THEORIES ABOUT THE CAUSES OF DEPRESSION

Helplessness and hopelessness

Being frustrated so many times that you have no hope is surely depressing. This is a
very old idea; 2,000 years ago Aretaeus, a physician, said melancholia sufferers
"complain of a thousand futilities." But it is also a fairly recent and rapidly changing
theory. Seligman !"#$% &as studying escape learning and found that dogs, forced to stay
in a 'o( &here they &ere repeatedly shoc)ed, soon gave up and stopped trying to escape.
*ot surprising. +oreover, ,$- of the dogs didn.t try to escape the ne(t day &hen the 'o(
&as modified so they could easily escape. They /ust laid do&n and &hined. They had
learned helplessness. Seligman said human depression &ith its passivity and &ithdra&al
might 'e due to "learned helplessness."
This single study of dogs stirred enormous interest among e(perimental psychologists
&ho had heretofore ignored the ancient idea of hopelessness. Ama0ing. Ho&ever, 1 thin)
&e are seeing the potential of research to slo&ly clarify and validate an idea. 2or
e(ample, &ithin a fe& years the "helplessness" theory &as 'eing 3uestioned 'ecause
many people in helpless circumstances do not 'ecome depressed and 'ecause this theory
does not e(plain the guilt, shame, and self4'lame that often accompanys depression. Ho&
can you feel helpless, i.e. &ithout any a'ility to control &hat happens, and, at the same
time, feel at fault and guilty a'out &hat happened 5arson 6 Adams, !"7!%8
A fe& years later, attri'ution and9or cognitive theory A'ramson, Seligman, 6
Teasdale, !"#7% came to the rescue &ith the reformulated helplessness theory. This
suggests that the depressed person thin)s the cause is internal "it.s my fault"%, sta'le
"things can.t change"%, and glo'al "this affects everything"%. This is a very different
theory no e(perimentalist had ever theori0ed that the dogs 'lamed themselves%. But soon
there &ere more pro'lems, e.g. research sho&ed that most depressed people, li)e dogs,
see the causes of their depression as 'eing outside forces, not themselves 5ostello,
!"72%. +oreover, 'oth the hopeless self4'lamer and the hopeful self4helper see the causes
of their 'ehavior and feelings as 'eing internal. So, internal causes may lead to optimism
as &ell as pessimism. And, finally again, ho& do &e )no& that the feelings of
helplessness or hopelessness precede and cause depression rather than /ust 'eing a natural
part of feeling depressed8
To deal &ith some of these difficulties, A'ramson, +etals)y, 6 Alloy !"7"%
modified the helplessness theory into a still 'roader hopelessness theory. The more
comple( hopelessness theory contends that prior to 'ecoming hopeless the person has a%
a negative cognitive or attri'ution style see ne(t t&o theories% and '% some unfortunate,
stressful e(perience. Because 'oth of these factors are involved, some people &ith
depression4prone thin)ing don.t 'ecome depressed 'y avoiding traumatic e(periences%
and some people go through a&ful e(periences &ithout getting depressed 'y avoiding
negative thin)ing%. The hopeless person expects bad things will happen in important
areas of his9her life pessimism% and9or that hoped for good things &ill not happen, and
he9she doesn.t e(pect anything to change that misera'le situation.
5onsidera'le research has supported parts of the hopelessness theory. 2or e(ample,
+etals)y 6 :oiner !""2% found that three cognitive views; a% attri'uting 'ad events to
unavoida'le and far4reaching causes, '% dra&ing negative conclusions a'out yourself
from a negative event "it means 1.m &orthless"%, and c% assuming one 'ad event &ill
lead to others in the future, when combined with high stress, are associated &ith
depression. 1n another study, they found that low self-esteem &as another crucial
ingredient in order to produce depression +etals)y, :oiner, Hardin 6 A'ramson, !""<%.
=lease note; depression might 'e avoided 'y reducing your negative thin)ing ha'its,
avoiding high stress, or 'y 'uilding your self4esteem.
