Interpretation, Meaning and the Shaping of Experience: Against Depression Being a Natural Entity and Other Forms of Essentialism

Many thanks to Ian Kidd and John Swinton for their most interesting, and extremely different, commentaries on my paper. I agree with the thrust of Kidd’s argument and hope that these possibilities may be explored more fully elsewhere. Swinton’s commentary is far more critical, and raises issues in need of urgent clarification—I therefore focus on these.

Swinton (2015, 295) begins his critique by saying that, “One of the basic presumptions that underpins the study and its conclusions is that depression is a natural entity that can be clearly identified and responded to.” This perception of my paper confuses and concerns me, because I am not sure what has given this impression. It has thus far proved impossible to identify characteristics of depression that are found in all instances of depression and that are not also found in a range of other human experiences, and other cultures have made sense of depression experiences in categories that are radically different from and yet at least as coherent as our own; this gives us strong reason to believe that depression is a cultural constructed category and not a natural entity.

Furthermore, not only the category of depression, but also our experience of it, is itself constructed by our culture and beliefs. For example, the tendency to experience depression psychologically rather than somatically (as some non-Western cultures often do) is probably shaped by Western society’s Cartesian underpinnings and preoccupation with the interior life. That our experience of depression is shaped by our beliefs and is culturally variable rather than being the static and immutable thing we might expect of a natural entity is at the heart of my paper: some religious beliefs about depression, I argue, can contribute to a far more fertile, therapeutic experience than can be given solely by biomedical accounts. Other religious beliefs have the potential to make the experience rather worse.

In my paper, I am not only not suggesting that depression is a natural entity; I am also kicking against another kind of essentialism: that some experiences of depression are inherently salutary, but others unchangeably pathological. Although I appreciate Swinton’s point that the different interpretations I cite may all bring something valuable to the conversation, I think that what is helpful about a spiritual health view is that experiences can be transformative (i.e., what is shared with a potentially transformative view), but that the salutary/pathological distinction should be left at the door. This is because it is likely to have a detrimental effect on people whose depression is regarded inherently as either pathological or salutary. A person who is told that their depression is pathological, and not salutary, may be dissuaded from interpreting, and experiencing, it as transformative. Conversely, we do not know whether Mother Teresa, who was told that her experience was salutary, would have found secular treatments such as talking therapies helpful, but we cannot exclude the possibility that they would have saved her years of mental distress had ‘salutary’ and ‘pathological’ forms of depression not been regarded as mutually exclusive.

Perhaps Swinton regards my paper as presupposing that depression is a natural entity because I do not say that it is not a natural entity. I am grateful to him for raising the point and allowing me to clarify it—and also for drawing attention to the ways in which the reification of depression and other mental illness categories causes us to problematize the person and to overlook depression’s social causes. This is a problem with both the moralization of depression as well as the medicalizing backlash against it, in Christianity and outside it, and is a theme I discuss elsewhere.

Swinton articulates a number of concerns about my approach being insufficiently God centered, which I can only respond to briefly here. ‘Therapeutic’ is used as a criterion, but as I define it this is not ‘materialistic’: it includes the idea that ‘healing may take place even in the...