J. Edward Goldman, MFT

03 October 2012

Depression is Powerlessness

I work with depression on a daily basis as a psychotherapist and have several years of experience in effectively treating it. I’ve also extensively studied it from a number of perspectives within psychology, psychiatry, philosophy, biology, and several other disciplines. Despite my changing interests and influences throughout the years, I always return to the following theme as both a psychotherapist and as a person: Depression is Powerlessness. Let me explain…

Depression is a belief in one’s powerlessness, a feeling of one’s powerlessness, a realistic perception of actual powerlessness that exists within the systems in which we inhabit in society, and it is a kind of overall experience existentially of the ultimate lack of control that we have as human beings over our own mortality, over the lack of an ultimate meaning bestowed upon our existence, of our aloneness in grappling with these realities, and of the freedom from which we cannot escape–the freedom to choose or not to choose, to do or not to do, to respond or to shrink away from the responsibility we have to ourselves to live our very own lives. In this sense, I absolutely believe that depression is best understood as as form of powerlessness, whether it is perceived or actual, or most often some combination thereof.

Depression involves many other things and is rich in its biopsychosocial layers: it does involve a neurotransmitter “imbalance” of some sort in the brain, presuming there is some kind of balance to begin with; it does involve distorted, exaggerated, and maladaptive thoughts, thought processes, and cognitions; and it is most certainly a product of the myriad social problems that we face as Americans and as global citizens in an industrialized and digital world. Nevertheless, the fact remains: depression is not reducible to any one of these aspects, and is actually experienced as something closer to hopelessness, helplessness, and powerlessness. Much research has demonstrated the importance of thoughts and feelings of hopelessness and helplessness in depression and in causing depression, and it would be foolish to deny the significance of these factors.

My contention, however, is that hopelessness or helplessness or any number of negative thoughts and feelings are actually themselves expressions of the primary human phenomena of powerlessness on the one hand, and of power on the other. Powerlessness, according to my theory, is the terminal point of that over which we have no control as human beings, most easily exemplified through death. Power, on the other hand, is the terminal point of that over which we do have control as human beings, although only so much control (that is, no absolute or ultimate control given the inescapability of our mortality). Power is most easily exemplified by activities that promote life at the very least and aim for human immortality at their greatest extreme.

To be sure, both powerlessness and power can either be good or bad, depending on the person, the circumstances, and many variables. That is not really what we are interested in–not their moral or ethical import, but their psychological significance. Powerlessness and power are both beyond good and evil and also, in a sense, explain the origin of “good” and “evil” in human behavior (which I will explain elsewhere! No time for that here…). Depression is a form of powerlessness in that it is ultimately oriented towards death, human mortality, and everything beyond our control. If we imagine, for example, the most extreme case of depression that we could encounter in practice or in theory, we would almost certainly see this person’s depression and the symptoms of their depression result in the person’s actual death, given that there would be such a great degree of inactivity and problems in functioning that the person could not survive, assuming that this hypothetical person could not wholly depend upon others for their survival. Why is this significant? Well, my point is that this cannot be merely a by-product of depression, symptom, or side-effect, but rather it is related to the nature of depression itself. Because depression is powerlessness and the ultimate expression of human powerlessness is death. That is what I’m postulating.

Nevertheless, as with all psychological phenomenon according to my theory, depression as powerlessness is often compensated for or balanced out by ineffective attempts at the depressed person seeking out power in their life. For example, the depressed person stays in bed and refuses to function in work, family, or relationships as some form of power or protest against unbearable realities of their existence; or the depressed person abuses drugs, alcohol, sex, food, internet, etc. as a way of attempting to gain control and power over that which they ultimately have no control in their life (i.e., whatever is existentially fueling their depression at bottom). Therefore, depression is powerlessness, but is certainly not only powerlessness. It is also an attempt at power, and a kind of dialectic between powerlessness and power–a relative balancing or counterbalancing of the two.

That is essentially my theory of depression and my philosophy underlying the way in which I treat depressed clients. This theory informs my approach to working with all aspects of depression, from the smallest to the largest. Particular clients will respond to specific modalities of treatment and what approach is best really depends upon the specific needs of a given client. Nevertheless, I find it impossible to effectively treat depression without this theory guiding me through the client’s unique experiences, symptoms, and reality. Along with my ABCDE, 5-Step Process of psychotherapy, this theory is the key to my success in helping people overcome oftentimes crippling depression that destroys and eats away at their lives. I have been very successful in treating depressed clients with diverse backgrounds and circumstances throughout my career. I know that it has much to do with both my person as a therapist, my life experiences, as well as with the way in which in conceptualize the phenomenon of depression in general. No one else has understood or articulated depression in quite the way that I have, though many have of course influenced me. I am indebted and grateful to those thinkers. Many have made just as noble of attempts to express just what exactly is this silent killer of a psychological phenomenon that has affected so many of us, so many of our loved ones, and countless individuals throughout human history.

Notice that I don’t use the words “disease”, “disorder”, or “mental disorder” to describe depression. That is intentional: I believe that depression is not exactly that–that that description is unfair on many levels, and that the depression that we experience is so much more than that. I am a psychotherapist, and though I obviously believe that there are clinically significant levels of depression that must be treated (in some cases whether the client is willing or not, as in suicidality), it is not my job to suggest or to assume that depression is purely a medical or biological phenomenon, or that depressed clients should be treated through medication. Indeed, medication helps many clients function at much higher levels than they did before medication. And many clients could barely function at all without it. Nevertheless, I am interested in the deeper psychological, existential, and multicultural reality of depression. This is what my theory provides. Depression is powerlessness, in short. And powerlessness is rich. And multifaceted. It is as varied and interesting as each and every person that walks into the door of my office, I must say.

Treating depression through psychotherapy is like fighting for a person’s life. It literally is a fighting-for and empowering of a client to live as best as they can in my view, with the fear and possibility of death looming in the background. It needn’t be so. Life doesn’t have to be lived like that. There is another way. And your life is absolutely a life worth fighting for! So if you are a person suffering from depression out there, or you think/feel that you might be, please contact me. I can tell you so much more. And I have a unique, specific therapeutic process to help you. It is my own: an integrative of all the best knowledge I’ve encountered in my education, experience, and practice.

Your depression can be helped. You can be helped. And you deserve it. Let’s leave the “disease” and “disorder” to the psychiatrists, doctors, and nurses. It usually doesn’t befit us. We are all so much more than that. We’re human. And you and I can figure out together how to overcome your powerlessness and how to achieve some real power, happiness, and freedom in this precious life of yours. Thanks for reading.