Saturday, August 22, 2009

Retroflection, depression, and meds

So I'm reading this old school (1975!) article from Ken Wilber called, "A Working Synthesis of Transactional Analysis and Gestalt Therapy." It's really quite brilliant and it reminds me why I fell in love with Wilber's early stuff. [And it also reminds me how disconnected I feel from his current writing which to me feels brittle and ossified with integral orthodox code speak (TM).]

Anyway I want to break down two ideas from his article and then use them as a jumping off point for a bigger discussion about our current mental health catastrophe in the United States.

Okay so everyone who has ever read a psychology text book understands the concept of projection:

Projection is when a feeling (anger, shame, fear) arises in me, but (for whatever reason: usually family, culture, or religion) that particular feeling is unacceptable to me, so rather than feeling it and experiencing it -- I PROJECT it out onto another person and describe THAT person as having the very feeling I am trying to avoid in myself. The other person just becomes a canvas or screen upon which we project those emotions that we don't know how to deal with inside ourselves.

Most folks in the United States know about projection because we have an ENTIRE POLITICAL PARTY, the Republican Party, whose entire political program consists of projection. They take all of the violence and hatred inside themselves and project it upon Barack Obama and then have little tea parties to celebrate their failure to own their own emotions. Good times.

But, Wilber's article also introduced me to a term that I was not familiar with: retroflection. And this is where stuff starts to get really interesting:

To retroflect means literally "to turn sharply back against." When a person retroflects behavior, he [sic] does to himself what originally he did or tried to do to other persons or objects. He stops directing various energies outwards in attempts to manipulate and bring about changes in the environment that will satisfy his needs; instead, he redirects activity inward and substitutes himself in place of the environment as the target of behavior. To the extent that he does this, he splits his personality into "doer" and "done to." (Perls et al., 1951)

So retroflection then is the inverse of projection. In projection I disown my own feeling and put it on someone else, in retroflection I take a behavior that I really want to direct onto another and direct it towards myself instead.

Then Wilber gives us the money quote:

Retroflections come in all flavors. A few of the more common are narcissism (retroflected affection), depression (anger), hypochondria (inspection), self-pity (pity), masochism (cruelty), compulsiveness (drive). As we mentioned, once a retroflection has occurred, and the personality is split into the active pincher and the passive pinched, the individual can--and usually does--associate himself more closely withe one of the two sides. Sometimes for the same retroflected impulse, the emotional tone of one pole is dramatically different from that of the other. For example, if a person retroflects his hostility and associates with the doer side, he feels active self-hate; but if he associates with the done-to side, he feels passive depression. So the retroflections I've just listed will, of course, change their tone a bit depending upon which pole the person associates with. In general, the more the impulse is inhibited, the more completely the person will associate with the passive, done-to side of the retroflection; that is, the more he will feel a NOT OK Child being beaten by his Parent.

So let's pause for a second and note how much the debate over mental health has changed in this country over the last 30-40 years. In 1975, when this was written, this sort of thinking (Gestalt, Transactional Analysis, Psychotherapy) was mainstream. It WAS Psychology and Psychiatry. Now we have moved almost entirely to a behaviorist ('I don't want to understand I just want to feel better now!') and biochemical ('it's just a chemical problem that can be fixed with a pill') model.

Now look, before you get pissed at me, I get that there is a biochemical component to many mental health problems and I celebrate those who have been helped by the new (much-hyped) psychopharmaceutical drugs. I think for many mental illnesses, such as schizophrenia and bi-polar, a biochemical model is probably a more helpful path for addressing the problem.

But that being said, what if Wilber is correct, or even partially correct in the quote above? What if many cases of depression really are just retroflected anger -- and we are just taking a pill for it instead of sorting out the underlying dynamic?

The implications are really quite startling.

First off, retroflection itself is an unhealthy strategy (obviously).

...a retroflected impulse does not really find an adequate object in the self--that is to say, a con-formed impulse is never completely satisfied. On the theory that something is better than nothing the Parent [in Gestalt terminology] will nevertheless keep directing blows at the Child--but this is a poor substitute (cf. Freudian "substitute gratifications"). As such, the conformed impulse frequently intensified its strength in an effort to find true and satisfactory expression ("return of the repressed"). A retroflector thus tends to increase his retroflecting activity.

So retroflection already has a tendency to grown over time. So then what happens if we take a pill for it? It would seem that we will never find balance in the world. The source (of the anger) hasn't been treated, rather the symptom has been temporarily obscured chemically. The body still wants to express that emotion, but has no outlet and now stumbles around in a fog looking for one. Doesn't that just set people up for a viscious cycle of more anger retroflected as more depression requiring more drugs, ad infinitum? Indeed, wouldn't the pharmaceutical industry just love that!? 'We don't know what the problem is exactly, but it seems to be getting worse, and the only solution is more of our patented drugs' (which in fact, make the problem even worse, requiring even more drugs...)

I think the political implications of this are even larger.

Play out this scenario with me:

1 in 10 women in the U.S. are on antidepressants.

