Sartre, Minkowski and depression.
Abstract: This paper explores the relationship between the ideas of Minkowski, a psychiatrist working at the beginning of the 19th century, Sartre, a key existential philosopher, and depression. Minkowski's exploration of the time dimension and Sartre's writings on choice, responsibility and self-construction are considered in relation to depression and psychotherapy.

Key words

Depression, Sartre, Minkowski, existential, time, phenomenology, personal impetus
Article Type: Report
Subject: Depression, Mental (Physiological aspects)
Existential psychology (Research)
Philosophy of mind (Research)
Author: Macgregor, Charlotte
Pub Date: 01/01/2012
Publication: Name: Existential Analysis Publisher: Society for Existential Analysis Audience: Academic Format: Magazine/Journal Subject: Psychology and mental health Copyright: COPYRIGHT 2012 Society for Existential Analysis ISSN: 1752-5616
Issue: Date: Jan, 2012 Source Volume: 23 Source Issue: 1
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom
Accession Number: 288874174
Full Text: Introduction

The ideas of Eugene Minkowski, a psychiatrist working in France at the beginning of the last century, and Jean-Paul Sartre, a key existential philosopher, together offer important insights into the kinds of experiences we commonly refer to as 'depression', insights that stand in radical contrast to the understandings of the mainstream medical model that are widespread in the western culture of the 21st century. I will show how their ideas, both individually and combined, challenge the normative assumptions underlying a western medical understanding of depression, opening up alternative routes to how we conceptualise and encounter depression. Minkowski established a system of structural analysis of experience based in phenomenological observation and description, and he is best known for his focused exploration of the dimension of time (Minkowski, 1933). Sartre explores fundamental questions of existence, focusing on choice, freedom and responsibility, and how we attempt to create sense and meaning out of the fundamental nothingness that is at the core of our existence (Sartre, 1943). It is a combination of these ideas, underpinned by a Sartrean notion of 'self', which I will extrapolate to propose a Sartre-Minkowski approach to understanding depression. I will then consider how their understandings might inform a therapeutic approach to someone experiencing this sort of phenomenon.

Phenomenology of depression

van Deurzen's holistic description of depression captures the phenomenon thus: 'a feeling of deflation, a sense that there is a lack of something, outside or inside oneself and usually in both at once' (van Deurzen, 2009: p99). A person in this state of mind has lost a sense of hope and relinquished their aspirations: this sense of despondency 'will press one further down and lead to further deprivation' (ibid). The experience of depression is one of a loss of energy and a lack of motivation, with a perception of barrenness. To greater or lesser extents these experiences are constituents of what it is to be alive: just in the same way that at times a person may feel energetic, hopeful, loved and optimistic, so too it is a fundamental part of being human to sometimes feel unmotivated, lethargic, hopeless and despondent. Our emotions come in cycles and are part of our fluid connection to the world (van Deurzen, 1997). It is when these experiences stagnate and become enduring, ongoing and pervasive that they begin to be thought of as a unitary whole, transformed from the constituent parts into what we identify as depression. Therefore, understanding depression entails exploring the specific components outlined in the description and examining how these specific experiences are created into depression.

Sartre's conception of self

We can begin to see how Sartre accounts for the experience of inner and outer lack at the centre of depression through his dismissal of man as predefined object and his conception of the subjectivity of man, who, to begin with, is nothing:

Man is, indeed, a project which possesses a subjective life, instead of being a kind of moss, or a fungus or a cauliflower. Before that projection of the self nothing exists; not even in the heaven of intelligence: man will only attain existence when he is what he purposes to be

(Sartre, 1948: p30)

Without projection we are nothing and Sartre suggests that conceiving ourselves as something, as a defined entity is itself deception: while 'we love to act as if we are set and substantial', this is itself an example of the kind of self illusion Sartre defines as 'bad faith' (Sartre, 1943: pp45-47). Rather than inner lack being implicated as a criterion for illness diagnosis, from a Sartrean perspective it becomes an expression of a particular awareness of existence a priori to projection. Sartre's concept of self challenges the 'depression=illness' correlation: perhaps the 'sickness' might reside in the individual and collective pretence of objectifying a 'something' from which we then cast experiences of nothingness or lack as maladaptive.

