Tales from the Dark Wood In the middle of the journey of life, I was plunged into a dark wood, for I had lost the right path. -- Dante, The Inferno Part VI: "From Childhood's Hour"by Douglas S Johnson From childhood's hour I have not been As others were, I have not seen As others saw, I could not bring My passions from a common spring… -- Edgar Allan Poe It has often been said that "the child is the father to the man." In fact, before the humanistic movement spearheaded by Maslow and Rogers, most clinical psychologists believed that childhood experiences were the primary determining factors in any person's adult development. As we will see in the case of "Sören," the subject of the next interview in this series, while childhood trauma does not predestine the complete doom of any individual, it may incline one to develop symptoms of depression later in life, especially if the upsetting event or events are not adequately dealt with in the mind or if they are repressed. (There is even more chance of such a person developing depression if she is biologically predisposed to the disorder or if she has what might be less than technically termed "a sensitive nature.") Having said this, I suppose that at this juncture, it is very important to understand the "deterministic modes" of psychiatric diagnosis. In the years since the birth of psychology as a science, two different schools of thought in regard to mental dysfunction (and, for our purposes here, depression) have come into being. On one side are the "physiological determinists," who would claim, as Freud once did, that "biology is destiny." That is to say, our lives are run by the chemicals that course through our brains -- bad chemicals, bad life. On the other side are the "environmental determinists," who claim, as Freud also asserted, that our experiences, and particularly those of childhood, shape who we are the same way a potter's fingers shape clay into a lovely vase or a useless blob. Those who take the "middle of the road" approach to these theories say that both sides are right, to a certain degree: both biology and experience shape who we are. Researchers in the field of psychological pathology are coming to see that this approach is a valid one in most cases. Certainly, there are instances in which one has a wonderful life and horrible brain chemistry and so one ends up depressed; and likewise, there are cases in which brain chemistry starts out fine and a miserable existence during childhood brings a resultant depression in adulthood. However, it is most often that there is a mixture of the two, a "tangled yam" of causation. So to what degree can childhood experience alone cause depression? "Sören" and those who as children were unfortunate enough to suffer physical, verbal, and sexual abuse, make for good study in this stead. First of all, feelings of self-worth and -esteem are certainly eroded by abuse or childhood trauma, which causes the person to feel out of control of his life. As uncertainty and self-loathing form a major facet of the disease of depression, we can easily see that this erosion by external circumstances puts the victim a good step toward the development of depression's symptomatology. Then there is the whole "out of control" aspect of the abuse victim's plight. As has been stated in previous installments of this series, one of the main symptoms of depression is that one has feelings of helplessness and an inability to deal adequately with and in her world. The depressive (and likewise, the abuse victim) looks around herself and sees people who apparently deal with living in a passable fashion, and then she views herself as being all the more incapable for the comparison. Feelings of being incorrigibly different, and, consequently, of being alone in the world, constitute another hallmark of depression; these same feelings are brought about by abuse during childhood. (Even abused and neglected children who are led to believe that "everybody lives this way" know instinctively that there is something terribly wrong with what is being done to them and that, in fact, their lives are not "normal." Therefore, they feel displaced in regard to their seemingly healthy peers.) The depressive views the world as a hostile, dark, hopeless place. So do many children who have grown up in an environment of ongoing abuse, neglect, or trauma. Also like the depressive, the victim of childhood dysfunction often begins to see his plight as being not merely local but cosmic and so eventually develops the "empty, meaningless, random universe" outlook often held by the depressed person. This is no doubt a less than exhaustive list of comparisons between the feelings of the depressive and those of the person abused or repeatedly traumatized in childhood, but it does serve to make the point that the salient symptomatology of depression can be brought about (or augmented) by abuse, trauma, and neglect during the formative years. One might ask which is worse, depression associated with problems of biology or depression caused by the suffering of abuse or childhood trauma, but it is probably more a difference of subtlety than of "which is worse" (as severity will differ from case to case, no matter what the cause or combination of causes). I suppose if we allow for extremes and go back to the idea of the person who gets depression simply based on brain chemistry and the person who becomes depressed solely due to traumatic experience, we can see that the difference between the two is the difference between a lab experiment and a shop project: the former involves an invisible blending of imperceptible atoms by way of primary physical forces, which brings about a perceptible result (assuming the lab chemicals explode or change color or something), and the latter involves an ongoing series of detectable, broad, mechanical actions that bring about a perceptible consequence. Simply stated, the second process is easier to see. Once again, we do not wish here to shortchange the biological side of depression by making the false inference that simply because abuse and trauma are external and thus more "obvious," a negative environmental stimulus is the more powerful cause or the one likely to be the root of difficulty in most cases of depression. That would be a step back toward Freud's assumption that obsessive-compulsive disorder is caused by bad toilet training. (Also, we must always remember that the "one cause or the other" polarity is mainly theoretical and that most cases are best approached from the "middle of the road mode" of diagnosis.) With all of that said about biological and environmental determinants in regard to the development of depression, I would like to push things one step further and propose what we might rather clumsily term the "supra-deterministic mode," in other words, Maslow and Rogers' "humanistic approach" to psychology. As we will see with "Sören," in addition to biological and environmental causation, there is a third factor in adult psychological development. In regard to this third determining factor, Lucien Malson once wrote that "existence -- or consciousness -- has the character of a spark or a flash; it is a permanent starting point, and for these reasons it cannot be reduced to the internal or external conditions of its appearance." What he was talking about was that part of ourselves which is self-directed, the stronger portion of our being that can override (to greater or lesser degrees) the biological influences of the present and the environmental influences of the past. "The influences that shape a man's life," Malson wrote, "to which he can submit but which he can also resist, are partly of his own making. As the subject and object of his own history as well as of the history of all, he both creates himself and is created, rising above any attempt to engulf him in determinism" [biological or environmental, dsj]. Such a view holds out eternal hope. This is not to say that depressives can magically get better by simply "pulling themselves up by their own bootstraps." Such flippancy would be unspeakably cruel and unfair. It merely offers the sufferer that "permanent starting point" from which she can begin to reconstruct her own life. In fact, this "self-determination" should not be construed as merely sitting around chanting affirmations and "willing" oneself to suddenly get better (although this shouldn't be altogether discounted either!), but also as seeking help and therapy for depression, taking anti-depressive medications if such are prescribed, exercising the body and the mind in constructive ways, finding the importance of God and spiritual living, helping others, and realizing that, even if one cannot completely overcome the influences of biology and early environment, one can most usually find ways and formulate strategies to continue to live a productive and full life. This is the sixth in an eight-part series on depression written by Douglas S Johnson exclusively for The New Times. Please send SASE for any reprints desired.