Depression and Its Forebears Derek Mcallister, Ph.D. Mentor

Home , History of depression, Jason Pratensis, Sehnsucht

ABSTRACT

Fallow Season: Depression and its Forebears

Derek McAllister, Ph.D.

Mentor: C. Stephen Evans, Ph.D.

This dissertation is part history, part analysis. It surveys prima facie historical

antecedents to our current clinical concept of depression—a chapter each on acedia,

tristitia, noche oscura, melancholia, and Tungsindighed. The analytic portion compares and contrasts each historical condition with depression, examining symptoms, etiology, historical context, and more. As it turns out, many, if not all, of these historical conditions can present with or essentially have some kind of spiritual etiology—unlike depression, which is often seen as a pathological psychiatric condition. More than a mere historical recounting, however, this dissertation also engages critically with the contemporary literature on depression and offers strategies for incorporating the “old” forgotten wisdom with the “new” discipline of psychiatry. This dissertation thus brings together the history of philosophy, philosophy of religion, virtue ethics, and philosophy of psychology and psychiatry (especially mental health), featuring themes from Thomas Aquinas, Søren

Kierkegaard, and the Desert Fathers, among others.

Fallow Season: Depression and its Forebears

Derek L. McAllister, B.A., M.A., M.A.

A Dissertation

Approved by the Department of Philosophy

Michael D. Beaty, Ph.D., Chairperson

Submitted to the Graduate Faculty of Baylor University in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy

Approved by the Dissertation Committee

C. Stephen Evans, Ph.D., Chairperson

Michael D. Beaty, Ph.D.

John J. Haldane, Ph.D.

Thomas M. Ward, Ph.D.

Michael P. Foley, Ph.D.

John R. Peteet, M.D.

Accepted by the Graduate School August 2020

J. Larry Lyon, Ph.D., Dean

Page bearing signatures is kept on file in the Graduate School.

TABLE OF CONTENTS

LIST OF FIGURES viii

LIST OF ABBREVIATIONS ix

PREFACE xi

ACKNOWLEDGMENTS xiii

DEDICATION xvi

CHAPTER ONE 1 Introduction 1 1.0 - What is Depression? Differing Levels of Complexity and Explanation 7 1.0.1 - Theoretical Models of Depression 10 1.0.1.1 - Constructing and comparing models. 13 1.0.1.2 - Varieties of models of depression 14 1.0.2 - How Diagnostic Practices Influence our Understanding of Depression 22 1.0.2.1 - Absence of telos 27 1.0.2.2 - Absence of etiology 29 1.0.2.3 - Reifying depression 33 1.0.2.4 - Biomedical model reinforced 36 1.1 - Recovering the Past (& What to Do with it Once it’s Recovered) 41 1.1.1 - Opening the Door to Spiritual Etiology 43 1.1.2 - Pluralistic Kinds of Depression 45 1.1.3 - A Non-Pathological Fallow Season 46 1.2 - Conclusion 47

CHAPTER TWO 49 Acedia 49 2.0 - Rationale for Inclusion 49 2.1 - Acedia in the Monastic Tradition of the Desert Fathers 55 2.1.1 - The Desert Fathers 56 2.1.2 - Evagrius of Pontus (345-399) 59 2.2 - Acedia from the Desert to the Wider World 66 2.2.1 - John Cassian (360-435) 67 2.2.2 - Pope St. Gregory I (540-604) 71 2.2.3 - Sloth’s Lost Familiarity in Recent Times, which Coincides Historically with the Advancement of Psychiatry 76 2.3 - Acedia’s Main Features 78 2.3.1 - Acedia is Irreducibly Spiritual 78

2.3.2 - Acedia Has Especially Notable Psychological Manifestations 80 2.4 - Considered Judgment on Relation to Depression 80

CHAPTER THREE 88 Tristitia 88 3.0 - Rationale for Inclusion 89 3.1 - Sorrow Over One’s Own Sin 94 3.2 - Thomas Aquinas on Tristitia and Acedia 98 3.2.1 - Aquinas’s View on Tristitia Immoderata 99 3.2.2 - Aggravatio animi: Tristitia aggravans, Anxietas, and Acedia 102 3.2.3 - Moderate Acedia 104 3.2.4 - Tristitia Alongside Agonia, Segnities 106 3.2.5 - Aquinas’s View on Acedia as Capital Vice (Acedia Immoderata) 112 3.3 - Back to Cassian & Gregory 116 3.3.1 - Gregory’s Capital Sin of Tristitia 117 3.3.2 - Cassian’s Logismos de Spiritu Tristitiæ (Spirit of Sadness) 120 3.4 - Considered Judgment on Relation to Depression 121

CHAPTER FOUR 123 Noche Oscura 123 4.0 - Rationale for Inclusion 124 4.1 - Noche Oscura in St. John of the Cross (1542-1591) 131 4.1.0 - Union with God 132 4.1.0.1 - A note on the writing/text 134 4.1.0.2 - Sanjuanist terminology 136 4.1.1 - Dark Night of the Senses — Active (A1.1—A1.15) 139 4.1.2 - Dark Night of the Spirit — Active (A2.1—A3.45) 142 4.1.3 - Dark Night of the Senses — Passive (N1.1—N1.14) 147 4.1.4 - Dark Night of the Spirit — Passive (N2.1—N2.25) 149 4.2 - The Problem of Saints in Darkness, & Whether There is a Further Night 151 4.2.1 - St. Teresa of Calcutta (1910-1997) – Spiritual Darkness 152 4.2.2 - Garrigou-Lagrange’s La Nuit Réparatrice: A Darkness Beyond Noche Oscura? 155 4.2.3 - Evaluating La Nuit Réparatrice against St. John of the Cross’s Teaching 157 4.2.4 - La Nuit Réparatrice and Depression 162 4.3 - Considered Judgment on Relation to Depression 164

