Times Books - January 12th 2008

THE NEW BLACK – Mourning, Melancholia and Depression
By Darian Leader
Hamish Hamilton

‘Timor mortis conturbat me’ is the refrain which runs darkly through medieval literature, like the ubiquitous memento mori a reminder of ‘the skull beneath the skin.’ The meaning is usually given straightforwardly as ‘the fear of death disturbs me’ yet such existential angst can equally be elevated beyond the merely selfish. After all, most of us are filled with a greater horror imagining the deaths of those we love. The contemplation of mortality, and concomitant grief – foresuffered and real - have been an inescapable part of the human condition since our ancestors shivered at howls in the impenetrable darkness.

It’s not surprising, therefore that a common human response to loss (usually bereavement but often another sort, involving some colossal unexpected life change) is the arrival of the Black Dog. People commonly speak of feeling ’depressed’ when they experience a temporary downturn in mood, or even the ennui caused by too much shopping and socialising, whereas depression as an illness signifies a severe emotional disturbance. Although Coleridge’s great ode ‘Dejection’ lists some recognisable symptoms (including separation from the world outside) one could argue that the fact of being able to craft a disciplined work of genius from a personal crisis precludes a state of genuine depression. Darian Leader would agree that if a modern Coleridge were to go to his GP suffering from a bad marriage and a creative block (not to mention the after-effects of all that self-medication) he’d probably be told to ‘take the tablets’ and join Prozac nation.

Considering the importance Freud attached to loss, it seems remarkable that psychiatrists took such a long time to recognise bereavement as a major cause of mental illness. Darian Leader’s aim is to disentangle the idea of natural mourning from that of melancholia, or pathological grief‘, in order to help ‘shed light on how we deal – or fail to deal’ with the losses that are part of human life.’ Correctly he objects to the fact that the old distinction between mourning and melancholia made by Freud in his famous paper has been lost in the lazy, modern obsession with ‘depression’ Right at the beginning he offers a crisp distinction: ‘In mourning we grieve the dead; in melancholia we die with them.’ So, as I interpret, in mourning one would say, ‘I exist, without my father, and even though it pains me, I accept that separation.’ In melancholia one would say, ‘I am nothing without my father and his loss is the whole of what I am.’

Yet at when drug companies have a vested interest in promulgating the idea of an ‘illness’ for which they can pedal a cure, and when people are more likely to seek medication than to endure a suffering that must be worked through with patience, such distinctions are lost. Darin Leader’s strictures are timely. In the seventies it was normal for a woman enduring the bewildered grief of a stillbirth to be prescribed tricyclic anti-depressants which effectively turned her into a zombie. Today the busy GP is likely to dish out drugs like Seroxat to a patient presenting with what analysis – ‘the talking cure’ - would reveal as sorrow. But Leader also objects to the ubiquity of the Cognitive Behavioural Therapies which, he says, are popular with healthcare trusts. CBT, he says, is a too-easy solution which views depression and mourning as isolated problems, which can be treated regardless of the context e.g. the life history of the patient. A practising psychoanalyst, he attacks, somewhat unfairly, mere therapists for treating depression is a symptom, not a cause. He is right to warn of quick fixes but surely wrong to suggest that only lengthy psychoanalysis can help. Even talking to a wise friend can, over time, help the mourner to detach from the dead. But yes, when the patient continues to be attached to the dead in a depressed, or melancholic state, a more serious level of help is needed.

Leader’s book begins well, is right to stress the importance of public mourning, but does not deliver all it promises – especially on the issue of how the arts can be ‘a vital tool in allowing us to make sense of the losses inevitable in all of our lives.’ The New Black’ is, I regret to say, rather a catchpenny title for an old subject which is much more rich and complex than Leader acknowledges. For example, the distinction between melancholia and mourning is made to great effect in Jahan Ramazani’s ‘Poetry of Mourning’ (1994), which offers a comprehensive account of ‘the modern elegy from Hardy to Heaney’, which would have informed Leader’s essay. Ramazani makes the point that much poetry is ‘melancholic (in psychological terms) in that the impulse is not to achieve but to resist consolation…not to heal but to re-open the wounds of loss.’ This is what Elizabeth Bishop called ‘the art of losing’ and Keats’s ‘Ode to Melancholy’ is just one example, offering the reader the beautiful, bleak truth that happiness and sorrow, love and loss must always co-exist.

There is a vast literature of death and mourning of which Darian Leader seems all but unaware. Three centuries before Freud, Robert Burton, in his fascinating treatise ‘The Anatomy of Melancholy’ (1621) writes of ‘sorrow as a cause of melancholy’ and gives countless examples of extravagant grief in ancient texts, from Plutarch to the Psalms. Burton writes that the death of friends is ‘so grievous a torment for the time that it takes away the appetite, desire of life, extinguishes all delights…’ Sadly, one cannot but contrast the turgid prose of the second half of ‘The New Black’ (which reads like a hastily written academic paper) with the lucidity of the American undertaker poet Thomas Lynch, who understands the melancholy truth of the ‘lacrimae rerum’, having experienced it at first hand:
“But burying infants we bury the future, unwieldy and unknown, full of promise and possibilities, outcomes punctuated by our rosy hopes. The grief has no borders, no limits, no known ends and the little infant graves that edge the corners and fence-rows of every cemetery are never big enough to contain that grief. Some sadnesses are permanent. Dead babies do not give us memories. They give us dreams.’

Yet, much as I would have liked Leader’s insights to have been bolstered by this creative hinterland (as promised, after all) it is even more astonishing that he makes no reference to the work of Colin Murray Parkes, whose seminal work, ‘Love and Loss – The Roots of Grief and its Complications’ (2006) manages to be both academic and written in prose which dances with love around its subject. Moreover, Parkes’s ground-breaking ‘Bereavement – Studies of Grief in Adult Life’ was first published in 1972 and itself acknowledges his debt to John Bowlby’s earlier work on loss. Naturally Parkes addresses issues of depression and atypical grief and yet Darian Leader all but implies that this is an unploughed furrow. He cannot but know of the debt to Parkes.

It’s a pity, because ‘The New Black’ contains the seeds of a much bigger, better work which would have built on the work of Parkes (and, indeed, of the American psychotherapist Irvin Yalom whose ‘Existential Psychotherapy’ addresses death anxiety as a potential source of depression) to reveal grief as an illuminator of the human condition, as well as its shadow.