Noonday Demon: An Atlas of Depression (Book Review)
Author: Solomon, Andrew
Reviewed By: Harold J. Fine, Vol XXVII, No. 4, pp. 47-48
Assailing the Seasons: An Encyclopedia of Depression.
Miniver Cheevy, child of scorn
Grew lean as he assailed the seasons
He wept that he was ever born
And he had reason
Edward Arlington Robinson
The media response to this book seems to extend beyond the usual hype. Solomon, a graduate of Yale and Cambridge is an author, novelist, a contributor to the New York Times, the New Yorker, and other journals. He is a critic and writer with a penchant for psychological and psychoanalytic themes. In one week it has leaped from 14 to 9 in the New York Times best seller list. The reviewers have come from the intellectual, literary, journalist and mental health communities. Is it Solomon's circle encompassing the New York celebrity/fashion/ cultural/entertainment complex that may make or break ideas and enterprises? Perhaps this is true, but only partially so.
This book is an exhaustive report about depression and its treatments. Solomon has presented a potpourri of phenomena that besets all of us whether in denial or consumed by melancholia and depression .His approval of treatments chemical, medical, talking, etc., is also bewildering. Surgical procedures are a pragmatic ally for Solomon and receive his approbation even though there are mild caveats. There is a retinue of case studies with diverse outcomes, be it friends, lovers and strangers who are afflicted and in the throes of depression or bipolar episodes.
Solomon's faith in the new breed of psycho-pharmacologists mixing cocktails of medications is surprising. These doctors are always optimistic and cheerful with their uplifting spirit as they mix their formulae like reborn homeopaths or like sophisticated alchemists searching for gold or the philosopher's stone.
A culture's way of dealing with noonday demons is deftly expressed from the genocidal fields of Cambodia by survivors of the Khmer Rouge to the African ritual of "dneup" and the frozen wastes of Greenland. In Greenland the benign Danish colonialism has provided a universal health care system with a psychiatric delivery system dealing with seasonal depressive epidemics and other support systems. Solomon has traveled to these places as well as the former Soviet Union and post communist Russia as a friend of jailed dissidents as well as Russian migrants to the USA and their immersion to America. Some of these migrants never adapt and feel compelled to return to a bizarre new Russia as their psyches have left them deeply scarred.
I have come to this volume as a clinician with 40 years experience of teaching, practicing and publishing. There is a consistent theme of early experience that "comes back" in later childhood, adolescence and adulthood at one or all stages of this depressive sequalae. That is pervasive feelings of loss and abandonment as a thundercloud ominously hanging over one's head like a character in the L'il Abner comic strip. It is more clearly discerned in the death of a parent, particularly sudden death. This is a deep narcissistic wound that may lead to worry a fear of abandonment and loss again and again throughout the life span. This could result in neurotic styles of obsessive states that contain or over flow into anxiety states and depression that become a holding environment or make more florid the rage and keening despair of loss all over again. Loss and melancholia is handled in many ways.
In Christian theology and its central theme of the crucifixion of Christ and the mourning and grief of His early followers was deep at this loss and abandonment. This was not only worked through the Resurrection but earlier group grief lead to imaging the departed and the waxing of imagination to a great story and dneup like rituals.
Another missing element not in Solomon's book in our culture is when denial is used extensively by individuals as a massive defense against a reality. It can be covered up go by a veneer of profound optimism of "don’t worry it will be okay." With an individual profoundly wounded it is of little use to hear this alien chatter.
Denial is a form of defective or incomplete repression in the selfhood going through the incorporation-introjection-indentification phases of development where denial is a major coping style. The work of Seligman about optimism has in effect become a school in psychology in the American grain trying to absent dysphoria in the human being via denial.
On page 62 in this book Solomon mentions only in passing a possible major issue in the understanding of the origins and treatment of the demon:
Traditionally; a fine line has been drawn between the endogenous and reactive models of depression, the endogenous starting at random from within, while the reactive is an extreme response to a sad situation. The same change has happened in the in the study of depression and affect disorders. The distinction has fallen apart in the last decade....
Oh what a truth! It is similar to what has happened in research in schizophrenia .I am referring to the research in the 50s and 60s where process and reactive schizophrenia distinguished that process as a genetic entity and reactive as a developmental one. Some schizophrenias were mixed. Studies suggested that 85% of the reactives would recover while the process had a significantly lower chance of remission regardless of modality of intervention.
The fashions and reality of genetics, DNA, and the behavioral cognitive treatment and the politics of mental health has suppressed this research and dynamic therapies toward an obscurity and a lack of feasibility by the economics of scale and the re-medicalisation of psychiatry.
One feels compelled again to offer yet another view of depression. It is based on a neo-Kleinian view. Klein has written about the schizoid-paranoid and depressive positions. Fine has extended the depressive position of Klein as a moral position and the previous ones as pre-moral. The depressive position is universal and is the engine along with elements of the the pre moral states as fundamental processes of character and personality. It is this later position introjected in a destructive push-pull that transforms the energy by various transformations to productive work and the creative process in visual, literary, science and art. Some of this is present in dream material to protect sleep and in problem solving. It would follow that the depressed state is necessary for progressive work with the liabilities of its potentials for human harm developmentally and emotionally.
Despite these reactions this is an important and enlightening book. Part autobiographical, it also has myriad discussions, both psychological and literate. . The prose is elegant, yet sullied by the contortions of pain and suffering. Surprisingly, that part of the text enlivens the story. Missing too, is the story of the author as a boy and his developmental sequelae that contributed to growth and significant pathology. It is overburdened with medical and chemical information hiding how an identity evolved. One wonders how Solomon may have intensely colluded in his own self- destructive drives and impulses.
This book elicits a history of our species and our diverse approaches in coping for survival. In spite of its length (does it need some more editing?) it is a good read for any and everyone.
I sent my soul through the invisible,
Some letter of the afterlife to spell:
And bye and bye my soul returned to me,
And answer'd I myself am Heav'n and Hell.
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