CHAPTER FIVE 166 Melancholia 166 5.0 - Rationale for Inclusion 168 5.0.1 - Black Bile - pre-17th-c.: Hippocrates, Galen, & the Humours 170 5.0.1.1 - Symptom #1 - anger-melancholy 173 5.0.1.2 - Symptom #2 - sorrow-melancholy 174 5.0.2 - Melancholy in Medicine (17th c. - 19th c.) without Aetiology 174 5.0.3 - Elizabethan & Romanticism’s 19th-c. Poetic Melancholic Genius 175

5.0.4 - Melancholy as a Psychiatric Conceptual Precursor to Depression 179 5.0.5 - Religious Melancholy in 17th- and 18th-century Clergymen 180 5.1 - Our Interest, Religious Melancholy in Particular 183 5.1.1 - Robert Burton’s Analysis of Religious Melancholy in The Anatomy of Melancholy (1621), Which is a Model for Understanding Later Accounts 185 5.1.1.1 - Religious melancholy as characterized by excess: disordered approach towards God where the mode is love of God 191 5.1.1.2 - Religious melancholy as characterized by defect: disordered withdrawal away from God where the mode is love of God 193 5.1.2 - The Non-Pathological Causal Predicament Preceding Religious Melancholy: Or, Who’s to Blame? 199 5.1.2.1 - God and the devil 201 5.1.2.2 - Physick 205 5.1.2.3 - Religion 211 5.1.2.4 - Moral impulse and weakness of faith 214 5.1.2.5 - Nostalgia and return to God 221 5.2 - Considered Judgment on Relation to Depression 224 5.2.1 - Is this Dame Acedia? 225 5.2.2 - Is this Dame Noche Oscura? 227 5.2.3 - A Final Word on Religious Melancholy’s Relation to Depression 228

CHAPTER SIX 231 Tungsindighed 231 6.0 - Rationale for Inclusion 232 6.1 - Tungsindighed 235 6.1.1 - Tungsindighed in SK’s Journals, Notebooks, & Papers 236 6.1.2 - Tungsindighed in Either/Or (1843) 241 6.1.2.1 - Tungsindighed in E/O - Volume I 241 6.1.2.2 - Tungsindighed in E/O - Volume II 246 6.1.3 - Evaluation of Tungsindighed 249 6.2 - Kjedsommelighed 253 6.2.1 - Kjedsommelighed in Either/Or (1843) 254 6.3 - Fortvivlelse 256 6.3.1 - Fortvivlelse in The Sickness Unto Death (1849) 258 6.3.2 - Fortvivlelse in Works of Love (1847) 265 6.3.3 - Evaluation of Fortvivlelse 269 6.4 - Considered Judgment on Relation to Depression 272

CHAPTER SEVEN 276 Conclusion 276 7.0 - General Strategies for Synthesis 278 7.0.1 - Historical Revisionism 279 7.0.2 - Revising Present-Day Concepts of Depression 279 7.1 - Our Particular Historical Conditions 280 7.1.1 - Caveat 280

7.1.2 - What to Do with Acedia 281 7.1.3 - What to Do with Tristitia Immoderata 282 7.1.4 - What to Do with Noche Oscura 283 7.1.5 - What to Do with Religious Melancholia 284 7.1.6 - What to Do with Tungsindighed 286 7.2 - Conclusion 287

BIBLIOGRAPHY 289

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LIST OF FIGURES

Figure 1.1 – Dimensions of categorization. 11

Figure 1.2 – DSM-5 criteria for MDD. 24

Figure 3.1 – The activation of passion: in the order of generation. 109

Figure 4.1 – Similarities and differences between “salutary” religious depression (what Durà-Vilà and Dein (2008) call the “Dark Night of the Soul”) and “pathological” religious depression, based on Font (1999). 129

Figure 4.2 – The Ascent of Mount Carmel. 160

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LIST OF ABBREVIATIONS

A - The Ascent of Mt. Carmel

APA - American Psychiatric Association

BVV - The Book of Virtues and Vices

C - The Spiritual Canticle

CA - The Concept of Anxiety

CD - Christian Discourses

CDC - Center for Disease Control

CUP - Concluding Unscientific Postscript

DSM - Diagnostic and Statistical Manual of Mental Disorders (by APA)

E/O - Either/Or

EUD - Eighteen Upbuilding Discourses

F - The Living Flame of Love

FT - Fear and Trembling

ICD - International Classification of Diseases (by WHO)

JP - Kierkegaard’s Journals and Papers (Hongs’ translation, Vols.)

KJN - Kierkegaard’s Journals and Notebooks (10 Vols.)

MDD - major depressive disorder

N - The Dark Night

NB - “Notesbog” (“Notebook”) a designation assigned idiosyncratically by Kierkegaard to a series of thirty-six quarto-sized, bound journal volumes.

NIMH - National Institute of Mental Health

O.C.D. - Order of Discalced Carmelites

OED - Oxford English Dictionary

O.P. - Order of Preachers (Dominicans)

O.S.B. - Order of St. Benedict (Benedictines)

Pap. - Søren Kierkegaards Papirer

p.c. - personal correspondence

PC - Practice in Christianity

PF - Philosophical Fragments

PG - Patria Græca

PL - Patria Latina

PV - The Point of View of My Work as an Author

R - Repetition

RCP - Royal College of Psychiatrists

RDoC - Research Domain Criteria (by NIMH)

RPC - The Register of the Privy Council of Scotland

S.J. - Society of Jesus (Jesuits)

SKS - Søren Kierkegaards Skrifter

SLW - Stages on Life’s Way

ST - Summa Theologiæ

SUD - The Sickness Unto Death

UDVS - Upbuilding Discourses in Various Spirits

WHO - World Health Organization

WL - Works of Love

PREFACE

Depression is a serious problem and a staple of our culture. I noticed in recent years that philosophers and other thinkers throughout history called similar conditions by other names. I had a hunch that we could learn something from that history—and that hunch has

paid off. For example, Thomas Aquinas spoke of something he called immoderate sorrow,

while Søren Kierkegaard spoke of despair, and English scholar Robert Burton and many

others used the term melancholy. It is striking that many, if not all, of the depressive-like conditions I survey here are understood to have some kind of spiritual etiology.