>f course, your needs and personality &ill determine ho& stressful a particular event
&ill 'e for you. Segal !""2% found that recovered dependent depressives &ere plunged
'ac) into depression 'y a loss or conflict in interpersonal relationships. But, self-critical
depressives relapsed &hen they failed at school or &or). >nly our most dreaded pro'lems
seem to set off depression.
This ne& hopelessness theory e(plains depression to a considera'le e(tent on the
'asis of pessimistic expectations of the future. Traditional thin)ing and other theories
?!, ?$, ?7, ?", ?!0 6 ?!<% say depression is caused 'y o'sessing a'out losses in the
past. Selective perception of the past is also thought to 'e important, e.g. self4critical
people don.t see their successes. Both 'ac)&ard4loo)ing and for&ard4loo)ing theories are
pro'a'ly true, sometimes. Some people regret the past ">f all sad &ords of tongue and
pen, the saddest are these, .it might have 'een."% and others dread the future 'ecause they
&ill mess it up or have no control%, and some do 'oth. +ay'e the negativism of some
depressed people e(tends to everything44the past, the future, me, you, the &orld...
As &e &ill see later, the therapy for helplessness and hopelessness includes a%
ma)ing more good things happen and9or increasing positive e(pectations, '% increasing
self4control44li)e &ith this 'oo), c% increasing tolerance of &hatever happens, and d%
increasing one.s optimism. 1deally, the depressed person &ill develop internal, sta'le, and
glo'al e(planations attri'utions% for good events, e.g. "1.m responsi'le for &hat happens,
and 1 can ma)e good things happen again in lots of areas." @i)e&ise, the shift should 'e
to 'elieving that e(ternal, unsta'le, and specific factors account for unpleasant life4
events, e.g. one of Seligman.s 'etter ad/usted dogs in the shoc) 'o( might say, "this man
is hurting me, he &ill surely stop soon, people only shoc) me in this 'o(... and 1 &ill
vigorously avoid getting into this 'o( again. 2or no&, 1.ll /ust tough it out."
Exercise: How do you explain things?
1t might increase your understanding of your o&n depressive moods to thin) of 7 or
!0 situations that could happen to you44'oth good and 'ad. A(amples; doing poorly on an
e(am, getting a good /o' or a promotion, having an auto accident, not 'eing a'le to get a
/o', getting a ne& friend, having a date that doesn.t &or) out, losing a girl9'oyfriend,
having a fight &ith a parent, relative, or child, etc. Bividly imagine each situation, then,
after&ards, &rite do&n &hat seems li)e the main reason or cause for &hat happened.
*e(t, as) yourself; a% 1s this cause due to me or someone or something else8 '% 1s this
cause going to influence /ust this situation or many others as &ell, i.e. ho& general or
ho& limited is the influence of this factor8 c% 1s this cause a temporary factor or long4
lasting8 d% Ho& important is this situation to me8 e% Chen 'ad things happen to me, do
1 conclude 1 am at fault or 'ad8 f% Chen something 'ad happens to me, do 1 assume
more 'ad events are on their &ay8 By loo)ing at your ans&ers over several situations,
perhaps you can figure out your attributional style. Are you a pessimist a'out the future8
Are you a harsh self4'lamer8 Chat do you thin) your faults are8 Do you 'lame your
'ehavior "1 didn.t study enough"44this is changea'le% or your character "1.m la0y" or
"1.m stupid"44hard to change%8 Chat are your strengths8 Ho& lo& is your self4esteem8
Do you see &ays to change8
There are even more good 3uestions you can as) yourself that should help you reali0e
that your depression can 'e changed :ohnson 6 +iller, !""E%;
The Exception Question; Chen are you the least depressed8 Chat &as the last
time you &eren.t depressed or do&n on yourself%8 Do you remem'er a time &hen
you e(pected to get depressed 'ut you &ere a'le to avoid it8 These )ind of
3uestions remind you that you have some self4control... that depression can 'e
changed. They cause you to start e(ploring the reasons for these changes44&hat
&as different8 Ho& can you reduce the depression again8
The Miracle Question; 1f the depression or self4critic% miraculously &ent a&ay,
ho& &ould life 'e different for you8 Chat &ould 'e the first sign it &as gone8
Ho& &ould others say you are different8 Chat &ould you 'e doing instead of
'eing depressed8 Be very specific a'out ho& your 'ehavior and feelings &ould 'e
changed. Chat are some of the e(citing possi'ilities if you &ere not 'urdened
&ith depression8 This starts you thin)ing a'out your potential in the future as a
happy person.