Sartre highlights the intricate interplay between self, relationship, time and environment: What do we mean by saying that existence precedes essence? We mean that man first of all exists, encounters himself, surges up in the world--and defines himself afterwards' (Sartre, 1948: p28). Implicit in this statement is the proposition that we can only define ourselves 'after the fact', since any definition is only ever after the moment of existence we are defining: we are non-definable in any static sense. Holding on to a fixed or rigid idea of who we are in the present distances us from fluid momentary experience. However, the realization that we have freedom and responsibility to choose ourselves, can seem so overwhelming that retreat into a more sedimented stance might serve to provide reassurance. The construction of experience into 'depression' may seem more tempting and containing, providing an alternative to the anxiety inherent in existence.

Disconnection and connection

Minkowski suggests that our present life is where we convert our past experiences into positive future action: inner lack is the result of a person's present disconnection from their past or future, or both (Minkowski, 1958: p132). In Findings in a Case of Schizophrenic Depression Minkowski notes that his client's fundamental past-present-future connection was lacking and time had become distorted (ibid). This is compared to the more usual focus on creatively utilizing past and present experiences to form future intentions and meanings. When a person becomes fixated on their past, isolating it and objectifying it, they may block off their future along with any accompanying forward momentum, motivation and desire. Without what Minkowski defines as a 'personal impetus' propelling an individual from his or her past towards their future they lose a sense of self (ibid: p134). Feelings of lack, despondency, loss of hope and loss of aspiration indicate either a person's disconnection of their present experience from their personal history or an inability to process experience into positive action for the future, or both. The person is isolated and stuck in a disconnected present. Feelings that would otherwise be experienced as a momentary part of a fluid range or continuum become sedimented and enduring (ibid).

Sartre's assertion that to begin with man is essentially nothing might at first glance seem hopeless, he suggests that through relationship we begin to find something: 'In order to get any truth about myself, I must have contact with another person' (Sartre, 1943: p186). Sartre suggests that whatever or whoever the Other may be, whatever kind of relationship exists between one being and another: 'without his acting upon me in any way except by the pure upsurge of his being--then I have an outside, I have a nature' (Sartre, 1943: p286). Being the external object of the Other's look solidifies essential nothingness into something, though this solidification limits freedom and the possibilities of transcendence (ibid: pp286-287).

The general and the specific

Minkowski observed that an individual can rapidly move from focussing on a specific present object or experience to extrapolating and expanding it into infinity, so that all people or all objects take on the same meaning, merging into an amorphous mass (Minkowski, 1958). For example, if I feel hopeless in a particular moment of relationship, I quickly transpose this feeling onto all of my relationships, rather than just appreciating it as a momentary experience with specific relational and time boundaries. If I recognize that the solidification that accompanies Sartre's casting of essential nothingness into something through the Other's look is temporally and relationally boundaried, I decrease the possibility of the generalisation from the specific described by Minkowski. This provides an important understanding of both how a specific moment of despair or despondency can be transmuted into a more enduring depressive experience, and how this evolution might be thwarted by expanding contextual awareness.

Forward momentum

As well as Minkowski's personal impetus providing temporal connectivity, it is a life force that carries us through difficult times. It takes a person beyond the limits of self into the world, creating 'works which sever themselves from us to live their own lives' (ibid: p134). Through these new creations, personal impetus forges an integral connection with the outside world. According to Minkowski, we achieve contentment through the completion of actions and through decision-making. Loss of personal impetus leads to a sense of disconnection and isolation, and stifles the completion of these new creations, also resulting in a loss of contentment and satisfaction. In a similar vein, Sartre proposes that a central challenge to existential psychoanalysis would be to make a worthwhile life-project within the boundaries of existential limitations (Sartre, 1943). Sartre describes man as fundamentally 'the desire to be', and that this desire is an 'a priori description of the being of the for-itself' (ibid: p586). From this position, we create meaning through values and intentionality, which carry us forward towards other people, our own future and into the world. Sartre's life-project and Minkowski's personal impetus help create the hope, momentum, contentment and creative energy without which we stagnate, disconnect from the world and fall downwards into depression.

