In 1998 I wrote about something I called “doppression”. Here’s an update inspired by an article in Medical Republic today #doppression
There are several models for viewing the experience that is popularly known as “depression”. The current dominant model consists of a collection of popular memes combined in a narrative something like this…
- Our natural state is not to be distressed
- Deviation from the natural state is a disease (pathology)
- Disease is predominantly caused by internal factors (genes, predisposition, biochemical disturbance)
- Although depression can be precipitated, the development of the disease reflects some internal deficiency or lack of coping skills.
- The deficiency can, to some extent, be treated with medication’ and the coping skills can, to some extent be leamt
- The best way of learning coping skills is through intellectual processes (cognitive behavioural therapy)
Some benefits of this model are that there is a widespread faith in the view that “a suitable medication, when found, can bring relief of suffering”. Many medications have been found that are helpful. The process of prescribing is viewed by doctor and patient alike as a significant step toward “recovery”.
Some drawbacks of the chemical deficiency model are that the person for whom medications are prescribed, or cognitive therapy instructed, are left with the idea that the illness was consequent to them being deficient or abnormal or misinformed or crazy. Context is acknowledged, but kept at a distance.
Strangely, this model dominates the landscape, despite lots of evidence that the microbiome might be more important than the brain in regulating emotions and neurotransmitters. Finally the connection between stress (particularly at work) is being made, and the complex interaction between sleep, stress, eating and activity is being explored.
In order to make meaning from the experience, there are many alternative models:
- Depression is a spiritual crisis and an opportunity for spiritual growth or awareness
- Depression is the result of some karmic misdemeanour
- Depression is a test of one’s mettle
- Depression has no meaning and is a consequence of the random occurrence of pain and Suffering.
- Depression is consequent to loss and represents to some extent a personal loss of self
- Depression is consequent to oppression (physical, verbal) , by either people or bypeople’s critical ideas which have been internalised as self-truths.
Being highly interested in language and its effects, and being disillusioned by the application for 10 years of the dominant model and my belief that it disempowers the “sufferer”, I have devoted much of my time in recent years to exploration of the latter model which has been articulated by several people. Most cogent for me is the modem articulation of these ideas in the context of so-called “narrative therapy”.
The strengths of this narrative model are that they give rise to options for any individuals who have contact with someone with depression to look at their own possible contribution to the perpetuation of the “disease”, by inadvertent oppression through the use of advice, judgement, inability to understand or accept what the “sufferer” is reporting, and give us also a chance to consider the possibility that in a dominant culture we are all trained so well to dominate that we often oppress others. Hence “doppression”.
Consideration of this model provides many answers, and might help us move past a current “obstacle in thinking” about depression; We seem to be way behind the eight ball in detecting, and modifying microbullying which I believe is a root cause of depression through explicitly delivered oppressive narratives (work performance review anyone?) and more subtly internalised self-oppressive narratives .
As Michael White points out, our culture has moved towards this acknowledgement by putting the “post traumatic” in “post traumatic stress disorder” which was previously known by several labels which pathologised the individual including “war neurosis”.
If you accept that the narrative model may have some merit, then I would invite you to consider the possibility that the ways that we usually relate to someone who is “doppressed”, actually generate and keep alive the condition. These ways include.. Pitying, advice giving, rescuing, refraining, ‘ criticising, confronting, neutral listening, reflecting back (without checking), indulging, ignoring, labelling (officially with “diagnosis” or unofficially with pathologising lay judgements (laybels [sic]) including “immature”, “weak”, “fragile”, “overemotional”, “angry” amongst a multitude of other labels.
I have become less interested in criticisms of the narrative model, as they often rely on dominant paradigms such as “evidence leads to truth” and “of all explanations, one must be more true than others” which is extended to “unless model A can be demonstrated to be more watertight than Model B, it is not valid”. I am not disinterested in such criticism because I think the underlying assumptions are flawed, but because they are unhelpful. inasmuch as they may lead to the dismissal of possible options for change. My assumption is that any approach which broadens options for action is worth privileging.
Much about the possibility that the way we treat others, especially by the language we use (“power words” such as “too” “but” “just”, “actually” and many more). More about Power words soon. I hope you find, as I did, that serious consideration of our language opens new doors for you and the people you relate to, and opens doors to freedom from doppression.