The How-Did-You-Do-It Question; Depression is an a&ful condition, ho& have
you managed to handle it8 Ho& have you )ept things from getting even &orse8
Ho& do you fight off the conditions that ma)e you get really depressed or to &ant
to hurt yourself8 Chere do you get the strength to 'e a survivor8 These 3uestions
cause you to loo) for your specific strengths and for other &ays to cope &ith
depression. They also help you see that depression is not caused 'y you and is not
an unavoida'le part of your 'eing. Depression and self4putdo&ns are e(ternal
pro'lems imposed on you 'y psychological or historical factors and
circumstances. These misery4causing e(ternal factors can 'e changed.
Ho&ever, there are still serious 3uestions a'out this hopelessness theory; Chen and
ho& are negative thin)ing styles learned in real life8 Again, &hich comes first the
thin)ing or the feelings8 1sn.t it illogical to feel responsi'le for ma)ing good things
happen 'ut not responsi'le for 'ad events although that is the &ay &e fre3uently thin)
a'out Fod44&e give Fod credit for good happenings 'ut usually not the 'lame for 'ad
things%8 Do hopeless depressives only feel guilty and ashamed of sins of omission8
Couldn.t sins of commission 'e impossi'le for me as a truly "helpless" person, unless 1
&as possessed 'y evil e(ternal forces that "made me do it" and &ith &hom 1
colla'orated8 Begins to sound li)e a !,20 &itch hunt, doesn.t it8 See later discussion of
guilt.%
Actually, the victim of depression may feel helpless, 'ut his9her emotions, &ea)ness,
and pessimism can have a very po&erful effect on others. A(amples; the typical
"helpless" person "as)s others to do things for him9her," "never does things on his9her
o&n," "gets others to ma)e decisions," etc. This is helpless8 Hardly, it is dependent,
demanding, and controlling =eterson, !""<%. These "helpless" feelings also serve as self4
e(cuses for poor performance for many of us it is 'etter to 'e seen as "feeling do&n"
than as a failure%. But only persons prone to depression are &illing to 'e e(tremely self4
critical "1.m a loser... helpless... &orthless"% in order to protect themselves against
criticism and to avoid facing future responsi'ilities Gosenfar' 6 Aron, !""2%.
Ho& do people respond to someone.s helplessness8 At first, people try to ma)e the
person feel 'etter; they try to meet his9her needs. But after seeing a lot of "helpless"
'ehavior from one person, people tend to get angry and9or avoid the su'tly may'e
inadvertently% demanding depressed person &ho never changes. 5learly, not all
"helpless" people are passive, ineffective, and feeling futile, li)e Seligman.s dogs. Some
are po&erful. Seligman.s latest vie&s are in =eterson, +aier 6 Seligman !""<%.
Hap)o !""2% 'elieves that depression not only results from an "illusion of
helplessness" 'ut also from an "illusion of control." 2or instance, Ba'y Boomers &ere
taught they could have it all44education, great /o', &onderful family, nice house and car,
fantastic travel, etc. That &asn.t true and Ba'y Boomers have an unusually high rate of
depression. They didn.t meet their e(pectations. Inrealistic e(pectations in 'oth
directions, i.e. hoping for too much change or 'elieving little change is possi'le, can
cause depression.
*egative vie&s
Bec).s cognitive therapy states that some&here in childhood the depressed4to4'e
person develops a negative vie& of the self, the &orld, and the future; "1.m no good," "the
&orld ain.t fair," and "it &on.t &or) out." Aach of these negative vie&s gets e(panded into
detailed 'eliefs; "1.m dum'," "1 can.t tal) intelligently," "1.m ugly too" and on and on.