In his later writing, Sartre describes praxis to account for the activity of a person or group 'organizing conditions in the light of some end' (Sartre, 1960: p829). Human existence is a project in time, a constant evolution of understanding and making history in the present, which is transcended towards a future that at once negates and incorporates the conditions of the present (ibid: p830). When Minkowski's personal impetus is lost and projection towards the future through a life-project is diminished we experience hexis, the opposite of transcendence, in which the future is accepted as closed (Cannon, 1991: p184). Living a social, political and relational existence means living with hexis, since a person cannot avoid accepting something of the historically contextualised status quo. Without living with some degree of hexis, each moment of existence and every social structure would be formulated as new (ibid: p170). The question for therapy in relation to these ideas from Minkowski and Sartre, is how the balance between hexis and praxis, between personal impetus and stagnation, is navigated. The extent to which a person is able to choose to reconnect with personal impetus from stagnation rests not just on the personal dimension (van Deurzen, 2009). Sartre describes how 'in an individual life, each praxis uses the whole of culture and becomes both synchronic (in the ensemble of the present) and diachronic (in its human depth)' (Sartre, 1960: p55). Exploring wider social, cultural and historical issues relating to stagnation and loss of impetus provides an important contextual backdrop for consideration of degrees of agency, choice and responsibility at each particular time.

The value of relationship

The ideas outlined so far have important implications for how we approach depression therapeutically. Sartre's description of how we create ourselves from nothing underpins the interplay between freedom and responsibility central to existential therapy: 'He will not be anything until later, and then he will be what he makes of himself' (Sartre, 1948: p28). If we return to Sartre's understanding that 'In order to get any truth about myself, I must have contact with another person', we appreciate how relationship is central to Sartrean therapy (Sartre, 1943: p186). The very process of being in contact with another person highlights awareness of some of the dilemmas of existing fluidly in relation that are central to the construction of depression: 'Each other finds his being in the other.' (ibid: p191). Given that each individual still ultimately has the 'entire responsibility for his existence squarely upon his own shoulders' facing our choices and creating ourselves from nothing is by no means an easy process (Sartre, 1948: p29). In therapy, facilitating relational exploration of the experience of being solidified through the external object of the Other's look, and the extent to which this solidification feels like a limitation to freedom and transcendental potential would seem central to issues of fluidity and sedimentation (ibid: pp286-287). Through examining the implications of freedom within the limitations of existence we help clients move towards appreciating the extent of their active agency in their own lives.

Minkowski's phenomenological exploration of the client's experience attempts to help the client clarify how they live in time. For Minkowski, establishing the meaning and motivation of a person's disconnection from personal history might begin to bring temporal balance and fluidity. Alternatively a person's sense of lack of hope or aspiration might be a consequence of a blocked future, perhaps as a result of not feeling able to face existential uncertainty.

Sartre's biography of Flaubert shows how the young Gustave thought of himself as living out a preordained destiny (Barnes, 1993). As a result he found it almost impossible to live with a future dimension and instead existed in repetitive cycles, thinking himself incapable of any change. If we imagine for a moment that Flaubert experienced what we understand as depression, we can consider how he might have been helped by Sartre and Minkowski. A Sartrean approach to psychotherapy might have begun with helping Flaubert consider how he cast himself as a fixed, determined object, explicitly pointing out the choices that he made to stay in his fixedness and considering these in a socio-cultural context. Flaubert might have been encouraged to begin to consider what he valued and what his intentions were for creating something of himself as he reached into the future. A central task of such psychotherapy would focus on facing personal responsibility to choose to engage or not with the actions and potential of his life project. Through considering these choices, Flaubert might have begun to experience the satisfaction that Minkowski suggests accompanies such a process. We can postulate that Minkowski might have explored the meaning of the repetitive cycles of Flaubert's existence, perhaps considering how these cycles thwarted his personal impetus from creatively reaching out into the world. Focusing on the specific choices of the present and the future might help to break the sorts of repetitive cycles that Flaubert experienced, and which often form part of the experience of depression.