By “etiology” I mean the origin or causal source of something, whether its proximate or ultimate cause. The clinical consensus today in psychology and psychiatry is that depression is multicausal. So in suggesting that depression has a spiritual etiology, it does not follow that the spiritual is the only cause. (Other causal contributors may be the biochemical, stress, systemic social inequality or poverty, etc.) Neither does it follow that all cases of depression will have a spiritual etiology. By “spiritual” etiology, I don’t mean to suggest that some demon or rogue spirit is the cause. Rather, I mean that causal explanations were historically given in terms of this and many more reasons understood spiritually: demonic oppression, spiritual trials, one’s own sinful culpability or guilt, and the perception of God’s abandonment or God’s withdrawing of His felt affection. In talking of “spiritual etiology” I mean at least this much: that the depression is partly grounded in the person’s understanding of what it means to be a self and in a failure to actualize that self. This results in a recognizable and deep dissonance in the unity of the self.

Fundamentally one’s spiritual life involves a connection to a sense of who they are—and that’s why this finding is so important.

Why is it important to look at history? Well, people nowadays often think that you are only your body (or something near enough), that depression is only a chemical imbalance. It is important to look widely so as to guard against faddish thinking. It was my desire to approach this hot-button issue in a patient, creative way with intellectual integrity, not just going to where the buzz is. So I began examining historical sources that explored other possible causal contributors to and explanations for depression. (It was a windfall that these sources came with their own advice for treatment and remedies!—some familiar, some unknown.) While recently some clinicians and theorists have offered various clinical interventions and theoretical frameworks for depression which explicitly incorporate religious-/spiritual- (R/S) factors, no one seems to have covered this wide a scope, this many historical conditions with their irreducibly spiritual features, and put them up against nature of depression.

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ACKNOWLEDGMENTS

When I started this project, I knew it would be difficult. As Donald Rumsfeld

succinctly remarked:

There are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns — the ones we don't know we don't know. And if one looks throughout the history of our country and other free countries, it is the latter category that tend to be the difficult ones (Department of Defense news briefing (12 February 2002)).

Indeed, these latter were the most difficult. In what ended up being a tremendous, though

ultimately imperfect, interdisciplinary undertaking, I was driven to become proficient not

only in philosophy, but also in psychology, history, philosophy of science, theology, etc.

This section is to acknowledge and thank very many people: those who held me

accountable and pushed me to keep going: my brother Brett McAllister, my mother-in-law

Mari Shipley, Brandon Johnson, Brandon Rickabaugh, Greta Turnbull, Sabrina Little,

Craig Clifford, Karl Aho, John Thames; those who asked for or read chapter drafts: my brother Jeremy McAllister, Kyle Strobel, Robyn Gaier; those who asked for or read related papers of mine borne from this project: Michael Willenborg, Chris Tweedt, Tasia Scrutton; those who helped me think through various ideas related to this project: Harrison Lee, Nick

Colgrove, Nathan Cartagena, Brandon Dahm, Jared Brandt, Alex Hoffman, Ryan Bond,

Yunus Prasetya, Bryson Butler, Paul Chaloux, Tihana Vajagić; those who sent me valuable

reading material: Nik Breiner, Burke Rea, Caroline Paddock, Chad Bogosian, Rob Elisher,

Chris Bobier, Jim Marcum, John Rosenbaum; those who encouraged or inspired the project’s beginnings: Bob Kruschwitz, Alina Beary, Greg Ganssle, J.P. Moreland, Tom

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Senor; those who encouraged or supported further study in psychology and psychiatry:

Lance P. Kelley, Lauren Barron, John R. Peteet, Charlotte vanOyen-Witvliet, Sarah

Schnitker, Kevin Timpe, Christian B. Miller, JoAnn Tsang, Alisha Wray; those who

entertained my questions about German words: Nathan Mueller, Adam Myers; and about

Latin words: Tom Ward; and about Danish words: Marilyn Piety; and those who indulged

me in my many research rabbit trails, the dusty corners of scientia I’d find myself in after

hours of toiling: Tim Heckenlively, Frank Beckwith, Victoria Sweet, Hans Boersma, Fr.

Robert Verrill, Renée Jorgensen Bolinger, Lars Fredrik Svendsen, Alex Pruss, Christopher

Tomaszewski, John Haldane, Mike Foley, David Lyle Jeffrey, Hans Boersma, Rob Miner,

Hanna Pickard, Mike Richardson, Ronald Bradshaw, Trent Dougherty, Jonathan Kanary,

and many others whom I have unfortunately forgotten at the moment.

Then there were those who encouraged me even when they may not have entirely

known what this project was: my wife Nakia, my mother Kelli, my father Brian, my sister

Jenna Carruba, Aunt Nancy, Aunt Debbie, Walter Dirion III, Rose Derion McGuire, Donna

FaRuth Huckaba, Martin Huber; and those who provided enduring inspiration in ways they

may not have even known: my son Oliver, my late great-uncle Tommy Gaylon Jones, my precious great-grandmother Rosa (Dirion) Clark, age 97, and my late great-grandfather

Rev. Raymond Wallace Clark, who departed this earth in March 2020 at 99 years of age.

(They were married 81 years.) PaPa Clark taught me by example how to persevere. Once he got that dreaded draft letter from Uncle Sam, he served his country in WWII as a Private in the U.S. Army, 9th Infantry Division, 47th Regiment, Able Company, 1st (Rifle) Platoon.

He weathered a bitter winter at the Battle of the Bulge; after the Battle at Remagen Bridge,

his was the first Allied division to cross the Rhine; and he saw firsthand the terrible

xiv aftermath of Hitler’s Endlösung (or “Final Solution”) when his unit liberated the Mittelbau-

Dora death camp at Nordhausen. Seeing all this relentless death changed him; he preached for over 71 years, including the very day he departed this life. For all his heroism as a soldier (Bronze Star, Purple Heart, all the accolades—he is even, inexplicably, front and center in a famous photo with Gen. Omar Bradley and two Soviet generals when the

Western Allies met the Russians near Wittenberg just days before V-E Day…), he was always far, far prouder of having served the Lord all his life in his vocation as a minister.

