Weariness of the Self


The individual is subjected to a feeling of insufficiency. The second solution eliminates the notion of personality and of the clinical skill of the psychiatrist for diagnosis, thanks to the use of a model of syndromic cutting up: That is, to get rid of the question: The technical means consisted of the elaboration of standardized diagnosis criteria, which described the symptoms clearly, and thus could be accurate guides for the diagnosis of depression. This is the famous DSM, the Diagnosis and Statistical Manual for Mental Disorders, the third version of which was elaborated by American psychiatry during the seventies and published in The medical aspect was intended to treat a patient who no longer needed to tackle his conflicts to be treated pharmacologically.

Its decline has been facilitated by a new question: This question was also engendered by the growing diversity of antidepressants after , when new molecules which were less toxic and easier to handle for general practitioners were launched. The figures of conflicts declined to the benefit of figures which pose deficit or insufficiency as the problem, and well-being as a the solution. In the medical version , the insufficient individual is no longer the principal agent of his healing; he is reduced to the proper status of patient, the status of immediate agent of his illness.

This transformation of the notion of depression occurred in a context of normative and value changes, which became obvious during the sixties.

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Traditional rules of framing individual behaviors were no longer accepted, and the right to choose the life one wanted to live started entering mores. Following a substantial amelioration of material conditions in Europe and in the US, there were simultaneously new opportunities for social mobility for the working class and a new attention to oneself promoted everywhere in society and which is now our commonsense.

The perception of intimacy was changing: Hence, of course, new hopes, but also new worries.

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This period was characterized by a dynamic whose two facets were: In the foreground, the emancipation of mores was taking off. Rieff, The Triumph of Therapeutic. In the background, numerous psychoanalysts and psychotherapists worried about narcissistic-type mental pathologies which seemed much more numerous than before. Their patients were dominated by personal insecurity and feelings of having lost their self-esteem. It seems it is less desire which was at stake, than a need for being, expressing itself through permanent insecurity.

The new typical patient no longer seemed to be neurotic. Actually, this decline of neurosis was widely discussed, notably in France: But today, the issue of narcissism is clearly a strong preoccupation among psychoanalysts who deem that most patients are subjected to such neurosis. Parallel to this increasing preoccupation with depression, was a parallel increase preoccupation with addiction.

Clinicians emphasized the auto-therapeutic use of drugs or addictive behaviors. Addictive intake seemed to be the other side of the depressive void. Instead of having symptoms, the patient attenuates conflicts through compulsive behaviors addiction and impulsive behaviors, with violent or suicidal acting out. To summarize , the decline of reference to neurosis overlaps with the decline of a form of a social life, which used to express itself in terms of subjection to discipline and of supposedly cut and dry conflicts. Depression, whose main trait is the loss of self-esteem, can be considered as a pathology of greatness: Then, depression is part of the democratization of the exceptional, of this quest to be only oneself, which is the primary vector of the redefinition of contemporary individuality.

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If personal choice is the first vector, the second one is the rise of personal initiative norms and values, which has developed since circa, notably in the workplace. At the same time, psychiatrists were giving more and more credence to the idea that the fundamental disorder of depression was inhibition, which has become the cardinal concept of depression.

It is in this context that a new class of medicines was launched on the market: ISSR, of which Prozac is the first kind. In raising hopes of getting over any type of psychic suffering, whether one is sick or not, the new class of antidepressants personifies, rightly or wrongly, the unlimited possibility of manufacturing ones own mind without the dangers of illegal drugs.

In a pill-taking society, no one would be able to distinguish between therapeutic goals and performing goals. During the sixties, psychiatrists used to say that recovery was quite certain. There is no mystery here, because it is the definition of depression itself that has been enlarged: The notion of dysthymia, which designates this type of depression, has replaced the notion of neurosis, and is treatable with antidepressants. The antidepressant has become a medicine for neurosis. The quality of life with comfortable and harmless medicines has replaced the idea of recovery, whatever was that idea.

The mastering of the human mind is not going to happen anytime soon. Second remark, Prozac and all similar antidepressants are part of a general shift in the field of medicine which is no longer only a medicine of disease, but also a medicine of health and a medicine of enhancement, as more and more illnesses are becoming chronic. But the case of psychotropic drugs addresses moral issues in Western society, because it is the mind which is at stake, that is, what western societies consider to be the essence of human.

