[quote author=I Don't Want To Talk About It]
Billy Jodein was a disheveled, wisecracking, overweight college freshman referred to me by his university health service in a last-ditch attempt to keep him in school. An acute episode of overt depression had taken its toll on Billy, leaving him barely enough energy to get out of bed in the morning, and little left over for study, friends, or sustained concentration. Although Billy’s brash style might at first hide his condition, depression had gripped this young man, and it was about to toss him out of school and back home to his parents. For close to a month , Billy “just didn’t have it” to get himself to many of his classes , let alone to the library. The few friends he had made were steadfast enough, although he was convinced he was boring to be around . When alone, he ached to be with other people. When with other people, he felt alienated and burdened— out of step— and he spent much of his time wishing they would just go away.
If Billy offered poor fellowship to others, he was far worse company to himself. When I ask him what he does all day, sitting for hours alone in his little dorm room, Billy answers with the warped bravado of his self-described “grunge sensibility.”
“Mostly,” he replies, smiling pleasantly, “I’d say I flay myself.”
“You flay yourself?” I ask, willing to take on the role of straight man.
“Psychological self-immolation.” Billy nods, a parody of sincerity. “Self-immolation is my favorite hobby.”
“How is it? “I ask.
“Oh, it’s loads of fun,” he answers.
“I meant, how does it go?” I try again.
Billy spreads his hands. “That’s just it,” he tells me. “It doesn’t go. It doesn’t go anywhere. It just sits there, right on top of me. Right here on my chest. And it goddamn refuses to move.”
Billy has managed to evade my question, and I suspect he is not yet ready to expose to me the dialogue that rages inside his head. But I have seen enough depressed men in my practice to guess what “flaying” himself signifies.
At Billy’s age, I myself was no stranger to such self-immolation. At sixteen, seventeen, I did not manage to sit still long enough to allow the voices inside my head to have their way with me. I ran from them. But even without giving in, I knew their essential message well enough :
There was something wrong with me, something unlike other people—something frightening and bleak. I felt a perverse sense of blackness, sadness, a grim coldness at the center of things. I can recall this state of dead disconnection since early childhood.
...............
I think I understood what Billy Jodein meant when he told me that he flayed himself.
[/quote]
The author Real suffered physical abuse at the hand of his father in childhood and had taken to drugs at a young age. Most of his buddies of the time were either dead or revolving door patients in mental institutions. He outlines his own struggle with accounts of those of his patients in the book.
[quote author=I Don't Want To Talk About It]
There are many ways to describe the experience of depression , many aspects of the disorder one might choose to center on. My focus in treating depressed men has been primarily
relational .
What kind of relationship does a depressed man have with others’? I ask, followed by:
What kind of relationship does he have with himself?
The answer to both of these questions is often: a bad one. Writers like Knauth or William Styron vividly describe the “ pure psychical anguish ” that patients like Billy endure. In the last twenty years, all manner of depressed men have passed through my doorway— young, old, successful, incompetent, kind, and angry. Each one of them has had one thing in common:
his relationship to himself was a cruel one.
I tell Billy Jodein that I think of depression as an auto-aggressive disease, a disorder in which the self turns against the self. If we were able to take a psychic stethoscope and listen in to the unremitting conversation looping inside Billy’s mind, we would hear harsh, perfectionist judgment matched with bitterness, mistrust, and hopelessness. Billy comes by such harshness “honestly,” as they say. Like most of the depressed men I have encountered, Billy had a history
of sustained childhood injury. The bridge that links injury in childhood and depression in manhood is violence.
Psychological violence lies at the core of the traditional socialization of boys in our culture. For many boys, that social wound is further aggravated by their unique family experiences. If “boy culture” exposes most young males to some degree of psychological injury, those growing up in especially difficult circumstances, particularly those also possessing genetic vulnerabilities, are most at risk for depression later in life. The violence they are exposed to as children takes up residence inside their minds as adults. Overtly depressed men like Billy are frozen, endlessly rehearsing repetitions of pain and despair.
If overtly depressed men are paralyzed, men who are covertly depressed, as I was, cannot stand still. They run, desperately trying to outdistance shame by medicating their pain, pumping up their tenuous self-esteem, or, if all else fails , inflicting their torture on others. Overt depression is violence endured. Covert depression is violence deflected. In either case, understanding depression in men means coming to grips with men’s violence. How has the door of the psyche been opened to such a dark visitation? By what mechanisms does violence in the boy’s environment become internalized as a stable force inside his own mind? Although he is unaware of his knowledge, Billy Jodein knows how.
“Every night before he came home, I would watch my mother scurry around the house like a fat little hamster,” Billy tells me during one session, crossing the legs of his artfully ripped blue jeans. With his acne-ridden face, spiky hair, and pudgy disorder, Bill thrusts himself out into the world, a pugnacious whirl of chaos, daring someone to try cleaning him up. This is our fourth session, and Billy has already threatened to stop coming. His demeanor makes it clear that he is in therapy to placate his school, his worried parents, and me, in that order.