I hope I have made him proud.

I was grateful to receive a 2019-2020 Cross-Training fellowship in Psychology by the John Templeton Foundation through the Society of Christian Philosophers, which proved to be a tremendous aid for learning more about the state of the discipline. Given that logistics are not my strong point, I appreciate those who provided invaluable editorial help: Haley Tomaszewski, Luci Yang, and Sandra Harman. Given that lack of stability and schedule (for writing time and daily work) is an especial weakness of mine, I would also like to thank those, especially Harrison Lee, who lended help and stability during the

COVID-19 quarantine. If it were not for all the support, camaraderie, and commiseration,

I would have much more firsthand personal experience with depressive-like episodes than

I care for. Finally, I would be remiss not to thank in particular the readers and interlocutors on my dissertation committee: John Peteet, John Haldane, Tom Ward, Mike Foley, Mike

Beaty, and most of all my mentor and adviser Steve Evans, who was such an essential help and guide from start to finish and the greatest exemplar of a hard, honest worker. Any missteps, oversights, outrageous inferences, false claims, and the like are entirely my own fault and should not reflect poorly upon those from whom I have learned so much.

To Mom

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CHAPTER ONE

Introduction

“Fads in psychiatric diagnosis come and go. All of a sudden everyone seems to have the same problem. Quack theories explain the outbreak; quack treatments presume to provide [a] cure. Then, equally suddenly, the epidemic runs its course and the once ubiquitous diagnosis disappears from circulation.” — Allen Frances, M.D.1

“In every age the classics are translated anew, for our idiom is constantly evolving; but the spiritual needs of man are always basically the same.” — Very Rev. Christopher Latimer2

Today, there are a reported more than 300 million people affected by depression.3

Yet the word “depression” did not come into common usage in psychiatry until around

1908.4 For that matter, psychiatry as a distinct discipline did not even exist until the 19th century.5 It is extremely unlikely that the referent of “depression” (i.e., the human condition

1 Ch. 4, Frances (2013). Allen Frances was chairman of the task force for DSM-IV.

2 Foreword in The Collected Works of St. John of the Cross (1964/1973).

3 WHO (2017). I treat “clinical depression,” “depression,” and “major depressive disorder” (MDD) as fairly synonymous terms. See Section 1.0 below. Also, I draw a sharp distinction between an instance of depression and the concept of depression. I say more about this distinction below in Section 2.4.

4 Adolf Meyer (in 1908, according to Ban 2014) insisted on the usage of the term to replace “melancholy,” what Meyer called “a depression of mental energies, of an as yet unspecified nature” (Healy 1997: 38; cf. Ban 2014: 17). “Extraordinary as it may seem, therefore, it would have been effectively impossible to call what we now call depression ‘depression’ at any time in history other than this century” (Healy 1997: 272). Prior to this, the word “depression” had enjoyed some loose association with melancholy since Heinroth (1818) conceived of melancholia as a “depression of emotion,” without depression of the other faculties (Ban 2014: 11).

5 This is when professional psychiatric organizations were established: RCP in 1841 (Bewley 2008) and APA in 1844 (McGovern 1985, Barton 1987). In addition, depending on whose account you read, there 1 the psychiatric term picks out) began to exist when the word first came into our lexicon.6

Rather, what we now refer to as “depression” was once called by other names, for example,

“melancholy”7 or “vapours,8 to use the now archaic language of early medical and proto- psychiatric concepts. Beyond medicine, there was a range of other historical conditions such as the Desert Fathers’ acedia, St. Thomas Aquinas’s immoderate sorrow [tristitia immoderata], and Søren Kierkegaard’s despair [Fortvivelse].9 Whether or not these be conceptual precursors to depression is not clear,10 but there is certainly a lot of overlap in descriptive symptomatology.

are multiple claims to the title ‘father of psychiatry’ or ‘founder of modern psychiatry’, including Benjamin Rush (1745-1813), Philippe Pinel (1745-1826), and Emil Kraepelin (1856-1926).

6 I think it would be a mistake to think that the referent of “depression” is altogether new. I take this as needing no argument, but consider the oddness of the alternative, that this particular state of depression came into existence when psychiatrists invented, or otherwise developed, the concept of depression. This puts the cart before the horse, as psychiatrists obviously first needed to empirically observe certain symptoms or behavior which could then be classified or codified in a certain way. Not to mention, such an odd narrative suggests a wildly implausible view of human nature, one that assumes a relatively sudden change, rather than a gradual adaptation or a general diachronic consistency, in the behavior and affect of a large percentage of the human population. (Emphasis on “relatively”, since social constructionists typically hold that these sorts of changes happen quite slowly, and that the appearance of the word is merely the crystallization of the concept.)

7 And its Middle English etymon “malencolie” in 1473(?): “After many right sorowful syghes engendrid in þe roote of malencolie” (Le Fèvre 1473/1894: I. lf. 10). Incidentally, Raoul Le Fèvre’s work is said to be the first book printed anywhere in English, though it was produced on the Continent, in either Bruges or Ghent.

8 “The dispiriting symptoms of a nervous illness commonly called vapours, or lowness of spirits,” writes Bayne in Duncombe (1773: II.87).

9 Each of these, though not strictly medical concepts, has been suggested as (or mistaken for) some kind of conceptual precursor or early synonym for depression. For acedia, see Altschule (1965), Radden (2002), and McAllister (2020); for immoderate sorrow, see Miner (2009); for despair, see Cappelørn (2008), Hannay (2008), and Marino (2008).

10 Feld (2011), Radden (2002), and others have acknowledged the fundamental difficulty of tracing this genealogy. “In her anthology of texts dedicated to melancholy, Jennifer Radden emphasizes the categorization conundrum that baffles all attempts at interpretative coherence in the case of melancholy and acedia. She notes that hermeneutic labor has been undertaken primarily toward detailed descriptions and intricate classification. Radden observes that the hermeneutics of melancholy has not notably advanced since the seventeenth century” (Feld 2011: xix).