Wilber argues that depression is just retroflected anger.

Women have a lot to be angry about -- they (legally!) get paid less than men for doing the same job, they are subjected to sexual violence in everyday life equal to the level of sexual violence men experience in prison; and a lot of men are assholes to name just a few potential sources of anger.

If that retroflected anger (depression) gets treated with a pill -- do we ever pass equal pay legislation? Do we ever find ways to end sexual violence in society? Do we ever find ways for men and women to relate to each other differently? IF the source is not chemical per se -- but rather injustice in society -- and we take away the very emotion that is the impetus for action, does society ever move forward or are we just narcotized to enjoy our increasingly unjust society?

One of the strange things about our current era is that problems are mounting rapidly -- the gap between rich and poor grows, Wall Street just stole several trillion dollars from your IRA and another trillion from the U.S. Treasury, heavy industries are poisoning our water, food, land, and children. In ordinary times, people would be marching in the streets with torches and pitchforks. But today, people are all like, 'I don't know what's the matter with me (retroflection) I gotta get my doctor to prescribe something to fix ME.'

It would seem to me that our unpleasant emotions are the very catalysts that we have been given (by God/natural selection) that enable us to improve collectively over time. It is our very discomforts -- our depression converted back to anger that has driven every single historic improvement in people's lives -- from abolitionism to women's rights to the current fight for LGBT equality. And if we take away that sensation, how does a society ever muster the collective energy to fight back against the numerous injustices all around us?

Said differently, if we have a burr in our shoe, and we take a pill just to rid us of the painful sensation of the burr -- do we ever go look for the burr, and doesn't it just fester and eventually get infected?

Look, believe me I have enormous compassion for the suffering I see in my friends and in myself. But in spite of billions of dollars worth of prescriptions, I don't really see the situation getting better and in many respects it would seem to me that it is getting worse (which as I pointed out above, Big Pharma would just love). IF Wilber is correct, that would perhaps explain this seeming paradox -- of course people are increasingly miserable because we're not treating the source of the problem at all and so it festers and grows.

I don't know whether Wilber (and Gestalt and Transactional Analysis) is correct. Wilber's been wrong about a lot of things, so this wouldn't be the first time. But it sure resonates with me and feels intuitively correct.

For more on the steps one would take to work with the shadow -- to transform retroflection into emotions that can be seen and integrated, please read the rest of the article, "A Working Synthesis of Transactional Analysis and Gestalt Therapy."

Update #1. For more on the problems in modern psychiatry and psychopharmacology, check out the Carlat Psychiatry Blog.

2 comments:

Anonymous said...

Your article really touched me, it feels so true. Like something I already knew but hadn’t quite wrapped my hands around, something I haven’t been able to call out in the way that you have here. The older I get, the more I feel I am becoming an angry feminist. I have always been a feminist, but the anger is newer.

Misogyny so ingrained into our cultural fabric…

The proliferation of women convinced that enduring the health (sometimes life) threatening mutilation of their bodies and faces will somehow bring them more fulfillment, make them whole, create self esteem. The fact that this mutilation is now extending to vaginas, toes, no part of the woman’s body is okay. They are all wrong. All must be changed.

The magazines on the newsstand and their constant blaring of weight winners and losers, who gained ten pounds and has no self control, who lost her man to a hotter woman, who is desperate to marry every man she dates (Jennifer Aniston, their favorite whipping girl), who has the worst bikini body. OMG guess who has cellulite! Women dissected for our consumption. Men are not treated the same. They may be included in the beach body articles but not at the same saturation, more as a token inclusion than the mainstay of the article.

Men are partying bachelors who won’t settle down, randy rogues. Women are desperate to be married, before they are too old and lose their looks, thus, their appeal. If women over 30 look good, they look good for their age, or “age gracefully,” always the mention of aging accompanying any positive comments, and always praising women who STILL LOOK GOOD even when they are OMG OLD! A backhanded compliment if ever there were one. Their wisdom, experience, humor, all take a back seat to how well they’ve maintained their looks (see any article on Michelle Pfeiffer). Men just look good. No man in his forties is getting the “for his age” treatment. On the internet women are skanks, whores, hos, hags; Paris Hilton’s private parts are used out, infected, disgusting. What about Mick Jagger’s? This doesn’t get said about men. Women are judged on their sexual desirability daily, on their appeal to men (MILF anyone)? Women are nothing without the mail gaze. Old hag the worst insult to a woman; what is equivalent for a man?

This is an incomplete catalog, written off the top of my head, I could go on and on for days, and I have spent years being depressed, and I’m pissed as hell.

RFK Action Front said...

Thanks for your thoughtful comment!

I think your analysis of our culture is spot on (and brilliantly said).

I think Wilber would say (and I would agree) that anger is key to returning to health, returning to balance. Anger is the thing that takes the retroflection (the anger turned upon oneself) and points it back (outwards) at its rightful target -- the source of the anger or injustice.

Thanks again for your comment.