Situating Sadness

Women and Depression in Social Context

Janet M. Stoppard, Linda M. McMullen

• Publisher: NYU Press
• Year: 2003
• ISBN:
  9780814708552
• Topic: Psychologie
• Subtopic: Psychopathologie

It is well known that depression occurs more often in women than in men. It is the most commonly encountered mental health problem among women and ranks overall as one of the most important women's health problems.

Researchers have studied depression a great deal, yet women's depression has rarely been the primary focus. The contexts of women's lives which might contribute to their depression are not often addressed by the mental health establishment, which tends to focus on biological factors. Situating Sadness sheds light on the influence of sociocultural factors, such as economic distress, child-bearing or child-care difficulties, or feelings of powerlessness which may play a significant role, and points to the importance of context for understanding women’s depression.

Situating Sadness draws on research in the United States and other parts of the world to look at depression through the eyes of women, exploring what being depressed is like in diverse social and cultural circumstances. It demonstrates that understanding depression requires close attention to the social context in which women become depressed.

1

“Depressed” Women’s Constructions of the Deficient Self

Linda M. McMullen

If you’re miserable and you feel weird, you think it’s because you’ve got a flaw, there’s something wrong with you.

—“Depressed” woman to her psychotherapist

FOR MANY PSYCHOTHERAPISTS, this quote will be familiar both for its content and for its speaker. It is the sort of statement often made by those who seek psychological help in Western cultures, the majority of whom are women. However, this very ordinary statement is in fact quite revealing. First, it exemplifies the dominant way in which we, in contemporary Western society, try to explain distress, particularly the distress we label “depression.” Specifically, we focus on the influence of psychological factors—of the person’s features, such as ability to cope, strength of character or willpower, motivation—as a way of explaining why one person experiences a debilitating psychological disorder such as depression, and another does not. Focusing on these aspects establishes “depression” and other forms of psychological distress as stemming from personal failings or inadequacies. If I am “depressed” or otherwise distressed, it must be due, at least in part, to characteristics of my person, to personal flaws or failings, to my deficiencies as a person. While in earlier times we may have believed “depression” to be the result of an excess of black bile or a reduction of nervous energy,¹ we now implicate psychological factors to a significant extent, even if we acknowledge that genetic vulnerabilities and levels of certain chemicals in the brain might be involved.

Second, the opening quote is revealing precisely because it was spoken by a woman. Although it is now well established that in Western society about twice as many women as men are diagnosed as “depressed,”² this was not always so. Well-documented accounts of the history of melancholia and depression³ indicate that less severe forms of melancholia in the late medieval and Renaissance periods were thought to be afflictions of the passive, sensitive, intellectually and morally superior male. By contrast, the present-day condition we call “depression” is, as noted above, associated with weakness, deficiency, and personal failings, and with being female. As so aptly stated by Schiesari (The gendering of melancholia: Feminism, psychoanalysis, and the symbolics of loss in Renaissance literature), “the melancholic of the past was a ‘great man’; the stereotypical depressive of today is a woman” (p. 95).

My focus in this chapter is on how the gendered, devalued condition we now call “depression” is constituted in the lives of women who have been diagnosed as “depressed.” By analyzing the metaphors and other figurative expressions used by “depressed” women as they talk to their psychotherapists about themselves and their lives, we can see how the deficient self is presented by these women. I focus here on metaphors and other figurative expressions for two reasons. First, when people are asked to talk about how they view themselves and their experiences (as is the case in psychotherapy), they often have difficulty finding the words to convey their ideas and, as a result, they frequently resort to using nonliteral words and phrases. So, psychotherapy is a context that is rich in this kind of language. Second, scholars of language and culture have stressed the significance of figurative language as a window onto shared cultural understandings.⁴ Figurative expressions come into being, survive, or fade away depending on the extent to which they foster communication of culturally salient conceptions. If, as I have indicated, our conception of “depression” has changed over time, then focusing on contemporary metaphors and other figurative expressions should provide a window onto how a common understanding of “depression” is constructed in a particular historical and cultural context—in the present case, early twenty-first-century America.