Too many sociologists or philosophers, when they talk about topics such as mental health, psychotropic drugs, psychotherapies, depression, psychic suffering, etc. If the use of these notions is descriptive, it is of course true, because there is more psychiatry, more psychology, etc. It is true, but pointless. In fact, they are used in a normative meaning.

This is wrong, because these claims mean genuine society is what used to be. And this transformation is related to the values of autonomy, values for which the question of personal responsibility is a major issue.

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Is Autonomy a weakening of social links or a transformation of the spirit of action? The issue we are confronting is not a psychologization of social life resulting from a weakening of social links, but a general redefinition of the concept of illness, of the relationship between the normal and the pathological according to the current supreme value of individual autonomy.

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This is why the topic of disability is a major issue in psychiatry today: In the new world of mental health, health and sociality are intertwined. The transformation of the relationship between the normal and the pathological has accompanied the subsuming of the values of discipline by the values of autonomy, which now permeates the whole of social life.

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This means everyone is supposed to decide and act in every sphere of life as the actor of … his own work, his own education, his own health, his own illness, etc. There has been a change in the hierarchy of values: Mechanical obedience is embedded by and subordinated by autonomous obedience. Drawing on the accumulated knowledge of a lifetime devoted to the study of the individual in modern democratic society, Ehrenberg shows that the phenomenon of modern depression is not a construction of the pharmaceutical industry but a pathology arising from inadequacy in a social context where success is attributed to, and expected of, the autonomous individual.

In so doing, he provides both a novel and convincing description of the illness that clarifies the intertwining relationship between its diagnostic history and changes in social norms and values. The Meaning of Madness, second edition. Recovery of People with Mental Illness: Philosophical and Related Perspectives. Handbook of Music and Emotion. The Vicarious Brain, Creator of Worlds. The Oxford Handbook of Philosophy and Psychiatry. Reflections on the Musical Mind. Philosophy's Role in Counseling and Psychotherapy. Psychiatry and the Business of Madness.

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During that period, depression was generally considered not as a clinical entity, but as a crossroads entity that one could find both in neurosis and psychosis, which were considered genuine pathologies. And as Young emphasizes, the comparative aspect of the work, stressing the very different sources and meanings surrounding how depression is understood in each culture provide Anglophone readers with an opportunity to discern what otherwise might go unnoticed — their "taken-for-granted beliefs about the normal and the pathological" Young xii. Lena rated it really liked it Apr 04, This period was characterized by a dynamic whose two facets were: It is a summary of what was, how it came to be, and where we are at today. The weariness of the self: Rebecca rated it really liked it Apr 26,

Psychiatry and Philosophy of Science. The Deja Vu Experience. The Psychology of Good and Evil.

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The End of Normal. The Quantitative Analysis of Social Representations. As A Man Thinketh.

Essays on Neuroscience and Political Theory. The case is built through an in-depth look at treatment responses, first electroconvulsive therapy, followed by imipramine and its companions, and finally the SSRIs. The thesis involves a transformation, in his words, of the meaning of depression, prompted in part by changes in the goal, and effects, of anti-depressant medicine. Stimulants to action replaced the older idea of a cure for pathology. Broader cultural shifts and traditions are also invoked to explain these changes.

At the turn of the twentieth century, the depressed self was one of inner conflicts giving rise to depressive suffering; by the turn of the twenty-first century, with unbounded freedom of action "end-of-the-century individuality" had produced a sovereign self, who "believes herself the author of her own life. The pathologies of the individual had come to involve "the responsibility of a person who has freed herself from And depression is a "state of mind inherent to individualism" Preface page xiv.

This brief sketch does not do justice to all the strands of Ehrenberg's substantive thesis, but should suffice to introduce his positive claims and the flavor of the writing - for which a warning is in order. To the Anglophone reader these claims are at times bothersome in their vagueness and generality. They are unconstrained by any hint of phenomenological support, let alone research data, for example, and give little attention to questions of definition or conceptual clarification, even with terms as loose as 'self. This indefinability in turn gives rise to a paradox: Nonetheless, given its centrality, allowing 'depression' as what patients claim, psychiatrists diagnose, and anti-depressants treat, leaves the reader in uncomfortable waters.

At times the writing also takes on the turgid style that is anathema to analytic approaches. Consider, for example, the following randomly chosen passage from the conclusion: The major fact of individuality during the second half of the twentieth century was the confrontation between the notion of limitless possibility and the notion of the uncontrolled.

The rise of depression set off the tensions produced by this confrontation, as the realm of the permitted crumbled before the onslaught of the possible.