Many present-day researchers have known about these other historical conditions,

but aside from a few exceptions, they often account for them by some hand-waving

assimilation into modern medical and psychiatric paradigms. For example, former Clinical

Professor of Medicine at Harvard, the late Mark D. Altschule states laconically, “according

to Cassian, feelings of anger, acedia, and depression were deadly sins; however, today they

are regarded as psychiatric symptoms.”11 In truth, Altschule is painfully wrong.12 And he

ironically commits the same offense he charges to Petrarch: “solipsistic misinterpretation

of the meaning of acedia.”13 But the lesson here is this. Very often, the modern medical

paradigm unjustly overshadows these earlier religious and metaphysical paradigms, which

are seen as akin to alchemy, or some other outdated theory, “tinctured with lunacy,”14 when

it comes to describing and explaining what these historical conditions really are.

The comparison with alchemy is lesson-worthy. Alchemy is surely ludicrous, right?

An obsession with transmuting base metals into gold sounds more like magic than modern

chemistry. And so the narrative has been throughout much of the 20th century. What

surprise it was, then, when in the 1980s, historians of science began deciphering

alchemists’ texts, and eventually Lawrence M. Principe was able—to his “utter

disbelief”—to replicate an alchemical experiment!15 He had “cobbled together obscure

11 Altschule (1965: 117). Cf. Flanagan (1965a, 1965b) for a response contemporary to Altschule.

12 See my rebuttal of Altschule’s spurious claims in McAllister (2020).

13 Altschule (1965: 119).

14 “Any contemporary scholar who even dared to write about alchemy, historian Herbert Butterfield warned, would ‘become tinctured with the kind of lunacy they set out to describe’” (Conniff 2014).

15 On reproducibility of alchemical experiments, Principe explains, “To forestall the criticism that such a study would pick and choose at nuggets of recognizable ‘chemical technology’—assaying, production of chemical products, and so forth—and would ignore the context and a ‘fundamental goal’ of alchemy, let us be specific in restricting ourselves for this study to the subset of alchemy known as chrysopoeia, the 3 texts and scraps of 17th-century laboratory notebooks to reconstruct a recipe to grow a

‘Philosophers’ Tree’ from a seed of gold.”16 Principe is convinced that alchemists were actually quite reasonable, operating along similar basic principles (e.g., of generation, of replication) that chemists would later employ.17 It’s just that their jargon and framework was so mysterious and thus inaccessible.

The alchemists, obsessed with secrecy, deliberately described their experiments in metaphorical terms laden with obscure references to mythology and history. For instance, text that describes a “cold dragon” who “creeps in and out of the caves” was code for saltpeter (potassium nitrate)—a crystalline substance found on cave walls that tastes cool on the tongue.18

Partly because of this, modern chemists viewed alchemy with disdain—even while some appropriated their work!19 To explore and understand the forgotten wisdom in these alchemical texts, then, there needed to be a new historiographical approach, one which viewed alchemy and its jargon on its own terms. The language of alchemy, for instance,

making of gold, in this case specifically by means of the Philosophers’ Stone. The now-recognized impossibility of the end product of this important subset of alchemy has too often urged a precipitate rejection of the entire endeavor as imaginary or deceptive” (Principe 2000: 58). However, as Principe’s “Philosophers’ Tree” demonstrates, the alchemists were on to something.

16 “Supposedly this tree was a precursor to the more celebrated and elusive Philosopher’s Stone, which would be able to transmute metals into gold. The use of gold to make more gold would have seemed entirely logical to alchemists, Principe explains, like using germs of wheat to grow an entire field of wheat” Conniff (2014).

17 See Principe (1992, 2000) and Stahl (1730: 401-408). “By the seventeenth century, several well- defined but currently little-recognized schools of alchemical thought had developed, crystallizing around different choices of starting material and propagating along lines of descent through different authoritative authors” (Principe 2000: 58).

18 Conniff (2014).

19 “Robert Boyle, one of the 17th-century founders of modern chemistry, ‘basically pillaged’ the work of the German physician and alchemist Daniel Sennert” (Newman, qtd. in Conniff 2014). Cf. Newman (1987, 1994), Principe and Newman (2001), Principe (1998, 2000), and Newman and Principe (1998).

4 laden with mystery and metaphor, is best seen as verbal art,20 and its images must be understood from an art historical perspective, in their original context, to be appreciated fully.21

For historical conditions like acedia, tristitia immoderata, Fortvivelse, and others, my task here is similar—and no less difficult, given how mulish the dominant empirical scientific paradigms tend to be. Just as it is inaccurate to say that alchemists were actually simply doing chemistry, it is inaccurate to claim that the Desert Fathers were simply doing psychiatry or psychology.22 My task here is to explore and understand the forgotten wisdom in these theological, philosophical, and spiritual texts in order to understand these historical conditions on their own terms.23

One might object at this point, saying that it is dubious to try to retrospectively

“diagnose” historical persons with any psychiatric illness, and that it should not be attempted, given the dangers of “medical reductionism” and the allure of fashionable

20 Vickers (1992). Cf. Principe (1992) and Principle and Newman (2001).

21 Szulakowska (1986) argues that alchemical images have been wholly divorced from their context.

22 As suggested by a simple reading of Deacon Basil Ryan Balke (2017): “Was Evagrius of Pontus perhaps one of the first psychotherapists?” However, to Balke’s credit, he later acknowledges the complexity of what Evagrius was doing: “I wonder if Evagrius would have viewed such counseling as a tool not simply for psychological health, but a tool to set aside sin and grow in the spiritual life” (Balke 2017).