“What do you mean, ‘hamster?’” I ask.
Billy pushes up the glasses that threaten to slide down his nose —an abrupt, jabbing motion— and curls his lip in a sneer. “You know, like totally frenetic. Trying to get everything all straightened out before Dad got home. Every dish, every ashtray. I could see the fear in her eyes. I mean subtle, but definitely frantic, in her own controlled little way.”
“Go on.” I lean forward.
Bill takes a big swig of diet Coke and rests the wet can on a bare knee sticking up through his jeans. “I had this realization one day,” he tells me. “This‘ah, hah !’ experience, you know? And I told her. She was all running around and, like, I said, ‘Hey, you know, Mom. I hope you understand that everything you’re doing is totally useless.’”
“And?” I ask.
He shakes his head. “She hardly heard me,” he says. “But I told her anyway. I said,”‘ You do know that no matter what you do, he’s still going to go off on you. If he feels like it. I mean, no matter what. No matter how nice the dinner is or whatever.’”
“Go off?” I ask.
“You know , flip out.” Billy combs through thick, unruly hair with his chubby fingers.
“And how did she take it?” I ask.
“Could have saved my breath.” He pulls on the Coke. “Believe me.”
“Why?” I ask.
“Well, she heard me, I guess. I mean physically. Just sort of blinked at me and kept going .” He grins to himself. “Just like one of those little Duracell guys, you know. Just kept on tickin’.”
Even though it is a pose, even though I know he is young, I find Billy’s snide mannerisms annoying.
“Is this funny?” I challenge him.
“Excuse me?” he bridles.
I take a breath, try to relax. “I was just wondering what you might be feeling if you weren’t joking” I say, halfheartedly, suddenly tired.
Billy squints up at me for a moment, as if considering for the first time that I am in the room with him. He looks at my face longer, and more seriously, than I have been accustomed to. “Long day?” he asks, not mockingly. I look back at him.
“Yes,” I say. “To be honest. Why?”
He shrugs. “You looked kinda tired.”
“Thanks, Billy,” I tell him. “I appreciate that.” And, after a pause, “Do you want to answer?”
“Your question?” He smiles. I nod, waiting for some big revelation, but he only shrugs. “Kinda useless, I guess. That’s how I’d feel if I didn’t make a joke out of it,” he tells me.
I let it go. “And when your dad did get home?” I ask him.
“Yeah, so”— he looks down at his soda can—“ why would it be different from every other night he came home?” he asks, with another reckless jab at his glasses. I worry he’ll miss and poke his eye.
“Meaning, they argued?” I ask him.
“That’s one way to put it,” he answers.
“You have another—” I begin, but he cuts me off.
“No, you’re right. They fight. ” He seems nervous.
“Describe it,” I ask him.
“Like what? What would they say? The words?”
I nod.
“Aw, you know, just, ‘F*** you! I won’t live like this anymore, ‘ and then, ‘You’re such an ass***! I can’t believe you treat me like this!’” He shakes his head. “ Et cetera. Et cetera. Et cetera,” he intones. “Believe me.”
“And this would go on every night?” I ask.
“Most nights,” he tells me.
“Where would you be?”
“Are you kidding?” he sits up. “Hey, I’m at a friend’s. Really , ‘Have a nice day!’” Under my gaze, Billy’s ready smile dissipates. He sits back, deflated. “Or, maybe, up in my room,” he says, sounding like a kid, “listening to music.”
“Billy,” I ask. “Are you feeling anything as you say this?”
“Now?” he asks, “Naw.” Although I can see he is sad.
“And how would you feel back then?” I pursue.
“About their fighting?” He stalls.
I nod. “About anything. All of it.”
“Not too much,” he says, appearing more and more a little boy, kicking his feet in the chair. “Sorry for them, mostly, I guess . They were just so pathetic.”
“So, you’re aware of feeling sadness for them,” I tell him.
“Well, just that they’re both such jerks,” he replies.
“Uh-huh. And what about you, Bill?” I lean toward him. “You were the kid listening to all of this night after night. The kid upstairs in his bedroom.”
“What about it?” he says, sullen , pugnacious.
“You felt sad for them, but what about your feelings for yourself?” I ask.
“Yeah, I’m pretty used to it,” he says, a tough guy.
“Oh, you are.” I lean back.
“Hey,” he says, “this has been going on a long time.”
“Yeah,” I say. “How long? How old were you when all this first started?” I ask him. “Give me the youngest age you can remember them bickering.”
“It’s been like this the whole time,” he protests.
“Nine, ten, seven, eight?”
“Yeah, all of it,” he says.
“And you think that little nine-year-old might not have had some feelings ?” I ask him. “ That seven-year-old boy?”
“It was a long time ago.”
“You can’t remember?” I press.
“No,” said quickly, belligerently, then, “Why should I?”
“I’m just wondering what happened to them, that’s all.”
“My feelings?” he asks.
“Right,” I say.
He flashes a supercilious smile. “Well, that’s assuming I had them,” he says.