Historical and Contemporary Metaphors for Depression

Dating from the time of the ancient Greek physician Hippocrates, one of the earliest (and long-lasting) metaphors for melancholia and depression is that of being in a state of darkness.⁵ Originally, this metaphor was linked to the presumed cause of melancholia and depression, that is, an over-abundance of black bile in one’s system, and to the experience of fear, gloom, dejection, and clouding of thought and consciousness that were typical in persons who suffered from melancholia or depression. We can see evidence of this metaphor in present-day descriptions of depression as being like a “black cloud” or a “rainy day” and in common expressions such as “I feel blue” or “I feel dark.”

A second long-lasting metaphor is that of being weighed down.⁶ Again, this seems to originate from the physical characteristics of melancholia and depression, specifically, the experience of a heavy head, of a body that is borne down by a weight, of a bent-over head, neck, and drooping body posture. The sense of being weighted down is clearly contained in the present-day term “depression” which actually denotes being pressed down, and in common expressions such as “It’s like I’m carrying a load around,” “I feel burdened,” and “I feel so heavy.”

But, perhaps the most recognizable contemporary metaphor for what we now refer to almost exclusively as “depression” is that of being “down” or “low.” These expressions are part of a larger metaphor theme that I call “Depression is Descent.”⁷ Central to this theme are expressions about the place that is depression (e.g., “the dreary, dismal pit,” “rock bottom,” “in the gutter,” “down in the dumps”), about the ease of descent once it is started (e.g., “spiraling down,” “going through a nosedive,” “sinking low”), and about the effort and will required for ascent (e.g., “pull myself out of it,” “have to slowly work my way back up,” “made efforts to climb out”). These expressions suggest that a significant way in which we presently construct “depression” is as movement in physical space from a higher to a lower position or place.

This notion of low position or place that seems to be at the heart of our conception of “depression” is linked not only to the physical or experiential features of this state of being (i.e., drooping body posture) but to social and cultural values and moral evaluations. For example, “down” is correlated in Western culture with sickness and death (e.g., “She’s very low” or “He dropped dead”), low status (e.g., “being at the bottom of the heap”), lack of power (e.g., “low man on the totem pole”), lack of virtue (e.g., “low-down thing to do”), and inferiority and inadequacy (e.g., “being at the bottom of the trough”).⁸ In short, to be “down” is to be lacking in a quality that is considered essential or important in our culture (e.g., health, high status, power, or virtue). To be “down” is the opposite of what we value.

The Research Question and Participants

If “depression” is linked to what is not valued in our culture, then studying how “depressed” persons talk about themselves and their lives might inform us about the value of various forms of selves in our culture. To begin to address this question, I have studied how the deficient or flawed self is constructed in the language of ten women in psychotherapy. I have focused on women’s talk because of the high frequency with which women are diagnosed as “depressed” and because psychotherapy is a context in which talk about one’s deficiencies and flaws is often encouraged.

The women whose metaphoric talk I analyzed had volunteered to participate in a time-limited (to a maximum of twenty-five sessions) psychotherapy research project.⁹ They ranged in age from twenty-eight to sixty-two years, were white, varied from having partial high school to completed university education, and presented themselves as having problems primarily with interpersonal relationships and with moods. Each of them had received a diagnosis of some form of depression.¹⁰ They were seen by experienced psychologists or psychiatrists who were also white and who provided psychodynamically oriented psychotherapy once each week.