These negative assumptions seem to 'e held on a very primitive level; facts don.t
influence these 'eliefs, so they never get 3uestioned or tested against reality. 2or a
'rillant investigation of the development of self4critical 'eliefs at an early age, see 5arol
D&ec).s studies of mastery4oriented thin)ing. These negative vie&s /ust lie dormant even
&hile more rational evaluations of self, &orld, and future may also 'e developed and used
as &e mature into adults. Then later in life, &hen the self is hit &ith some serious loss or
stress, often one that reminds us of a loss or trauma at an early age, the old unreasona'le
and destructive negative ideas suddenly ta)e over and dominate our thin)ing. 1t is our
negative ideas that produce our depression, not the stressful triggering event that
produces our depression. The deeper the depression, the more the negative ideas replace
rational thin)ing 5oleman 6 Bec), !"7!%.
Inder the influence of this primitive, negative thin)ing, our logic fails us. 2or
e(ample, &e /ump to conclusions, loo) at only one detail and disregard the 'ig picture,
overgenerali0e from one e(perience, magnify our faults and minimi0e our achievements,
and ta)e the 'lame see e(amples in ne(t t&o theories%. All of this adds a very dar) and
gloomy shado& over our mental life.
Gesearch has confirmed that sad4prone people notice the negative aspects of an event
they remem'er their goofs44'ut not other peoples.44and overloo) &hat they did right% and
assume too much of the responsi'ility &hen things go &rong. 1t has also 'een
e(perimentally demonstrated that thoughts induced 'y the e(perimenter% can influence
feelings and 'ehavior 5arson 6 Adams, !"7!%. Therefore, it isn.t /ust the depressing
event that ma)es us sad 'ut also every time &e remem'er and fantasi0e a'out the
disappointing event in the past or imagine a similar thing happening in the future, &e
create a more and more depressive mood. Gemem'er, though, negative cognition clearly
accompanies depression 'ut it has not 'een proven that negative thin)ing is the e(clusive
cause of depression; other factors may 'e involved in causing depression Barnett 6
Fotli', !"77%.
Ising methods much li)e @e&insohn.s, cognitive therapists colla'orate &ith the
patient to get him9her to investigate the relationship 'et&een his9her negative ideas and
his9her feelings of depression or actions. So, the therapist may as) the patient to
"investigate" &hether or not he9she can start ta)ing tennis lessons. 1f he can, that is a little
evidence against his 'elief that he9she can.t change anything. A fe& &ee)s later patients
are taught to identify their automatic negative thoughts that precede negative feelings.
The cognitive therapist does not attac) the patient.s irrational ideas as 'eing &rong. >nly
after the patient 'egins to dou't some of his9her o&n negative ideas, can the validity of
those thoughts and the logic and assumptions underlying them% 'e tested out and
evaluated by the patient &ith help from the therapist 5oleman 6 Bec), !"7!%.
5ognitive therapy notions a'out negative thin)ing overlap a lot &ith the hopelessness
theories, Gational4Amotive therapy irrational ideas%, and faulty conclusions theories
discussed later.
THEORIES ABOUT THE CAUSES OF DEPRESSION
1rrational ideas
Gational4Amotive therapy, as descri'ed 'y Allis 6 Harper !"#$%, Hauc) !"#<%, and
+aults'y !"#,%, emphasi0es that irrational ideas cause all our unreasona'le or e(cessive
emotions. 1n the !st century A.D., Apictetus, a Free) teacher enslaved in Gome, said,
"+en are not distur'ed 'y things that happen to us%, 'ut 'y the vie&s &hich they ta)e of
those events." 1n the !",0.s Al'ert Allis started teaching this simple philosophy; our
thoughts cause our feelings. Here is an e(ample;
A. 2irst, there is an event; our girl9'oyfriend says, "1.m going out &ith someone
else."
B. Then, our 'elief system44our irrational ideas44'ecome part of our perception of
the situation;
!% She9he doesn.t li)e me, 1.ve failed, no one &ill &ant me, 1.m &orthless,
1.ll never find as good a lover, it.s terri'le that he9she is dumping me. >r;
2% 1t.s a&ful that she9he &ould do that, it.s inconsiderate, it.s selfish, it.s
unfair, it.s em'arrassing, it.s mean, she9he is a terri'le person, &e made
promises, she9he has pro'a'ly 'een "loo)ing" for a 3uite a &hile, 1 hate
her9him.
