|J E P - Number 14 - Winter-Spring 2002|
Les bienfaits de la dépression. Eloge de la psychoyhérapie |
(Paris: Odile Jacob, 2001)
In his elegy to the benefits of depression, Pierre Fédida synthesizes the different approaches to this particular melancholy, to which today goes under the catch-all term, depression.
Fédida wants to give more value to a psychic state wrongly considered a mental illness. This is because he follows both psychoanalysis and a phenomenological tradition of psychopathology, the latter which had its moment of glory with Ludwig Binswanger, who was Freuds great friend, and medical director of the prestigious Bellevue Clinic in Kreuzlingen on lake Constance. There Fédida received a solid clinical and theoretical training between 1958 and 1966 from this great master of existential psychiatry, inspired by Husserl; in this, he approaches Henry Maldiney and Michel Foucaults early works. Both his university teaching following his agrégation de philosophie as well as his psychoanalytic career after his didactic analysis with Georges Favez, were (both) marked by Biswangers approach.
Since ancient times, melancholy has been considered an illness of the soul, a black humor, or even, as with Robert Burton in the 16th century, a state of existential despair of the subject, crushed by the dark failure of his ego or Gods abandonment. This state, a permanent expression of a well-being in being sad, was considered either a source of creation, or an annihilation of all thought. The spleen is necessary for the emergence of desire, but if it becomes obsessive, it ends up in destruction. This is thus the paradox of the melancholic necessity, a negative necessity inscribed in the depth of the human soul and generator of both the life and death forces.
At the end of the 19th century, when through Pierre Janets psychology the term depression appeared, the melancholic state began to be identified with a pure pathology, precisely when psychiatry abandoned the notion of melancholy for that of manic depressive psychosis. Since then, depressive subjects would be catalogued as psychic deficients or demented.
In 1917, Freud accepted the challenge in his paper Mourning and Melancholia, in which he made melancholy the unacceptable form of mourning, but also the emergence of a tragic ordeal of the human condition. In the case or mourning, the subject ends up detaching himself from the lost object, while in the case of melancholia, he feels guilty over its loss, he denies it, and then drowns in the void, believing himself possessed by the dead.
From the German and Swiss-German school (Roland Kuhn, Hubertus Tellenbach, etc.), Binswanger restitutes to melancholy its existential statute, defining it as a trouble which disorganizes the subjects psychic universe, to the point of altering all his relations with the world and with others. Today, against this tradition, the process of psychiatrization of subjectivity has reached (today) its peak. Owing to the abusive use of psychopharmeceuticals, every human being is by now compelled to no longer feel the slightest anxiety faced with death or the loss of an other. As a consequence, the depression is considered a social plague, and like the plague, an illness to be wiped out. At the same time, its symptoms proliferate because they have ceased to be related to an existential meaning.
Calling on Freud and Binswanger, Fédida avoids this contradiction, to restitute a certain nobility to melancholy. He thus distinguishes between depressivity (dépressivité), that is the creative state necessary to the tragic human condition, and depression (dépression), considered an inherent pathology to psychic life through which the subject identifies himself with the death drive. According to this view, depression could be put to good use as a negative process which allows the subject to protect himself against the ever present danger of melancholic annihilation. Faced with this illness, the best remedy would thus be to accept a depressive sufferance that the psychoanalytic cure could transform into a positive experience, in the case that the subject could not do it alone.
On the basis of clinical cases and studies on the literature or on Freuds relation with death, Fédida underlines that depression presents a challenge to psychoanalysis by forcing a confrontation with psychotherapies. Invented in 1872 by the English physician Hack Tuke and taken up again by Hippolyte Bernheim, the term psychotherapy refers to a method by means of which the doctor influences the patient, in order to provoke an interaction between the soul and the body. So, Fédida affirms that psychoanalysis is the only method capable of achieving this therapeutic project, because it takes into account the unconscious causality, and he theorizes on this influence in terms of transference. As a consequence, psychoanalysis must invade the psychotherapeutic field in the same way that depression invades the subject to protect him from melancholy, and to prevent him from drowning in the banalization.
Does this present position illustrate the struggle conducted by the author for 20 years (now) in favor of the teaching of psychoanalysis in the French university? It is precisely because the result of his struggle is uncertain that its teaching is constantly threatened by the partisans of experimental psychology. Their aim is to substitute the therapeutic relationship with the questionnaire, or the exploration of the unconscious with the opinion poll, risking moreover to train clinicians incapable of any kind of listening to psychic sufferance.
In conclusion, Fédidas book is as an autobiographic response to this devastating program. Is not the vital restlessness inherent in human depressivity the best weapon for combating the omnipotence of a barbarous objectivity?
Fédida is a member of the Association Psychanalytique de France (APF), as well as a university professor in Paris. He has published several works: Labsence (Paris: Gallimard 1980), Crise et contre-transfert (Paris: PUF 1992) and Le Site de létranger (Paris: PUF 1995). He has founded at the University of Paris-7 the Laboratory of Psychopathology and Psychoanalysis (since 1987) and the Studies Center on the Living (since 1993).