The Tyranny of Self Help or the Necessity of Existential Depression

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Tyranny Word Cloud

by Dr. Danna R. Bodenheimer, LCSW, author of Real World Clinical Social Work: Find Your Voice and Find Your Way  

     I sit down to write this blog on Wednesday afternoons when my son is in his occupational therapy appointment. I sit quietly in the waiting room. I take him to OT to help him negotiate his struggles with sensory processing. In other words, he experiences the world in a really deep way and he needs help not taking it all in so intensely.

     Irving Yalom, in 1981, wrote about near necessity of an existential depression. He basically suggested that a certain level of depression is normal, if not essential. He suggested that this depression is the byproduct of negotiating some key elements of our world and lives. These elements are death, freedom, isolation, and meaninglessness. He argued that the inner conflict that arises in negotiating these forces leaves us depressed and disillusioned.

     That is how I feel at this moment. I write this as the news out of San Bernardino is coming out, less than a week after a mass shooting at a Planned Parenthood in Colorado Springs. I don’t know much about the shooting yet, but I will soon. We all will. Then we will subsequently un-know it, so we can go on and manage our lives and psyches. Yalom argued, in many ways, that the “going on” that we do is the real pathology. And, the depression that would slow us down is actually a sign of our health, our true cognitive dissonance in the face of a world that makes less and less sense all the time.

     The shooting, today, is one that is will likely have taken out social workers. Us. The Center where the shooting occurred, from what I can tell, has been in existence for 44 years. Yesterday was their holiday party, a party designed to give those suffering with poverty, disability, and oppression, the chance to celebrate.  A quote from their Facebook page says: “The ICF Holiday Party is in full swing and SANTA is in the house! SANTA!” I feel like I can’t even stand the heartbreak of it. This Friday, December 4^th, was supposed to be their winter dance. I don’t think they can still hold that beautifully innocent event. I wonder how many of their staff members are dead. I wonder how many of their clients are dead.

     So, as my son is working on becoming less sensitive, I wonder if we need to be doing the opposite, for ourselves and for our clients. What if we can’t shake it? What if we can’t go on? Wouldn’t that be truly healthy?

     I had a client this week describe her fetishization of self-help. I found that term fascinating and incredibly spot-on. The self-help industry sets up social work up for failure by dangling the illusion of ultimate inner peace and sustainable calm. You can buy a book about how to get rid of everything in your home. You can buy a book about exactly what to buy for your home to make your home perfect. You can buy a book about how to connect with your inner creative goddess. You can buy a book about creating the perfect meditation practice. You can buy a book about how juicing will cleanse you so that you will never feel fat again. And you can read all of those books and wonder why you still aren’t well. And then you will probably feel like you should have bought a different book, a more “right” book.

     The fact is that there is a level of discomfort and pain, a level of sensitivity, that perhaps we should not remove ourselves from. And, we certainly shouldn’t keep trying to remove our clients from. Self-help offers the possibility of individual relief from intrapsychic strife. But, the truth is that the world is far more unwell than any one of our clients. As we enable the idea that the resolution to un-wellness can reside in any one psyche, we become more dishonest. Yes, we want to provide psychic relief. Yes, we want to bolster functionality. But there is also a certain dysfunction to functioning through the world as we currently know it.

     So, then what? What if we embrace dysfunction and depression? What if we refuse the dangling carrot of the self-help section at Barnes and Noble? What if we don’t try to make our clients feel less pain than they actually do at any given moment?

     Well, then I think that we are in the true heart of our work. I think we are in at least one of the four chambers that pumps the blood through the body of what we were founded upon. There are a few things that I think separate our work from all the rest. The NASW calls these things: service, social justice, dignity and worth of the person, importance of human relationships, integrity, competence.

     I agree, yet I might word it differently. I call these things: the refusal to sit idly by while innocent community members are gunned down, the refusal to pretend that it is all okay when the distribution of wealth in this country has become literally abusive, the refusal to diagnose homeless veterans with paranoid schizophrenia when they return to a country that has no place for them to rest their heads or to earn a paycheck, the refusal to think of a drug addict as a criminal. I could go on.

     When my clients come in tomorrow and are feeling scared and sad, I will be scared and sad, too. I will be scared and sad with them. And the ones who are not scared and sad are the ones who I will more seriously worry about.

     Maybe my son’s appointment will make him a little less sensitive because he will practice ways of integrating sensory processes. But I hope it doesn’t desensitize him too much, because we need as much sensitivity as we can get to decide what we are going to do. Because we have to do something.

Dr. Danna R. Bodenheimer, LCSW, is in private practice at Walnut Psychotherapy Center in Philadelphia, PA, and teaches at Bryn Mawr College Graduate School of Social Work and Social Research. She is the author of Real World Clinical Social Work: Find Your Voice and Find Your Way. Get the book at Amazon.com.