5. Then, &e have an emotional reaction;
!% 1f your 'elief system thoughts% is li)e B !%, you &ill feel serious and
lasting depression.
2% 1f your 'elief system is li)e B 2%, you &ill feel intense anger.
Hou see, it is not the e(ternal event44the re/ection44that creates the emotional
response, 'ut &hat &e say 'eliefs B ! or B 2% to ourselvesJ Ce have a choice.
1ndeed, &e could tell ourselves something entirely different and produce a very
different emotional reaction, for e(ample;
B. A more rational 'elief system;
<% Ce had some good times together 'ut o'viously there &ere pro'lems.
1 &ould have preferred that she9he had told me that she9he &as unhappy
and "loo)ing" 'ut it &asn.t a&ful. 1.m sorry &e didn.t &or) it out 'ut 1.ll
get through the hurt, and 1.ll learn to 'e a 'etter companion ne(t time.
5. A more reasona'le emotional reaction;
<% Some pain, regrets, and sadness for a fe& days or &ee)s 'ut not
intense, lingering anger or deep, prolonged depression.
Gational4Amotive therapy is more challenging and aggressive than most other
therapies. These therapists immediately point out and attac) the client.s irrational
thoughts and unreasona'le e(pectations. They directly suggest more reasona'le &ays of
vie&ing the self, the &orld, and the future. They also assign home&or) designed to
correct false 'eliefs.
Chat are some of the other harmful irrational ideas and thoughts8
Averyone should accept and approve of me; it is a&ful &hen
someone critici0es me.
1 should al&ays 'e a'le, successful, and "on top of things."
1 must have love to live in some cases44a particular person.s love,
as in the e(ample a'ove%.
1f 1 am critici0ed or re/ected or ma)e a mista)e, it means 1.m not
li)ed, unlova'le, and incompetent...it.s a&fulJ
A(ternal events, such as 'ad luc), other people, a sic) society,
cause unhappiness. 1 can.t control these things, so it.s not my fault
things are so a&ful.
*ote t&o things; first, a, ', and c are unreasona'le e(pectations, often impossi'le
goals. They are, of course, nice, common and in many &ays useful &ishes; everyone
&ould li)e to 'e approved, successful, and loved, 'ut &e can.t demand that our &ishes
al&ays come true. Chen things don.t go our &ay, it isn.t something a&ful to go into a
rage or deep depression a'out. Although an event may 'e regretta'le, it is al&ays a
psychologically understanda'le and 'ehaviorally la&ful outcome. @ater &e &ill see that
Karen Horney referred to these insistent neurotic needs or demands that things 'e the &ay
&e &ant them to 'e as "the tyranny of the shoulds." Secondly, d and e illustrate other
)inds of faulty logic that might underlie depression see cognitive therapy% and other
e(aggerated emotions. Gational4Amotive techni3ues and self4help methods are discussed
in chapter !E.
Some scientists dou't that irrational ideas and faulty logic cause depression. Some
dou'ters 'elieve the sad feelings e(isted before the sad4helpless thoughts, i.e. that
depressing genes or hormones or life events lead to our negative cognitive styles Barnett
6 Fotli', !"77%. >ther dou'ters, li)e Go'ert La/onc, 'elieve that emotion and cognition
are independent systems and, furthermore, irrational 'ehavior is 'ased on emotions, not
irrational thoughts 5ordes, !"7E%. 1n spite of criticism, cognitive e(planations are the
most accepted e(planations of depression among psychologists today.
Inreasona'le thin)ing and faulty conclusions
Depressed people are prone to thin) in several &ays that may produce sadness and
pessimism. 1f things have gone 'adly in the past depressed people are past4oriented%,
there may 'e a tendency to conclude that the future &ill 'e a&ful too. Actually, depressed
people usually don.t thin) much a'out the future. The future is depressing precisely
'ecause it has little meaning or no purpose for them... or is threatening. The erroneous
'elief that things &ill not get 'etter may lead to suicidal thoughts. This hopeless vision of
the future is 'ased on a general glo'al perception that their pro'lems are huge,
innumera'le, and insolva'le. A depressed person may have only a vague notion of
&anting "to 'e happy," "to put my life 'ac) together," "to find love and happiness," etc.