Because I used archival data and was not able to speak to the women themselves, the analysis of their metaphoric talk¹¹ must be understood as my description and interpretation of what I saw as patterns in their discourse. I brought to this analysis my personal-professional experience as a white, Western, female, clinical academic with an interest in culture and gender. What follows, then, is the product of a long period of engagement that I had with the women’s metaphoric accounts of the personal deficiencies that they presented as contributing to the problems they reported.¹²

Cultural Imperatives

Implicit in the women’s metaphoric accounts of their personal deficiencies were sentiments about how one should or should not “be.” I organized these sentiments along two broad imperatives that I have labeled “Don’t be too mothering” and “Don’t be too child-like.” At the heart of these imperatives are messages about cultural values and norms.

“Don’t Be Too Mothering”

Three of the women presented themselves as overly involved caretakers. Two of them spoke of having embraced too completely the role of mother, particularly in relation to their husbands. One woman, Barbara (aged fiftysix years), who was having difficulty coping with her impending divorce, described herself as having gone “to pieces” (session 1)¹³ when her husband separated from her and subsequently filed for divorce. She talked of how she had never been at the center of her husband’s life despite having placed him at the center of hers. She described this perception in the following ways:

[To the therapist in the first session] You’re going to see a lot of mothering in me, I’m sure, and maybe I have smothered him [husband] with mother love.

I have always played at least second, third, fourth, or fifth fiddle. His [husband’s] job has always been more important than [me], his mother … was more important than [me] … and I move up and down the scale but I’ve never played first fiddle in [husband’s] life—never … I’ve been second fiddle or third fiddle or fifth fiddle or fifteenth fiddle for a long time (session 4).

In a particularly poignant expression of the possible futility of her way of being, Barbara alluded to herself in the third person:

Even then you could be like the hen sitting on a nest. From all appearances, she’s doing what she’s supposed to be doing, you know—the mother or the earth mother or whatever. And she’s doing her thing. And the community of chickens expects this and here she is—she’s doing [it]—but, it occurred to me that she could be sitting on a glass egg—that even consent or even when you’re doing what you feel is good and right and conscientious and what God expects you to do and natural—even that doesn’t guarantee the reward—the ultimate reward (session 8).

In session 18, she summed up her views:

I tried to be his [husband’s] savior and he didn’t want to be saved.

and

Like the hen who sat on the nest—she was sincere but she was sitting on a glass egg, you know, maybe I’m sitting on a glass egg.

The irony in Barbara’s presentation is clear: On the one hand, by mothering, she was doing what she thought she was supposed to be doing, what she thought was expected of her both in the eyes of the community and in the eyes of God. On the other hand, her mothering was not only misdirected, in vain, and ignored; but it ultimately resulted in the loss of the person to whom it was directed.

Like Barbara, Carrie (aged forty-one years) also constructed herself as “too mothering.” Although Carrie and her husband had been separated due, in part, to his illegal business practices, they were now living together again, and both were seeing a psychotherapist about marital concerns. Carrie reported that she “protected and mothered” her husband, that she “didn’t know anything different except mother, protect, shield, hide” (session 11). Toward the end of therapy (session 21), she stated this self-construction most clearly:

So I’d pick up his load at home to relieve him to do what he enjoyed most.

I’m wondering if he thinks I’m smothering him.

It’s like I’m making him check in with his mother [by having him call home].

Again, similar to Barbara, Carrie saw herself as doing for others and as having her self placed on the periphery:

To me, through all that [husband’s business difficulties], I did not exist. Total energy was directed toward getting [husband] okay (session 11).

He [husband] screwed it up but yet it seems like it’s up to me to fix it (session 13).

There’s always some kind of stir or some kind of trauma or something that needs to be fixed, that [I] get put on the back burner to take care of whatever needs to be fixed or get involved in trying to, to fix something (session 17).

For Carrie, mothering was double-edged: it was necessary and expected, but also self-negating and self-ignoring.

In a variation of the construction of the self as “too mothering,” Susan (aged twenty-eight years), who presented with concerns about her mood swings, her weight, and her difficulty in maintaining close personal relationships, referred to herself throughout therapy as “Aunt Susan.” She used this version of her own first name to convey her view of herself as an overly involved, self-sacrificing caregiver. Although she recognized that she had enacte...