23 Some authors suppose that such historical conditions are different “hermeneutical paradigms” of roughly the same condition (i.e., whatever referent “depression” picks out). In my view, this is only halfway right, insofar as we note that (1) often there is not direct overlap or correlation between paradigms, and that (2) some hermeneutical paradigms, while interesting, are either wrong or incomplete. Which paradigms are on offer? “The original paradigmatic interpretations are identified as the medico-metaphysical, the theological, and the mythical. On this foundation, interpretations further proliferated and developed in multiple directions: alchemical, anthropological, ontological, metaphysical, phenomenological, existential, postmodern” (Feld 2011: xx).

5 diagnoses.24 My response, first, is that I am not diagnosing any psychiatric illness. The worry driving this objection stems from the application of current-day psychiatric categories onto historical persons, but this is not an accurate description of my project. For example, rather than labeling a 8th-century monastic “depressed,” I instead am using 8th- century language and concepts (and their contemporaries): “torpor”, “pigritia”, “desidia”,

“ignavus”, “hebetudo”, and “inertia”—all of which are preceded by “acedia” [ἀκηδία] in the 4th century.25 In any case, if the objector persists that I am doing something similar enough to psychiatric diagnosis that it warrants similar concerns, my reply is this. The evidence used to discern the nature of the historical conditions surveyed here is just as good as, if not better than, that used to diagnose a patient with clinical depression. Today, diagnosis is typically accomplished through the use of either an interview26 or some form of self-report27 (the latter of which is more common due to ease of use28). Each diagnostic tool comes with its flaws and limitations.29 By comparison, the written historical record

24 “Retrospective diagnosis is also subject to fashion…For a time schizophrenia was in vogue as a retrospective diagnosis, while more recently Kay Jamison [1993] has claimed that many great writers and artists suffered from manic-depressive illness” (Beveridge 2004: 126). Cf. Muramoto (2014).

25 See my analysis of Gregory’s lexicon in Chapter Two Acedia.

26 Interviews can be either a formal clinical interview with a licensed psychiatrist (e.g., SCAN in Eaton, et al. 2000), or a less-formal yet structured diagnostic interview which can be conducted by either physicians or nonphysicians (e.g., DIS in Hendricks, et al. 1983).

27 For example, the POMS (Profile of Mood States), CESD-20 (Center for Epidemiological Studies Depression Scale), BDI (Beck Depression Inventory), and GZTS (Guilford-Zimmerman Temperament Survey). Analogues exist for physical health, such as the PHQ-15 (Patient Health Questionnaire).

28 See also, for example, Burke, et al. (2005), a meta-analysis of several studies that compared depression with cortisol (stress) levels. Notably, each of the studies therein used diagnostic interviews to test for depression but used blood tests for cortisol.

29 While self-reporting assessments and even diagnostic interviews are less accurate, ostensibly due to underreporting one’s symptoms, feelings, and behavior, the more superior clinical interviews are limited in their need for interviewers with the appropriate board-certified qualifications and the time to assess.

from which I will be drawing is abundantly rich with diverse descriptions of human conditions, a source which surely rivals, if not surpasses, 15- or 20-question inventories.

The biggest difference between the historical conditions surveyed here and

depression, my reader will be quick to observe, is that depression is not widely understood

as fundamentally spiritual.30 It is understood as a pathological psychiatric condition, while many of these historical conditions are irreducibly spiritual in nature, even while they manifest in part psychologically. The question is what we make of this fundamental difference—especially when it produces an apparent conflict or inconsistency with the present-day discipline of psychiatry. In Section 1.1 at the conclusion of this chapter, I briefly outline a few strategies with respect to what to do with all this “forgotten wisdom” once it is recovered.

But first, I must say more about how this project is situated within the contemporary literature on depression, beginning with what depression is (Section 1.0).

This will seem like very tedious work, because it is. But this sort of weeding of the garden

and turning of the soil must precede the planting of any new ideas. (In this case, rather,

they are old ideas, yet very likely new to us.) All the more difficult when the ground is very hard.

1.0 - What is Depression? Differing Levels of Complexity and Explanation

What is depression? The answer you get largely depends on who’s answering, of

course—but it also depends on who’s asking. In Summer 2019, I shadowed clinical

30 Consult the section below regarding models of depression. While there are religious/spiritual models on offer, even these do not tend to view depression fundamentally, or even primarily, in spiritual terms.

psychologist Lance P. Kelley, using the occasion as an opportunity to pester Dr. Kelley

with questions about the theoretical side of things, namely, nosology and classification of

mental illnesses. I was there not as a psychologist or a medical resident, but as a philosopher

seeking insight for both my medical ethics course and the present project. So I began with

the central question looming on my mind, “What is depression?” Any other question he

dispensed with quickly and easily. This one, however, took him aback. He finally collected

himself and said, “If I’m talking to a first-year resident, I tell them we know exactly what depression is, how to identify it, how to diagnose it, how to treat it… If I’m talking to you, who’s read Allen Frances, I say, ‘We have no idea what depression is.’”

Kelley was pointing to a deep rift between the practical and the theoretical, between learning by rote on one’s initial way through and learning by deconstructing what one has rotely learned. The initial goal of the practitioner is simply to learn how to treat depression.

No doubt this involves some theory; the two cannot widely come apart. But the simple and immediate goal is to become familiar with the best treatment options and protocols for individuals presenting with classic depressive symptoms. Indeed, it is possible to proceed even quite functionally, treating the human brain as an opaque black box, prescribing the inputs that generate the desired outputs, without ever knowing how the fix works. Now practitioners should not be blamed for this arrangement, since their task is a very important one—especially in high-risk scenarios that demand urgent intervention.31 This simply is one side of depression. A full account would involve not only how to treat it, but also what it is. That task falls to theorists.

31 No doubt this is, according to Peter Adamson (2016), one of the reasons medical knowledge spread so much more rapidly than philosophical knowledge in the Islamic and European medieval world.

