bond which is in dis-order? And does that disorderalso involve – in an indirect, concealed or dormant way – a rapprochement? Loss ofcontact, and so contact with what is lost. Failure, and thereby enduring what isfailing.

At the end of his text ‘Comme Dans la Vie, en Psychiatrie’ Schotte refers to theancient Greek poet Archilochos, quoting his famous line on the primal rhythm oflife: ‘Appreciate what rhythm holds men’.87 Could lending a phenomenological earto depression, like Schotte is suggesting, make us more appreciative here? I would

like to think so. It seems to me a necessary thought. It can bring us closer to ourreality. These ‘neo-liberal’ times give us the illusion of ultimate freedom, butactually involve a new, extreme kind of servitude. And within this constellationdepression asserts itself especially there where this servitude as such is makingitself felt .

Notes

1

It concerns roughly the last fourty years. The term ‘postmodernity’ is avoidedhere as much as possible, since it is an overloaded term, which furthermoresuggests that we have left or are leaving the stage of modernity behind. Oursituation, in my view, is rather that of an intensified modernity. We couldtherefore also speak of ‘hypermodernity’ or ‘ultramodernity’, both referring to aninherent excessiveness of late modernity. It exceeds its own bounds, and corrodes,implodes, disintegrates.

2 This song of underground pop icon Lou Reed would be sung by Susan as aspecial guest in an episode of the American version of the talent show, America’s

Got Talent . But Reed prevented it by refusing the usual permission for the performance. His resistance was not enduring: two months later he set himself upas a sort of co-director of the video clip of Boyle’s interpretation of the song.Does this story reveal something of our ambivalence regarding these kind ofmedia phenomena? Viewed 21 December 2011,http://www.guardian.co.uk/music/2010/nov/09/lou-reed-susan-boyle.

3 At its website the WHO indicates its present and future ranking of depression:‘Depression is the leading cause of disability as measured by YLDs and the 4thleading contributor to the global burden of disease (DALYs) in 2000. By the year

2020, depression is projected to reach 2nd place of the ranking of DALYs



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calculated for all ages, both sexes.’ Viewed 21 December 2011,http://www.who.int/mental health/management/depression/definition/en/.

4 Along with the closely related International Classification of Diseases and Related Health Problems, currently ICD-10, published by the WHO. DSM andICD differ at minor points, which are not relevant for the line of reasoning in thisessay. Both systems are symptom oriented guidelines and thus pave the way to anapproach that focuses on ‘the symptomatology of a patient’ instead of ‘the lifehistory of a person’. Alain Ehrenberg, La Fatigue d’Être Soi. Dépression etSociété (Paris: Édition Odile Jacob, 1998), 169.

5 The ancient Greek word melas means ‘black’, e.g. in melankholia, referring to thesubstance that for two millennia was considered to be the source of this

affliction: black bile. Cf Darian Leader’s recent book on mourning, melancholyand depression, The New Black (London: Hamish Hamilton, 2008).6 The Dutch word ‘pil’ has the double meaning of ‘pill’ and ‘tome’.7 Interview with Andrew Solomon in the PBS documentary Out of the Shadows,

Chapter 7: The Promise of Treatment ; viewed 21 December 2011,http://www.pbs.org/wgbh/takeonestep/depression/video-ch 07 html.

8 SSRI’s, Selective Serotonine Reuptake Inhibitors, affect the levels of serotoninein the brain. Serotonine is a neurotransmitter, a messenger of nerve signals in brain cells. Whether a certain degree of serotonine reuptake is a cause or an

effect of depression is an unresolved issue. Nicknaming serotonine ‘the happyhormone’ doesn’t help to clearify it.9 Peter D. Kramer, Listening to Prozac, 2nd ed. (London: Penguin, 1997), VII.10 Kramer, Listening to Prozac, 247.11 Peter D. Kramer, Against Depression (London: Penguin, 2005), 4. 12 Kramer, Against Depression, 31.13 Jennifer Radden, ed., The Nature of Melancholy. From Aristotle to Kristeva

(Oxford/New York: Oxford University Press, 2000), 57.14 Kramer, Against Depression, 14.15

Kramer, Against Depression, 188/189.16 Kramer, Against Depression, 214.17 Kramer, Against Depression, 292.18 Robert Burton, The Anatomy of Melancholy (New York: New York Review

Books, 2001), 97, 100, 104.19 Typifying this quality of ‘plain illness’ Kramer uses a term introduced by

Stephen Jay Gould: ‘spandrel’; depression is an evolutionairy accident, collateraldamage, without any ‘deep’ meaning. Kramer, Against Depression, 250.

