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Freud and his followers--who until the past few decades dominated psychological thinking about depression in the twentieth century, have viewed depression simply as a result of loss. "Melancholy is in some way related to an unconscious loss of a love object, in contra distinction to mourning, in which there is nothing unconscious about the loss.... In grief the world becomes poor and empty; in melancholia it is the ego itself that becomes poor and empty" (l9l7-l925, p. l55). Freud arrived at this idea because he observed great similarity between the depression of people grieving after a death, and other depressives. But the idea of loss by itself is not useful as the central concept in understanding depression. Unless one employs a tortured logic, the notion of loss does not fit the psychological states of many depressives. For example, being convinced that one is of low moral character can feed one's depression, but it is not a loss in any meaningful sense; the person probably does not think of him/herself as ever having had the high level of morality that is the benchmark for the negative self-comparison. A Freudian may find a way to define this comparison as a loss, but such reasoning only confuses the issue.
The psychoanalysts then joined the Freudian notion of loss to the observed fact that people whose parents die, desert them, or cut them off emotionally in childhood, have a higher likelihood of adult depression than do other people. This observation was then combined with a medical approach to depression as an ailment that should be treated by dealing with the root cause of the childhood loss. This view of depression and its cure are diagrammed in Figure l. In this scheme, both the sadness and the negative self- comparisons are seen as symptoms of the underlying causes.
Figure 1
The medical view of depression has at least two crucial drawbacks: (l) the therapy based upon it does not have a good record of success in curing depression; and (2) even where it is successful, such therapy is enormously costly in time and money.
A very different view of depression--whose roots may be found in the emphasis on self-esteem by William James, who now is finally being recognized as the greatest of all psychologists, and a better student of human nature than Freud--is in the spirit of what is commonly called "cognitive psychotherapy". Cognitive psychotherapy, which by now is perhaps the dominant position in contemporary psychology, views the person's present thinking as in the middle of the chain of causality running from the person's childhood and present events at the input end to the sadness at the output end, as seen in Figure 2. The "irrational thinking" which both Albert Ellis and Aaron Beck emphasize as the cause of depression is consistent with this point of view.
Figure 2
At the foundation of the cognitive point of view is the age-old commonsense idea that each of us has at least some power to decide what we will spend our moments thinking about, and which other persons, events and ideas we will attend to. This is in sharp contrast with the psychoanalytic view, which considers our thoughts to be mainly determined by our personal history and present external events. Of course the difference between these two points of view is a matter of emphasis, but the emphasis is all- important in deciding how to tackle a case of depression.
The cognitive view holds that we can use their minds to deal with our inner problems just as we deal with our outer problems. For example, we assume that an ordinary person can say to himself or herself, "Now I'm going to stop watching television and start doing my income-tax return," and then the person can carry out that decision. Similar, the cognitive view is that you can say to yourself "Every time a customer makes me feel that I haven't done a good job, which usually puts me into a blue funk, I will remind myself how many of my customers appreciate me". Another example: In the cognitive approach, an excellent 40-year-old tennis player learns the habit of remembering, after a bad day on the courts, that he can beat 99% of the 20-year-old players, and also remembering how many people are not even physically fit to play tennis at all at age 40.
Self-Comparisons Analysis, as I call this point of view, is consistent with the cognitive view of human psychology that one can banish depression by changing the depressive's present mode of thinking. But the Mood Ratio is more precise in its identification of the depression mechanism than simply referring to "irrational thinking" or "negative thoughts" or "poor cognition". This formulation offers several avenues for fighting depression--by altering the numerator, or the denominator, or the dimension of evaluation, or the frequency of any evaluations, rather than focusing only on the numerator (and perhaps on the denominator), as do cognitive therapists. Furthermore, Self-Comparisons Analysis opens up a wholly new way of combating depressions that resist other approaches--Values Therapy.
Why Do Some People Have A Tendency To Get Depressed?
Unflattering self-comparisons come into everyone's mind from time to time. And everyone occasionally feels helpless. But some people--chronic depressives--continually make negative self-comparisons. Their prevailing mood therefore is sadness, and a sense of worthlessness accompanies the sadness even if the negative self-comparison apparently has nothing to do with the person's own worth--say, the loss of a beloved mate. Other depressives suffer from intermittent bouts of negative self-comparisons, either cyclically or irregularly. Both types of depressives have a special propensity to make negative self-comparisons.
How and why do some people get into the habit of making negative self-comparisons whereas other people do not? Among the possible influences are early separation of a child from a parent, especially by the parent's death; cold, unloving, or untrustworthy parents; genetic-chemical biological inheritance; overly-ambitious professional or moral aspirations; a series of experiences of failure and rejection in childhood or adulthood; and major personal or professional shocks in adulthood. It is usually a combination of influences that make any given person a depressive.
The depression sufferer wants to know: How can I, alone or with a counselor, alter these elements or their effects so as to produce fewer negative self-comparisons and hence less sadness, and thereby pull me out of depression?
The basic causes of the depression certainly are not irrelevant. And for any particular person it may prove reasonable or necessary to go back to the basic causes as part of curing the depression--or it may not be necessary or reasonable to do so. For now, let us focus on the fact that no matter what the basic cause is, there must be negative self-comparisons and a sense of helplessness or there will be no depression. To say the same thing positively: Eliminate the negative self-comparisons and/or the sense of helplessness, and you eliminate the depression, no matter what does or does not happen with the basic causes.
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