Therapeutic explorations

A Sartre-Minkowski approach would show clients that when they relax a fixed idea of who they are and how they might be, they begin to liberate themselves from their own individual suppression. An important theme of such an approach would focus on the balance between holding enough of an idea of self to project into the future through personal impetus, whilst maintaining fluidity and openness in order to hold off stagnation. Considering the socio-cultural element of how potential is thwarted or expanded is important in helping clients evaluate the choices that they have, and the extent to which they are free to take responsibility. Facilitating imaginative investigation of what sort of future a client might wish for might play an important part in loosening present experiences of stagnation and disconnection. Exploring what it is like to live with uncertainty and anxiety, and acknowledging these experiences as fundamental givens of existence, helps clients to face more openly how they might be holding onto more static ideas in order to alleviate anxiety, and how holding onto these ideas might be part of maintaining stagnation. Through these sorts of explorations we begin to help clients challenge the sedimentations and mineralisations that, from a Sartrean perspective, might be serving to maintain depressive experience (Sartre, 1960). To enable clients to face how they construct meaning and explore their own sedimentations, it is necessary to openly and critically question those sedimentations that are culturally constructed, such as notions of fixed self or personality, and the sedimentation of distress into psychopathology. For Sartre, the crux of helping somebody experiencing depression would be to focus on discovering a 'subjective choice by which each living person makes himself a person' (Sartre, 1943: p599).

The combined ideas of Sartre and Minkowski would suggest a therapeutic approach focussed on exploring the responsibility we each have to choose what we make of ourselves and how we live at a particular time; the associated implications and limitations of freedom and choice on a wider social level; and the temporal thread of our existence and how we connect to, and make meaning from, our pasts, presents and futures. While we might extrapolate and approximate what particular experiences of depression might mean and how they might be constructed according to Sartre and Minkowski, ultimately any understanding and exploration can only ever be of an individual's unique experience of being in the world at a particular moment in time.

References

American Psychiatric Association (A.P.A.) (2000). Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR). Arlington: American Psychiatric Association (A.P.A.).

Barnes, H. (1993). Sartre's Concept of the Self. In Hoeller, K. (ed) Sartre and Psychology: Studies in Existential Psychology and Psychiatry. New Jersey: Humanities Press.

Cannon, B. (1991). Sartre and Psychoanalysis. Kansas: University Press of Kansas.

Minkowski, E. (1933/1970). Lived Time: Phenomenological and Psychopathological Studies. Trans. Mekel, N. Evanston IL: Northwestern University Press.

Minkowski, E. (1958). Findings in a case of schizophrenic depression. In May, R., Angel, E. and Ellenberger, H.F. (eds) Existence. Trans. Bliss, B. New York: Basic Books.

Sartre, J.P. (1943/2003). Being and Nothingness--an Essay on Phenomenological Ontology. Trans. Barnes, H.E. London: Routledge.

Sartre, J.P. (1948/2007). Existentialism and Humanism. Trans. Mairet, P. London: Methuen.

Sartre, J.P. (1960/2004). Critique of Dialectical Reason. Trans. Sheridan-Smith, A. London: Verso.

van Deurzen, E. (1997). Everyday Mysteries: Existential Dimensions of Psychotherapy. London: Routledge, Second Edition.

van Deurzen, E. & Arnold-Baker, C. (2009). Existential Perspectives on Human Issues: A Handbook for Therapeutic Practice. London: Sage.

Charlotte Macgregor is an existential psychotherapist completing a Doctorate at New School of Psychotherapy and Counselling. She is researching an existential formulation of transformative experiences in nature.

Contact: Highfield, Colt Hill, Odiham, Hampshire, RG29 1AN.

Email: charlottekmacgregor@hotmail.com
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