20 Both techniques involve the insertion of electrodes into the brain, after which the brain itself resp the tenth cranial nerve is stimulated via the administration ofelectric impulses.




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21 Trudy Dehue, De Depressie-Epidemie. Over de Plicht het Lot in Eigen Handente Nemen (Amsterdam/Antwerpen: Augustus, 2008), 254.

22 Alan V. Horwitz and Jerome C. Wakefield, The Loss of Sadness. How PsychiatryTransformed Normal Sorrow into Depressive Disorder (Oxford/New York:Oxford University Press, 2007), 6.

23 Remarkable for instance, is their discussion of the execution of the Teenscreen program, which is developed to trace depressiveness and suicidality amongyoungsters at an early stage. The USA really seems to fight a ‘war on depression’,in which there is so much eagerness to beat the enemy that the tools ment for pre-screening more and more came to function as true diagnostic instruments.Horwitz and Wakefield, Loss of Sadness, 160.

24

See the end of note 4. Recently the book was translated into English : TheWeariness of the Self. Diagnosing the History of Depression in theContemporary Age (Montreal: McGill-Queen’s University Press, 2009). During alecture in Denmark Ehrenberg explained that in the English translation of theFrench title something essential is lost, namely the emphasis on the self as anactive state, a process or a task: the ‘becoming oneself’. A more suitabletranslation then would be ‘The weariness of self-realization’. Viewed 21December 2011, http://vimeo.com/16530794.

25 Ehrenberg, Fatigue d’Être Soi, 9.26

Lately Ehrenberg published a study in which the French context of mentaldisorders is compared with the American one: La Société du Malaise (Paris:Édition Odile Jacob, 2010).

27 Ehrenberg, Fatigue d’Être Soi, 10.28 Ehrenberg, Fatigue d’Être Soi, 203. Cf Ehrenberg, Société du Malaise, 215:

‘pills of performance’.29 Ehrenberg, Fatigue d’Être Soi, 189. Cf. Kramer’s definition of depression as

‘disorder of neuroprotection’ or ‘disorder of neuroresilience’. Kramer, Against Depression, 56. Cf. Nikolas Rose’s essay ‘Becoming Neurochemical Selves’, in

Biotechnology. Between Commerce and Civil Society, ed. Nico Stehr (Somerset:Transaction Publishers, 2004), p. 89-128.30 Horwitz and Wakefield, Loss of Sadness, 14.31 Ehrenberg, Fatigue d’Être Soi, 194.32 As I was adding the finishing touch to this essay I got the look at the most recent

work of Dufour that had just been published: L’Individu Qui Vient ... Après le Libéralisme. The individual hasn’t arrived yet, Dufour states right at the beginning of the book: ‘That our epoch is that of egoism, is certain; but that ofindividualism, not at all. For a good and simple reason: the individual has neverexisted yet.’ Dany-Robert Dufour, L’Individu Qui Vient ... Après le Libéralisme(Paris: Éditions Denoël, 2011), 11. Through a deepened analysis of earlier



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themes Dufour arrives, partly via Kant and the early Karl Marx, at a first answerto the question what could be the successor of the ‘isolist’ pseudo-individualism

of ‘total capitalism’: a true individualism that is named ‘sympathetic’, because itis receptive to the other. The book ends in an appendix that contains thirty‘emergency measures’ which should ‘create an environment that offers chancesfor everybody to fulfil himself as an individual’. Dufour, L’Individu Qui Vient ,359.

