Reflections on Phenomenological Method in Depression

Heidegger as a Theorist of Melancholia

For phenomenological psychopathologists an important methodological question is which philosopher, or philosophical corpus, one is going to draw on to help organize and illuminate raw psychopathological data. For the main phenomenological psychopathologists of the past this involved selecting from among phenomenological philosophers and keeping close to them to varying degrees (Broome, Harland, Owen, & Stringaris, 2009). For Minkowski it was Bergson, for von Gebsattel it was Scheler, and for Binswanger it was Heidegger and then Husserl. A question that arises is what makes the choice of philosopher non-arbitrary?

A pragmatist, or pluralist, answer to this question which I tend to favor is that psychopathologists should be willing to select philosophies which are well fitted, or suited, to the area of psychopathology of interest. Hughes in her article on “Melancholia, Time, and Death” (Hughes, 2020) selects Heidegger (specifically, Division 2 of Being and Time and associated writings). I think she makes a good choice. Heidegger’s suitability is supported by his well-recognized phenomenological talent, his first personal experience of low mood/suicidality and his familiarity with the German Lutheran cultural tradition (which has strong interest in the phenomenon of Despair). Several psychiatrists (e.g., Kurt Schneider, Nassir Ghaemi, John Cutting) have considered Heidegger’s work highly illuminating when it comes to depression and there has been an interesting difference between those who think it illuminates only mild depression and those who think it illuminates severe depression. Hughes thinks it illuminates severe depression. This is an under-trodden and I think promising path despite the difficulties—which include problems in getting high quality phenomenological data in severe depression was well as the notorious obscurity of some of Heidegger’s writings.

The Melancholic Experience of the Future

Using Heideggerian categories, Hughes constructs a thesis that severe depression is a state of experiencing Dying (a collapse of one’s intelligible world in which, attuned by anxiety, the ability to project oneself into meaningful projects and possibilities is nullified or negated) together with the impossibility of experiencing Demise (the experience that one’s body, as a biological entity, will perish). The experience of severe depression that is constructed by Hughes thus seems to be one whereby there is a collapse of the ability to project oneself into possible futures which is experienced as never ending because one experiences oneself as unable to perish as a biological being.

In the article, Hughes also makes apposite but brief remarks on the temporal desynchronization that people with severe depression experience with others (and vice versa) and on the impact of depression on capacity to make decisions related to dying. These are important topics but, given space, I focus on the central thesis of Dying without Demise commenting on phenomenologically accuracy.

First, Dying: Hughes’s Heideggerian characterization of severe depression as an experience of Dying seems right to me and consistent with a phenomenological interview study I have conducted in severe depression (Owen, Freyenhagen, Hotopf, & Martin, 2015; Owen, Martin, & Gergel, 2018). Across cases of severe depression one can discern a basic experience of the inability (painfully felt) to project oneself into meaningful projects and possibilities. I think it can be characterized as the collapse of a previously intelligible experiential world (Dying in Heidegger’s sense). But Hughes’s elaboration of Dying in depression as involving an experience of the future as blocked, closed off (p. 204) or that there is no intact future (204) I think is inaccurate. In severe depression interview evidence suggests there is an experience of the future. This can be lost in some self-reports due to the fact that it can be difficult for people to describe their experiences (a common sentence is “I don’t know”) and because expression is typically given in a negative form. For example, “I don’t feel anything at all” can be verbalized at the same time as clear non-verbal expressions of anxiety. I think it is more accurate to say that in severe depression there is an experience of the future (rather than no experience of the future at...