Posted by: aboutalbion | June 21, 2019

Dorothy Rowe: an alternative voice on depression

Observation suggests that the common playground complaint of “It’s not fair” is commonly interpreted as children having a desire for everything to be “fair”.

Yet, only a few weeks ago in the High Court, the legal argument was made that “Parliament has no substantive freestanding obligation of fairness … It is clear from case law that the enactment of primary legislation carries with it no duty of fairness to the public.”

It seems that there are two different worlds here. Childhood hopes revolve around the rule of fairness, whereas adult hopes for fairness are misplaced.

Well, what has all this to do with Dorothy Rowe and depression?

Quite recently, I stumbled upon an obituary notice of the life of Dorothy Rowe. She was unknown to me as a writer, and I appreciated reading the obituary and especially about her professional work as a psychologist.

I was particularly drawn to her approach in relation to depression. She had little time for chemical interventions for depression. Instead she advocated an approach which listened to patients with a mental ‘illness’. And she collected evidence that there was a ‘critical life event’ that triggered a patient’s depression in almost every case. This evidence informs her best known book (Dorothy Rowe (2003) Depression: the way out of your prison (third edition). London, Routledge).

In particular, she singled out the “Just World Hypothesis” [JWH] (aka Just World Fallacy / Paradox / Theory) as the popular and culturally deep-rooted theory which underpins the childhood orientation of how the world should work.

In her own words, ”The most popular metaphysical belief is that we live in a Just World, where goodness is rewarded and badness is punished”. … If this is a Just World, then nothing can happen by chance. The basic rule is simple. If you are good, you are rewarded. If you are bad, you are punished.” (p46f) In her view, as we grow up, we imaginatively adopt this theory about how the grown-up world works

So for Dorothy Rowe, a private ‘critical life event’ causes mental distress when disastrous real world events come close to us and challenge and upset our imaginative theory of how the world works. She sees the essence of depression as an emotional paralysis that overtakes us as we resist the invitation to modify our theory (based on fairness). In other words, depression is a defence against the invitation to change our own subjective (childhood) mental modelling of the real world.

She lists advantages of believing in the JWH. First, it means that, if you are good, then nothing bad can happen to you, and you and your family are safe. Second, it means that, if you are good, you have some limits to your compassion and sympathy, since an encounter with suffering in other people can be privately interpreted as their punishment arising from their bad behaviour.

However, the disadvantages of believing in the JWH are greater and acutely unhealthy. If you are good, and a catastrophe happens to you, the JWH does not allow you to say, “That was a chance accident” because nothing happens by chance.

So, if you are good, and a catastrophe happens to you, you are forced to make a choice. Either the JWH is a delusion (like Father Christmas), or (since good people have a habit of blaming themselves) you are bad and you deserved what happened to you.

In the first option, many young people do leave the JWH behind when they leave home and begin to see for themselves the randomness with which “real life” distributes rewards and punishments. But the JWH is in practice very difficult to leave behind since (for many) it has been an integral part of their childhood. When a disaster does overtake us, Dorothy Rowe’s case notes include examples of such young people continuing to ask themselves, “Why me? What have I done to deserve this?”.

In the second option, believing yourself to be bad, you have an explanation that satisfies the JWH. If you had been a good person, then this disaster would not have happened. However, now you believe yourself to be bad, you decide to work even harder to be good. Dorothy Rowe notes that trying to be good in this scenario is a wretched way to live since you are now alone in the prison of your depression. Here, you have the comfort of being safe in the company of the JWH … safe from the chaos that was threatening to overwhelm you if you left the JWH behind … but the personal cost of living safely in a prison is living alone … the unhealthy option.

In conclusion, Dorothy Rowe invites depressed people to change the way they see themselves and the way they see the world. And her pithy way of expressing this is to ask, “Do you want to be good or do you want to be happy?”

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