33 Dany-Robert Dufour, The Art of Shrinking Heads. On the New Servitude of the Liberated in the Age of Total Capitalism (Cambridge: Polity Press, 2008), 42.

34 Dany-Robert Dufour, ‘Dix Lignes d’Effondrement du Sujet Moderne. RelevésSismographiques’, in Les Maladies du Liberalisme. Cliniques Méditerranéennes.

Psychanalyse et Psychopathologie Freudiennes, ed. Serge Lesourd (RamonvilleSaint-Agne: Éditions érès, 2007), 104. See also Dufour, L’Individu Qui Vient , 39.35 Dufour uses the term ‘postmodern’ for covenience’s sake. Dufour, Art of

Shrinking Heads, 14.36 Dufour, Art of Shrinking Heads, 4-5.37 Dufour, Art of Shrinking Heads, p. 42. 38 Dufour, Art of Shrinking Heads, 12 (slightly altered translation). See also

hereafter, where Dufour typifies the world of total capitalism with one word: theadjective ‘Deleuzian’. Dufour, Art of Shrinking Heads, 92ff. See also note 40.

And see the following remark: ‘What Deleuze failed to see was that, far frommaking it possible to get beyond capitalism, his programma merely predicted itsfuture.’ Dufour, Art of Shrinking Heads, 11.

39 Title of one of Dufour’s studies: Le Divin Marché. La Révolution Culturelle Libérale (Paris: Éditions Denoël, 2007).

40 Dufour, Art of Shrinking Heads, 157. The power/desire opposition constructed bythe left was a mistake, says Dufour, it created blindness for the Sadean side ofcapitalism. Dany-Robert Dufour, La Cité Perverse. Libéralisme et Pornographie (Paris : Éditions Denoël, 2009), 271. Nikolas Rose makes a similar remark when

he states: ‘power and freedom are not antitheses’. Nikolas Rose, Inventing OurSelves. Psychology, Power and Personhood , 2nd ed. (Cambridge: CambridgeUniversity Press, 1998), 98.

41 Dufour, Cité Perverse, 113.42 Dufour, Cité Perverse, 56.43 Initially Mandeville was considered to be a heretic and was therefore nicknamed

Man Devil . The neutral, scientific adaptation of his thought by Smith made itacceptable and respectable. Dufour, Cité Perverse, 112, and Dufour, L‘IndividuQui Vient , 77

44 From The Wealth of Nations; Dufour, Cité Perverse, 9, and again 150.




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45 From Juliette; Dufour, Cité Perverse, 9, and again 150. At the end of L’IndividuQui Vient (see note 32), which aims for an individualism termed ‘sympathetic’ –

so the opposite of the Sadean, ‘isolist’ version of it –, Dufour presents thefollowing reversal of the ultraliberal reversal : ‘What I have received, I should beable to return.’ Dufour, L’Individu Qui Vient , 347.

46 Dufour, Cité Perverse, 172.47 Dufour, Cité Perverse, 11.48 ‘Sade leaves hell’, writes Dufour (Cité Perverse, 175). He was exiled to it being a

pernicious, perverse writer in the narrow sense of the latter word. The momentthe market was mortally wounded – by the world crisis – he is released, in orderto give global capitalism a new vital impuls. This, on the basis of the pursued

perverting (in the broad sense of the word) of the relation Amor Dei / Amor sui.49 Dufour, Cité Perverse, 178, 18050 Dufour, Cité Perverse, 322-32351 Dufour, Art of Shrinking Heads, 157.52 Dufour, Art of Shrinking Heads, 71.53 Dufour, Le Divin Marché, 325/326, and ‘Dix Lignes d’Effondrement du Sujet

Moderne’, 107.54 Dufour, Cité Perverse, 297.55 The same question applies to the statement by Horwitz and Wakefield on

possible ‘healing and reparative functions’ of normal sadness, that ‘are still notunderstood’. Horwitz and Wakefield, Loss of Sadness, 23.56 Paul Verhaeghe, Het einde van de psychotherapie (Amsterdam: De Bezige Bij,

2009).57 Antoine Mooij, De psychische realiteit. Psychiatrie als geesteswetenschap, 3d

revised ed. (Amsterdam: Boom, 2006). 58 Term used at the end of the nineteenth century by one of the patients of Joseph

Breuer, Bertha Pappenheim, alias Anna. O., to describe the new kind oftreatment, entirely based on words.