>f course, &ithout the pro'lems 'eing defina'le, o'/ective, specific, managea'le, and
circumscri'ed, depressed people don.t have specific plans, i.e. doa'le, clear4cut, self4help
steps in mind for attaining realistic goals. Cithout plans for changing, they have no hope
and no motivation. They feel li)e victims, not masters of the situation. That is
unreasona'le. They can change.
Depressed people seem to reason poorly in several other &ays. A(amples; they are
concrete thin)ers and have difficulty generali0ing e.g. after 'eing taught to 'e assertive
&ith his9her 'oss, he9she doesn.t thin) of 'eing assertive &ith his9her spouse%. They see
nothing illogical a'out giving credit to luc), other people, Fod, fate, etc. for the good
things and 'laming themselves for the 'ad things in their lives. Chile depressed people
focus on the 'ad happenings in their lives, some of them tend to deny the "'ad"
emotional parts of themselves, such as anger, violent, and selfish urges, etc. >thers see
only the 'ad. And, their "solutions" for their pro'lems are often unrealistic, such as a
person &ith t&o children and an unhappy marriage &ho &ants to have another child "to
improve the marriage" or a floundering overly critical student decides to drop out and
live &ith his9her father although they have never related &ell. Ce can.t cope &ell &ithout
thin)ing straight; this includes having a purpose and a plan for living see chapters 2 6
<%.
There is still more &rong &ith the depressed person.s thin)ing processes. Therapists
and scientists studying the 'rain have contended that a part of our mental ma)e up
compels us humans to e(plain everything see attri'ution theory in chapter E%. Some of
us, hating uncertainty, need an immediate, simple, "it.s for sure" e(planation; others of us
need lots of data, time to &eigh different opinions, and careful thought a'out the issue
'efore &e arrive at an e(planation. This reflects the difference 'et&een simple "'lac)4
and4&hite thin)ing" dichotomous thin)ing% and comple( "tolerance of am'iguity."
Depressed people gra' hold of immediate, clear4cut 'ut pessimistic e(planations; that is
their "e(planatory style," namely, "it.s my fault" happy fol)s 'lame the situation or
someone else%, "my &ea)ness messes up everything" and "it &ill never change, so &hy
try8" Co&, &hat a prescription for depressionJ Geality is; you aren.t entirely to 'lame,
the supposed fault &on.t mess up everything, and the situation44including you44can and
&ill change. Depressed people must learn to thin) differently.
Ce need to understand &hy some depressed people are such rigid and poor thin)ers.
1t is critical )no&ledge for &or)ing &ith suicidal patients. The closed4mindedness of
depressed people is ama0ing. Hap)o !""2% descri'es counseling a patient &ho recently
had a heart attac) and a 3uadruple 'ypass. This man &ouldn.t tal) or open his eyes during
the first hour of therapy; he 3uietly cried &hile his &ife told his story. Chen the patient
finally tal)ed in the second session, he only said, "1.m going to dieJ" and so''ed. He
could do nothing and thin) of nothing 'ut dying. 1n contrast, Bi)or 2ran)l survived the
'rutal conditions of a *a0i concentration camp, &hile many died, 'y intensely desiring to
live so he could 'e re4united &ith his &ife. He had a purpose and thought there &as some
chance if he could stay alive. Ce must use our rational mind to find those rays of hope
and to develop realistic plans to ma)e our future 'etter.
Self4critical &ithdra&al
1f &e are sad, &e respond more slo&ly and avoid ordinarily pleasant it may not 'e
pleasant to the depressed person% and unpleasant events. 1ndeed, there is evidence that
depressed people are especially sensitive to pain and even mildly irritating situations
5arson 6 Adams, !"7!%. =erhaps 'ecause of this sensitivity, some depressed persons
have developed uni3ue &ays of reducing pain or stress in addition to avoiding or
&ithdra&ing, namely, 'y ma)ing self4critical or self4hurtful remar)s &hich may reduce
criticism from others or, in some masochistic &ay, reduce the stress%. This sounds a lot
li)e the story of Sooty Sarah 'elo&. The outcome could 'e a misera'le recluse.