“Billy.” I lean forward and catch his eye. “I think you still have them.”
“You know, Terry,” Billy sneers, “not everyone needs to fit inside your neat little—”
I cut him off , speaking softly. “You finally manage to get out of that hellhole of a family and not five months into your freshman year you’re so depressed you can’t sleep, eat, or make it to class. But you sit here and tell me this is our last session, you have nothing to work on, and you don’t have any feelings.” His face flushes, but I keep going. He is either going to get on board or not. “You know, if you keep going on like this, Billy, I think you’ll be headed right back home again . Is that what this is really about ?” I ask. “Before the end of next semester, I’d guess.” I lean back in my chair. “Believe me.”
He turns on me , angry. “That was a low blow, mister!” Even though it is in anger, I can feel his connection.
“You need help, Billy,” I tell him, flatly.
“‘ You need help, man. Hey. You really need help, ‘” Billy mocks me, furious, turning his face to the wall. But his eyes fill with tears, despite himself. We sit, quiet awhile, not looking at one another. A few minutes pass. “I’m a loser,” Billy says at last, the apathetic veneer collapsing. He sounds small, frightened. “A big fucking loser!”
“You’re a boy,” I answer. “A sad boy trying to deal with it all.”
Billy stays quiet awhile, still not looking at me. A few minutes later he says, still in his child’s voice, “You want to hear the sickest thing?”
“Okay, sure,” I say gently.
“I swear,” he begins to cry softly, “this is so f****g ill.” “Go on,” I tell him. “The sickest thing is … I think I miss them.” He stifles his tears . “If you really want to know the truth. I mean, how is that?” He twists further away in his chair . “I think that, really, what this whole thing is, is I’m homesick is all. I finally get the f*** out of there and then I fall apart ‘cause I’m homesick. Jesus!” Billy buries his face in his hands and, for a brief moment, fully gives in to his tears.
I hand him a tissue. “Go on and cry, Billy,” I say. “There’s a lot to be sad about. You have a right to be sad.”
“I hate this!” he gasps. “Breaking down.”
“You’re not breaking down. You’re crying. Breaking down happens to people who don’t cry.”
Billy blows his nose, loudly , a couple of times. He squints up at me with his belligerent, acne-ridden face. “Do you know what the f** you’re talking about?” he asks , collecting a mound of tissues on his lap.
“Here.” I hold up the wastepaper basket, like a hoop, for him to throw his wet tissues into. “ Take a shot.”
[/quote]
One of the characteristic features in Billy's account that Real picks up on is that there is an absence of feeling for the child. Billy felt sorry for the parents but not for himself. Later events showed that Billy did not simply cut off feelings for his own child self - he actively despised that self.
[quote author=I Don't Want To Talk About It]
In depression, the childhood violence that had been leveled against the boy— whether physical or psychological, active or passive— takes up permanent habitation within him. The depressed man adopts a relationship to himself that mirrors and replicates the dynamics of his own early abuse . This phenomenon, which I call
empathic reversal, is the link connecting trauma to depression. To understand the mechanism of empathic reversal, we must accept a disturbing truth— that trauma intrinsically involves fusion between the offender and his victim. In the very moment of damage, some form of unholy intimacy occurs, in part because trauma always involves a failure of boundaries. In active trauma, a child’s boundaries are violated. The parent is uncontained , out of control. In passive trauma, the parent neglects the child’s needs; the boundary between parent and child is too rigid, impenetrable. Both are instances of boundary dysfunction .
......
When a child is traumatized— by a parent who is either negligent or out of control— his first and most profound response will be to take responsibility for the failing parent.
When a child
comes face to face with a caregiver’s pathology , that child will do whatever he must to reinstate the caregiver’s psychological equilibrium. A child’s need to preserve his attachment, his willingness to contort himself into whatever shape the parent needs him to be in during such moments represents one of the least recognized, most pervasive, and most powerful psychological forces in human development.
...........
Both as a result of the boundary failure and as an unconscious coping strategy, the child will take the feelings that the parent is not handling responsibly into his being. Along with whatever other feeling-states may be involved— anger, pain, lust, fear— it is inevitable that one of the feeling-states transmitted to children in such traumatic moments will be the feeling of shame.
.....
When a parent traumatizes a child, he is in a state of shamelessness. If the injurer felt appropriate shame, he would contain his harmful behavior . The shame a parent does not consciously feel will be absorbed, along with other unconscious feelings, by the child. Pia Mellody has called these transmitted states
carried shame and
carried feeling. They are the means by which the wound, the legacy of pain, is passed from father to son, mother to son, across generations. Carried feeling and carried shame are the psychological seeds of depression.
[/quote]
The injury causing events of childhood with its accompanying psychological exchange plays out as a drama repeatedly in later life in different situations with different actors.
Elan Golomb described the internalized tyrant as the "negative introject" (
link ). In effect, trauma splits up the internal psychic land of the victim into a harsh punitive child (internalized from the abuser) and the scared, traumatized child (the repressed victim).