59

Rose, Inventing Our Selves, pp. 2, 78, 186 and 150ff. Cf his essay ‘Becoming Neurochemical Selves’. There he touches on Ehrenberg’s depression study,declares that ‘such a global cultural account is unconvincing’, but passes over theissue of the nature of depression as experience. Rose, ‘Becoming NeurochemicalSelves’ , 17. Cf Ehrenberg, Société du Malaise, 263.

60 We are all addicted, says Dufour, in the broadest sense of the term: ‘we haveturned into our very own tyrants, having become slaves of our desires-urges’(French: passions-pulsions); ‘we regain ourselves desubjectified, completelymoved to the side of the object’. Dufour, L‘Individu Qui Vient , 277.

61 Kramer, Against Depression, 14.



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62 Jacques Schotte (1928-2007) was a Belgian psychiatrist and psychoanalyst whowas acquainted with, among others, Leopold Szondi and Jacques Lacan. He was

chiefly active in Leuven and advocated a psychiatric approach that does justice tothe whole human being (‘antropopsychiatry’) and took the view that via pathology the sources of human existence could be unlocked (‘pathoanalysis’).

63 Leo Spitzer, Classical and Christian Ideas of World Harmony. Prolegomena toan Interpretation of the Word ‘Stimmung’ (Baltimore: John Hopkins Press, 1963).

64 Jacques Schotte, ‘Comme dans la Vie, en Psychiatrie… Les Perturbations del’Humeur comme Troubles de Base de l’Existence’, in Qu’ Est-ce que l’Homme? Philosophie/Psychanalyse. Hommage à Alphonse De Waelhens [1911-1981] (Brussels: Publications des Facultés Universitaires Saint-Louis, 1982), 648.

65

Schotte, ‘Comme dans la Vie’, 642.66 Schotte, ‘Comme dans la Vie’, 667.67 Jacques Schotte, ‘From Redefining Depressions to Reassessing “Nosology” inPresent-day Psychiatry. A Three-fold Post-script to the Papers of van Praag and vanden Hoofdakker’, in Biological Psychiatry. Marching Backwards into the Future,(Leuven: Leuven University Press, 1989), 74. Cf. Schotte, ‘Comme dans la Vie’,672. 68 Schotte, ‘Comme Dans la Vie’, 670, 665-666.69 Schotte, ‘Comme Dans la Vie’, 667.70

Schotte, ‘Comme Dans la Vie’, 668.71 Martin Heidegger, Being and Time, transl. Joan Stambaugh (Albany: State of New York Press, 1996, 126.72 Schotte, ‘Comme Dans la Vie’, 673, 623.73 Schotte, ‘Comme Dans la Vie’, 637.74 Schotte, ‘Comme Dans la Vie’, 637-638.75 Schotte, ‘From Redefining Depressions’, 72.76 Schotte, ‘Comme Dans la Vie’, 643.77 Schotte, ‘Comme Dans la Vie’, 669.78

Schotte, ‘From Redefining Depressions’, 78. 79 Schotte, ‘From Redefining Depressions’, 78.80 Schotte, ‘From Redefining Depressions’ 71.81 Schotte, ‘From Redefining Depressions’,79. Cf. Schotte, ‘Comme Dans la Vie’,

639.82 Schotte, ‘Comme Dans la Vie’, 637.83 Schotte, ‘From Redefining Depressions’, 72.84 Schotte, ‘Comme Dans la Vie’, 644. Here Schotte also links bon accord ,

attunement, to kairos, the right moment or good time.85

Schotte, ‘Comme Dans la Vie’, 673, 623.




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86 Schotte, ‘Comme Dans la Vie’, 665-666.87 Schotte, ‘Comme Dans la Vie’, 673.