What is depression? One way to approach this question is by discussing (as I do in

Section 1.0.1) the various theoretical, explanatory models of depression, models which

primarily aim to give an explanatory account of what depression is, including its course,

etiology, risk factors, and associated features. I spend a good deal of time (under 1.0.1.2

“Varieties”) on Religious/Spiritual (R/S)32 models of depression, given its relevance to the present project, with the specific aim there of familiarizing the reader with the prevalence of, the benefits and risks of, and the present challenges for developing R/S models. Another way to approach the same question is by examining (in Section 1.0.2) the diagnostic practices used to identify depression “in the wild,” as it were, or in the clinical setting. This

very practical activity involves starting with an intensional definition of “depression” and

related terms, then applying that intension to its extension.33 I want to examine how such

an intensional definition, with its descriptivist, symptom-severity approach as provided by

the DSM,34 has not only influenced the discipline towards a reductionistic understanding

of depression, but has also simultaneously propagated an a-teleological35 understanding of

healing human persons in mental health generally. A third way to approach the same question is to begin with ostensively picking out instances of depression, with no prior

32 This is nomenclature standardly used in psychology: “By spirituality, we are referring to a search for the sacred—elements of life that are seen as manifestations of the divine, transcendent or ultimate, either inside or outside of a specific religious context (Pargament 1999; Pargament, et al. 2013). Religion takes place in the larger context of established institutions and structures that aim to facilitate spirituality (Pargament, et al. 2013)” (Exline, et al. 2014: 208, italics in original).

33 “The extension of a term consists of the set of things to which the term applies” (Howard-Snyder, et al. 2013: 117) whereas “An intensional definition specifies the meaning of a term by indicating the properties a thing must have to be included in the term’s extension” (ibid., 119).

34 As opposed to a “causalist” (Zachar and Kendler 2007) or “contextualist” (Horwitz, et al. 2016) approach which takes into account more explicitly the etiology, or cause, of depression.

35 From ἀ- (a-, “un-”) + τέλος (télos, “end”),

explicit theoretical machine in place.36 Such an approach might be found in memoirs or

vignettes of persons with depression, but I will not actively pursue this approach here.37

Only once we get through these weeds can we begin to see the reasonableness of such a

project as this which firmly insists on looking back to history for answers.

1.0.1 - Theoretical Models of Depression

There is no shortage of theoretical models of depression which try to explain or account for what depression is and how individuals come to be depressed. Before getting there, however, we have already encountered a deep controversy: for should we say “have depression” or “be depressed”? This difference in parlance demarcates a fundamental difference between competing ontologies, whether depression is a discrete entity (or some

“extra thing”) or whether it is simply the result of disordering within the agent. (and hence,

no “extra thing”).38 The first ontology, purportedly dominant over the last half-century with the DSM and ICD, takes “mental disorders [in general] as largely discrete entities that are characterized by distinctive signs, symptoms, and natural histories.”39

36 Picking out by ostension is an extensional way to define something. For example, instead of giving you necessary and sufficient conditions for “orange”, what properties it should have, and so on, I can simply point to a particular orange fruit to indicate that that is an orange.

37 There will be several vignettes, of course, and examples of depression, or something near enough, throughout this dissertation; however, I do not necessarily offer these as an ostensive definition per se.

38 Some people have used the terms “Aristotelian” vs. “Galileian” approach to classification, but I opt not to use the terms here, since these are likely misnomers, appropriated by a psychologist to describe a wide variety of changes in all of science. Lewin (1935) is a landmark work on the distinction, drawn from physics and applied to psychology, which involves much more than a difference in classes, but also in essences, lawfulness, valuation, etc. Cf. Carson (1996), Lilienfeld and Treadway (2016).

39 Lilienfeld and Treadway (2016: 435).

On the other ontology, by contrast, mental illnesses are simply the effects, signs, manifestations of an underlying disordering of a substance. In that regard, depression is not itself a substance, or a thing one possesses, but instead is a condition or state reflective of when underlying substances get disordered and disarrayed.40 Zachar and Kendler put the same debate in more simplified terms: entities versus agents.

A diamond is an entity. Entities are things that are generally uniform from case to case. Entities also exist in networks of lawful relationships that can be scientifically described. A person is an agent. Agents are dynamic. They have purposes and intentions that make them unique.41

This is just one of many different ways psychiatric disorders can be categorized. Zachar and Kendler (2007) offer a helpful overview of these “Dimensions of Categorization” (See

Fig. 1.1), some of which I address later in this chapter.

40 For their part, Lilienfeld and Treadway (2016) see the new RDoC classification program by NIMH as an example of an imminent trend away from the so-called Aristotelian approach and, by extension, toward transdiagnostic treatments—i.e., those that apply the same treatment across (what would otherwise be many different) diagnoses. Put another way: transdiagnostic treatments are “those that apply the same underlying treatment principles across mental disorders, without tailoring the protocol to specific diagnoses” (McEvoy, et al. 2009: 21). The “RDoC may eventually shift psychiatry and clinical psychology closer to the goal of precision medicine (Insel 2014), or at least the more modest goal of stratified medicine, in which interventions are tailored to individuals within well-defined subgroups demarcated by laboratory-based profiles (Kapur, et al. 2012)” (Lilienfield and Treadway 2016: 447).

41 Zachar and Kendler (2007: 559).

Why does this debate (let alone all the other debates) about categorization matter?

There are of course key philosophical issues lurking here, such as concerns for parity and simplicity when it comes to classifying correctly, which have both practical and theoretical consequences.42 That particular debate, by the way, has been referred to as “lumpers” vs.

“splitters”: those who classify by “lumping” illnesses into a few broad categories vs. those who “split” illnesses into many different categories finely distinguished.43 The downside of “splitting” is the ungoverned proliferation of nominally different mental illnesses which are yet symptomatically very alike and thus difficult to distinguish clinically.44 Thus, though it is not apparent at first, this fundamental philosophical debate between different ways of conceptualizing mental illness can have great bearing on how we treat depression: whether to use a single transdiagnostic protocol across several diagnoses, or to have a one- to-one relationship between the very many diagnoses and protocols (come what may of multiplying entities). It is also a matter over which is primary or deserves more emphasis:

42 “This is the principle of Ockham’s razor: “entities are not to be multiplied beyond necessity” (entia non sunt multiplicanda praeter necessitatem entia non sunt multiplicanda praeter necessitatem)” (Jutel 2011: 15-16).

