The View from Hell

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Ask Sister Y

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Paul asks:

One of the supposed signs of clinical depression is a person’s inability to enjoy their usual interests. Do you consider this to be a societal denial of an individual’s process of disillusionment and another facet of the conspiracy against suicide?

DSM-IV Major Depressive Disorder is diagnosed on the basis of one or more Major Depressive Episodes. A Major Depressive Episode is a period of at least two weeks during which at least five of a list of criteria are present. One of these five criteria must be either the “depressed mood” criterion, or the “loss of interest” criterion to which the question refers. So it’s actually a really special criterion, not just one of many things on a list. In some ways, it’s the essence of the disease, to the extent that we conceive of it as such.

This very special criterion is stated thus in the DSM-IV (and not scheduled for alteration in the DSM-V):

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

The diagnosis of Major Depressive Disorder is critical to the question of suicide rights, since the modern conception of suicide is as the consequence of untreated mental illness. As the vomitrocious puts it, “Over 90 percent of people who die by suicide have a mental illness at the time of their death. And the most common mental illness is depression.”

Suicide, we are told, is the act of a mad person, not a genuine choice. One of the other diagnostic criteria for depression is, in fact, suicidal ideation or “thoughts of death.” This is a very suspicious move; while on the one hand, the media explain suicide as a result of mental illness, the psychiatric establishment defines the desire to die as part of a mental illness. The criterion Paul points to deals not with the desire to die, but with a failure to find satisfaction in the world. This defines the well-functioning of a person as finding satisfaction in everyday activities.

But are we really so sure that satisfaction is properly found in human activities?

Pathologizing a failure to find satisfaction and meaning in life is, to some degree, appropriate – failure to find meaning represents a real source of suffering in the world, and pathologizing something allows us to “treat” it. But it should be recognized that this failure to find meaning and satisfaction is not a failure to see truth. It’s not like hallucinating that you have a pet lion, or hallucinating that the walls are not there. There is a genuine epistemic question as to whether meaning and satisfaction are available or even properly found in life.

When you hear a news story about suicide, it will probably mention what I think of as the “party line”: suicide is caused by untreated mental illness. Next time you hear this, read between the lines. The deeper meaning, according to actual DSM-IV criteria, is something like: suicide is caused by not finding enough satisfaction in life to justify the pain.

I’m not sure I’d use the word “conspiracy,” since that implies conscious collaboration toward an explicit goal. There is collaboration toward a goal, but it must be largely unconscious. The field of Terror Management Theory has created a robust model of human mental functioning in which we are constantly reminded of our own death, but just as constantly engage in defense mechanisms to prevent the terror associated with thoughts of death. These defense mechanisms are most commonly “worldview preservation” – attaching ourselves to something eternal, something that has meaning and will live on after we are gone. I would posit that most everyday activities in which people find meaning qualify as mental defenses against the future reality of death. They point us away from truth – the truth of eventual extinction. This refusing-to-see-truth helps us function. But is functioning really so great?

Rob asks:

Really trivial question: what’s behind the pseudonym “Sister Y”?

Y is my Vietnamese name – I’m not Vietnamese, but my, uh, heterosexual life partner is, and a close friend of his family gave me the name Y. (This family friend also has the honorary title “Sister” (ji), which I think is cool.) It has complicated diacritic marks over it, to indicate that it’s pronounced with a falling-then-rising-tone, like you’re really surprised to hear something: “EEeeeEEE???!?” It’s a relatively common name, and I’m told it means something like “dream.”


Written by Sister Y

January 18, 2011 at 4:42 pm

Posted in Ask Sister Y

5 Responses

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  1. Your question as to whether satisfaction is properly to be found in human activities is apposite, although rarely asked. In fact, I think I've only seen it explcitly stated before in Adorno's Minima Moralia:

    Psychoanalysis likes to give itself credit for returning to human beings their capacity for enjoyment, since this latter is disrupted by neurotic sickness. As if the mere term “capacity for enjoyment”, assuming the thing even exists, did not suffice to degrade such in the worst possible way. As if a happiness, which is due to the speculation on happiness, would not be the opposite of happiness, a further trespass of institutionally planned modes of conduct into the ever-shrinking domain of experience. What sort of condition must the ruling consciousness have achieved, when the binding proclamation of extravagance and champagne-inebriation, formerly reserved for attaches in Hungarian operettas, is raised to a maxim of the right life in brute earnest. Decreed happiness looks exactly like what its name suggests: to partake of it, the fortunate neurotic must also sacrifice the last bit of reason left remaining by repression and regression, and for the sake of the psychoanalyst, has no choice but to find inspiration in the trashy film, the expensive but bad meal at the French restaurant, the serious “drink” [in English in original] and sexuality reduced to doses of “sex” [in English in original]. §38, “Invitation do dance”. Translation by Dennis Redmond

    On an unrelated note, is the “complicated diacritic” Ỷ?


    January 18, 2011 at 6:37 pm

  2. Interesting! I dig Adorno, and this quotation is particularly nice. The way he puts it makes it possible to see that psychology is rather Aristotelian in orientation – people have a purpose, we return them to performing that purpose.

    Except the “purpose” keeps changing with every generation . . .

    And I think there are two vowel tone diacritics, and that might one of them. The other one is the one that looks like a comma, if I remember correctly.

    Sister Y

    January 18, 2011 at 7:06 pm

  3. Sister Y,

    Your boy, Tauriq Moosa, seems to have gone off the deep-end with his latest piece on 3quarksdaily:

    He links to your “Oregon's Law” post towards the end.


    January 20, 2011 at 1:29 am

  4. And for those too lazy to cut and paste:

    I bet Tauriq will enjoy the fact that people call him my boy. ❤

    Sister Y

    January 20, 2011 at 2:39 am

  5. Indeed, I am enjoying that fact. It is both ironic and humorous on so many levels.

    I'm wondering why I've gone “off the deep end” though — the essay seemed pretty simple and I had positive and negative feedback. Neither of which indicated something as dramatic as going off the deep-end. I did discover, in this piece, that Carl Sagan was a sacred cow (for a few unnamed folk – oh! more irony!), and was privileged (?) enough to be quoted by (I don't know whether that's good or bad considering some of the people that write for them).

    So please excuse me if I don't check into a mental asylum just yet, good sir/ma'am Meatgrinder (love the name BTW).

    Am also interested to know why I'm considered Sister Y's boy. It is an honour to be considered as such anyway. I wish I had a certificate to put on my wall! Feel the antinatalist love ❤


    March 9, 2011 at 11:55 pm

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