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Boddé, Mike. Pil. Hoe een Cabaretier zijn Depressie Overwon. Amsterdam: Nijgh& Van Ditmar, 2010.

Burton, Robert. The Anatomy of Melancholy. New York: New York Review Books,2001.

Buuren, Maarten van. Kikker Gaat Fietsen! Of over het Leed dat Leven Heet. Rotterdam: Lemniscaat, 2008.

Dehue, Trudy. De Depressie-Epidemie. Over de Plicht het Lot in Eigen Handen te Nemen. Amsterdam/Antwerpen: Augustus, 2008.

Dufour, Dany-Robert. ‘Dix Lignes d’Effondrement du Sujet Moderne. RelevésSismographiques’. In Les Maladies du Liberalisme. Cliniques Méditerranéennes. Psychanalyse et Psychopathologie Freudiennes, edited by Serge Lesourd, 91-107.Ramonville Saint-Agne : Éditions érès, 2007.

–––, Le Divin Marché. La Révolution Culturelle Libérale. Paris: Éditions Denoël,2007.

–––, The Art of Shrinking Heads. On the New Servitude of the Liberated in the Ageof Total Capitalism. Cambridge: Polity Press, 2008.

–––, La Cité Perverse. Libéralisme et Pornographie. Paris: Éditions Denoël, 2009.

–––, L’Individu Qui Vient … Après Le Libéralisme. Paris: Éditions Denoël, 2011.

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Odile Jacob, 1998. –––, La Société du Malaise. Paris: Édition Odile Jacob, 2010.

Heidegger, Martin. Being and Time. Translated by Joan Stambaugh. Albany: State of New York Press, 1996.

Horwitz, Alan V., and Jerome C. Wakefield, The Loss of Sadness. How PsychiatryTransformed Normal Sorrow into Depressive Disorder . Oxford/New York: OxfordUniversity Press, 2007.

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ed. London: Penguin, 1997.



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–––, Against Depression. London: Penguin, 2005.

Kuiper, P.C.Ver Heen. Verslag van een Depressie

. Den Haag: SDU, 1988.Leader, Darian. The New Black. Mourning, Melancholia and Depression. London:Hamish Hamilton, 2008.

Radden, Jennifer, ed. The Nature of Melancholy. From Aristotle to Kristeva.Oxford/New York: Oxford University Press, 2000.

Rose, Nikolas. Inventing our Selves. Psychology, Power and Personhood , 2nd ed.Cambridge: Cambridge University Press, 1998.

–––, ‘Becoming Neurochemical Selves’. In Biotechnology. Between Commerce andCivil Society, edited by Nico Stehr, 89-128. Somerset: Transaction Publishers,2004.

Schotte, Jacques. ‘Comme dans la Vie, en Psychiatrie… Les Perturbations del’Humeur comme Troubles de Base de l’Existence’. In Qu’ Est-ce que l’Homme? Philosophie/Psychanalyse. Hommage à Alphonse De Waelhens [1911-1981], 621-673. Brussels: Publications des Facultés Universitaires Saint-Louis, 1982.

–––, ‘From Redefining Depressions to Reassessing “Nosology” in Present-dayPsychiatry. A Three-fold Post-script to the Papers of van Praag and van denHoofdakker’. In Biological Psychiatry. Marching Backwards into the Future,edited by Hugo de Cuyper and Gerard Buyse, 63-110. Leuven: Leuven UniversityPress, 1989.

Solomon, Andrew. The Noonday Demon. An Anatomy of Depression. London:Vintage, 2002.

Spitzer, Leo. Classical and Christian Ideas of World Harmony. Prolegomena to an Interpretation of the Word ‘Stimmung’ . Baltimore: John Hopkins Press, 1963.

Styron, William. Darkness Visible: A Memoir of Madness. London: Vintage, 1992.Wurtzel, Elizabeth. Prozac Nation. Young and Depressed in America. Boston:Houghton Mifflin, 1994.

Bert van den Bergh is senior lecturer and researcher at The Hague Universityand Erasmus University Rotterdam in The Netherlands.

e-mail: [email protected]

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