Ce need to understand &hy some depressed people are such rigid and poor thin)ers.
1t is critical )no&ledge for &or)ing &ith suicidal patients.2orest and Ho)anson !"#$%
did an interesting study supporting the notion that self4punishment could 'e re&arding,
i.e. an escape from conflict &ith someone else. 1n this study an aggressive partner &as
permitted to shoc) depressed and non4depressed su'/ects. Then those &ho &ere shoc)ed
&ere given the choice of shoc)ing their partner 'ac), shoc)ing themselves, or ma)ing a
friendly gesture to the partner. 1f the depressed su'/ects elected to shoc) themselves, their
autonomic responses stress% declined more rapidly than if they &ere aggressive or
friendly. *on4depressives got relief only 'y shoc)ing the other person, not 'y self4
punishment or 'eing friendly. 2or most of us, it seems astonishing that anyone &ould hurt
themselves more after 'eing hurt 'y an aggressive S>B. Cell, there seems to 'e some
relief44a payoff44for depressed persons if they punish themselves instead of attac)ing the
aggressor. +ay'e sadness is partly a self4punishment and9or su'stitute for aggression%.
This needs to 'e understood 'etter and may also 'e involved in the ne(t odd4sounding
theory.
Anger turned in&ard
=sychoanalysts have long 'elieved that anger to&ards others gets turned against
ourselves. >ur anger converted into self4hatred causes depression. Karen Horney see
+onte, !"70, or any theories of personality 'oo)% &rote that the 'asic pro'lem starts &ith
neurotic parents &ho are inconsistent 'oth overindulgent and demanding%, lac)ing in
&armth, inconsiderate or openly hostile, or driven 'y their o&n needs. The child resents
these things. But parents are po&erful and a child.s only means of survival. So, 'ecause
of fear or love or guilt, the child represses the anger. The child, 'eing small, alone,
confused, and helpless in an unpredicta'le, hostile &orld, is, of course, scared. Ho& does
the child protect itself8
The child, a&are of his or her &ea)ness, the criticism of others, and his or her o&n
hostility and fears, develops a "despised" self4concept. Also, the resentment of others has
'een turned against the self; "1 am unlova'le, a 'ad person." At the same time, the child
starts to develop a notion of an "ideal" self44&hat he9she should 'e44in order to survive
and get the love and approval he9she &ants. This ideal self, trying to compensate for
&ea)ness and guilt, sets up impossi'le demands, called neurotic needs. These needs are
unconscious, intense, insatia'le, an(iety4causing, and out of touch &ith reality. 2or
instance, if one has a neurotic need for affection, it 'ecomes urgent to 'e loved 'y
everyone, all one.s peers, all the family, teachers, the paper carrier, etc. Horney listed
several neurotic needs, primarily needs for perfection, po&er, independence, and
affection. All are attempts to handle the primitive hostility from childhood. So, ho& do
&e get depressed8
1n e(treme cases, some people 'ecome so self4effacing, i.e. compliant, unselfish, and
modest, they almost do a&ay &ith their "self." Suffering, helplessness, and martyrdom
are their ideals. They need to 'e loved, li)ed, approved, important, 'ut ta)en care of.
Their "solution" is; "1f you love me, you &ill not hurt me." But 'eneath this saintly,
goody4goody surface sometimes 'oils the old anger, rage, and strong urges to 'e
aggressive and mean. Besides, love never runs smoothly44remem'er everyone must love
them44so these )inds of de/ected people may turn against themselves, 'ecoming very self4
critical and unhappy. >ften they have also 'ecome 'itter 'ecause the un&ritten
agreement &as 'ro)en, namely, "1.ll 'e nice and not hate you, if you &ill love, respect,
and care for me al&ays." =eople striving for sainthood often suffer 'ecause others &ill
not al&ays put them first.