“I’m depressed,” my patient said, settling into her chair with a big sigh and schlomping her bag down on the floor. Strange, because she smiled and said this in a social way, as though her favourite contestant had been voted off Strictly, rather than in any way that suggested chronic anxiety or immobile despair. “No, not depressed,” she corrected herself. “Sad.”
Ah, sad. Sad is great. Sad is a huge achievement. In Mourning and Melancholia, Freud talks about turning depression (melancholia) into ordinary sadness, and he outlines the differences (at some length). It can be a long and tortuous process (the transformation, not reading Freud) and at the end of it we’re still sad. This is a source of enormous disappointment to many, if not all, patients.
We go into therapy in the hope of ending up happy and content, our relationships sorted (please), finances in order (ha!), future rosy (yuh…). It can be fantastically irritating when, after years of working through, all the loss and thwarted desire is still there. There, but at last understood.
Staring at the ceiling on my own analyst’s couch, I remember saying: “I just want you to make it all okay.” Somehow this quiet intellectual man, after many years of training and his own long analysis, was supposed to resurrect my murdered father, pay my mortgage, find me a fulfilling career and a caring boyfriend and make my chaotic past bearable. I think he may actually have laughed at my request (a great rarity in the analytic setting—jollity is usually pretty thin on the ground).
Anyway, it is strange to find myself so often now on the receiving end of these requests. “How do I get over it?” “How can I stop thinking about it?” “I just want to be happy.” I’m tempted to say, “You can’t,” “You won’t,” “It’s impossible,” all of which are true, but I suppose it is a tiny bit more complicated than that.
Because, of course, there is a vast difference between feeling persecuted by loss or trauma and incorporating it into your life as processed and bearable. A difference between turning something over and over in your mind like a kind of torture and thinking clearly about something. A difference between being depressed, confused, fragmented and being sad about something that has happened, but knowing what it is and how you feel.
Sometimes these differences seem small. These days I am jolted awake by a screaming nightmare, sweating and breathless, my feet hurting (“Perhaps you clench them?” my analyst once suggested) about once a fortnight or less. Before analysis it was every night, that’s if I slept at all. Not only that, but I now understand the origins of my nightmares. I get it—my feelings of chronic nocturnal unsafety obviously plague me at night.
So, this patient’s correction from depressed to sad (and it took me about a year to persuade her that she was depressed in the first place—she just presented a bad husband and wanted me to provide the tools to leave… “Oh, no problem. I have them right here under my chair…”) was actually one of these tectonic shifts that so pleasingly occur in therapy. Gradual and imperceptible as they happen, but actually a fundamental transformation.
Depression is a chronic reaction to a past that is often unknown to the conscious mind, but sadness is a reaction in the present to sad stuff. The difference between “I can’t stop crying and I don’t know why” and “My dog died so I am sad.” Therapy can’t protect us from life, but it can help us cope with it. That, annoyingly, really is as good as it gets.
Ah, sad. Sad is great. Sad is a huge achievement. In Mourning and Melancholia, Freud talks about turning depression (melancholia) into ordinary sadness, and he outlines the differences (at some length). It can be a long and tortuous process (the transformation, not reading Freud) and at the end of it we’re still sad. This is a source of enormous disappointment to many, if not all, patients.
We go into therapy in the hope of ending up happy and content, our relationships sorted (please), finances in order (ha!), future rosy (yuh…). It can be fantastically irritating when, after years of working through, all the loss and thwarted desire is still there. There, but at last understood.
Staring at the ceiling on my own analyst’s couch, I remember saying: “I just want you to make it all okay.” Somehow this quiet intellectual man, after many years of training and his own long analysis, was supposed to resurrect my murdered father, pay my mortgage, find me a fulfilling career and a caring boyfriend and make my chaotic past bearable. I think he may actually have laughed at my request (a great rarity in the analytic setting—jollity is usually pretty thin on the ground).
Anyway, it is strange to find myself so often now on the receiving end of these requests. “How do I get over it?” “How can I stop thinking about it?” “I just want to be happy.” I’m tempted to say, “You can’t,” “You won’t,” “It’s impossible,” all of which are true, but I suppose it is a tiny bit more complicated than that.
Because, of course, there is a vast difference between feeling persecuted by loss or trauma and incorporating it into your life as processed and bearable. A difference between turning something over and over in your mind like a kind of torture and thinking clearly about something. A difference between being depressed, confused, fragmented and being sad about something that has happened, but knowing what it is and how you feel.
Sometimes these differences seem small. These days I am jolted awake by a screaming nightmare, sweating and breathless, my feet hurting (“Perhaps you clench them?” my analyst once suggested) about once a fortnight or less. Before analysis it was every night, that’s if I slept at all. Not only that, but I now understand the origins of my nightmares. I get it—my feelings of chronic nocturnal unsafety obviously plague me at night.
So, this patient’s correction from depressed to sad (and it took me about a year to persuade her that she was depressed in the first place—she just presented a bad husband and wanted me to provide the tools to leave… “Oh, no problem. I have them right here under my chair…”) was actually one of these tectonic shifts that so pleasingly occur in therapy. Gradual and imperceptible as they happen, but actually a fundamental transformation.
Depression is a chronic reaction to a past that is often unknown to the conscious mind, but sadness is a reaction in the present to sad stuff. The difference between “I can’t stop crying and I don’t know why” and “My dog died so I am sad.” Therapy can’t protect us from life, but it can help us cope with it. That, annoyingly, really is as good as it gets.