43 Sometimes “clumpers.” This also goes for categorizing brain structures. “Neuroanatomists categorize themselves into ‘clumpers’ and ‘splitters’ based on how they like to organize the brain. Clumpers prefer to simplify the brain into as few sections as possible, while splitters divide the brain into thousands of pieces, all with their own Latin or Greek names. To make things even confusing, splitters like to throw in to the mix the name of the scientist who first described that brain area, so we end up with names like ‘Zuckerkandl’s fasciculus,’ ‘the ventral tegmental relay zone of Giolli,’ and the ‘nucleus reticularis tegmenti pontis of Bechterew.’ This is one of the reasons medical students are terrified of their first course in neuroscience” (Fallon 2013: 47).

44 This is true within a single kind of disorder such as anxiety disorders, from DSM-I (1952) with its 3 such disorders to DSM-5 (2013) with its upwards of 27 such disorders. It also rings true across apparently distinct kinds of disorders, such as the glaring similarities and clinical indistinguishability between schizophrenia (formerly dementia praecox) and bipolar disorder (formerly manic depression). Kraeplin, once staunchly representative of differentiating them, ultimately expressed doubt saying, “We cannot satisfactorily distinguish between these two diseases” (Kraeplin 1920: 527). Cf. Greene (2007).

entity or agent, diagnosed mental disorder or person, biochemical causal explanation or

personal causal explanation.

Beyond these foundational debates about classification are the actual theoretical

models of depression themselves. A theoretical “model of depression” at the very least is

explanatory (whether in whole or part): it is a second-order theory that unifies empirical

phenomena into a coherent explanation regarding the human person and the presence of

depressive-like symptoms.45 “Models exist at different levels, from more broad models that

apply to all depressed patients…to the more specific that explain a particular dimension of

the illness…A model does not have to be comprehensive to be useful.”46 Constructing and

comparing models of depression, thus, is more a conceptual task than an empirical task.

And, as we shall see, the judgments within a model concerning the nature of depression—

what it is, what its course is, how to treat it, etc.—unavoidably come front-loaded with

philosophical assumptions.47

1.0.1.1 - Constructing and comparing models. In constructing a model of

depression, Roose, McGrath, and Mann (2013) suggest that “ideally models of mood

disorders should” have at least the following seven characteristics. Some are general to scientific models or theories—(1) explanatory power, (2) falsifiable—while others are

45 “Explanatory models of depression are constructed to serve multiple purposes including: (1) helping clinicians organize a body of knowledge to help in patient evaluation and treatment planning, (2) guiding research, and (3) informing about treatment outcome” (Roose, et al. 2013: 1).

46 As Roose, et al. (2013: 1) elaborate, “a model may be constructed to understand treatment response or course of illness and have little if any explanatory value with respect to gender difference in rates of illness.”

47 See, for instance, the first variety, which, taken in isolation (i.e., not combined with other models), presupposes either a strong or weak form of biological reductionism.

more specific to mood disorders like depression. For instance, they should (3) help identify

potential new treatment targets, and (4) have predictive value for treatment response and

prognosis. “Perhaps most important, models should (5) advance research and clinical care

without inhibiting innovative thinking to better understand disease pathophysiology, (6)

help develop treatments and prevention strategies, and (7) stimulate the formulation of new

models.”48

It is unclear what they mean by this last desideratum. Ideally, one would think, we

would want a model to be true, to correspond to reality. Not only is such a desideratum

lacking in their checklist, but assuming we formulated a model that does indeed correspond

very closely to reality, what need would there be to “stimulate the formulation of new

models”? Including this as a necessary criterion in our checklist seems to defy practical

reason. (So much for Baconianism.) Moreover, the fifth desideratum certainly seems well- intended and reasonable, but we should be wary to ensure it does not couch any hidden assumptions about the inevitability of Post-Enlightenment scientific progress and the march towards biological reductionism.

1.0.1.2 - Varieties of models of depression. Given the multiplex nature of depression, it is not surprising to see a wide range of proposed models of depression. The

WHO, for instance, acknowledges this complexity saying, “Depression results from a complex interaction of social, psychological and biological factors.”49 In the U.S., both the

CDC and the DSM also agree that depression is “a serious medical illness with mood,

48 Roose, et al. (2013: 4-5).

49 World Health Organization (2017).

cognitive, and physical symptoms.”50 Following Barlow, et al. (2017), Goldstein and

Rosselli (2003), Ogden (1999), and Read, et al. (2014), we can surmise at least main four

varieties of theoretical models of depression that have been historically prominent. (The

following list should be taken as selective and as a helpful heuristic. Keep in mind, also,

that many of the following can just as easily be put to use in explanations regarding

depression’s etiology, risk factors, or associated features.)

Biological, biochemical, and biomedical models of depression (e.g., biological-

disease model (Srinivasan, et al. 2003), bio-genetic model (Read 2014)) tend to emphasize

the underlying pathophysiology, which may be due to genetics or one’s environment [i.e.,

anything non-genetic] (e.g., endocrine system, circadian rhythms, S-alleles,

neurotransmitters), as the cause of or reason for one’s depression. Thus, on such models,

depression is understood theoretically to be (or be due to) genetic or inherited

predispositions; chemical or hormonal imbalances; or changes in the brain or nervous system, among other possibilities (cf. Barlow, et al. 2017: 238–250).

“The current view of the etiology of depression is best summarized as a prototypical gene-environment interaction model similar to that for other complex diseases such as cancer, hypertension, and diabetes” (Saveanu and Nemeroff 2012: 52).

Let us pause to note a couple important things. First, despite the consensus that depression is multivariable, there remains a strong tendency towards biological reductionism, most evident in research: a recent multiyear review of peer-reviewed literature reveals that “the vast majority of research stems from a biological paradigm (81%).”51 We are certainly

50 Pratt and Brody (2014). The DSM, originally published in 1952 by the APA, is now in its 5th ed. (2013).

51 Jenkins and Goldner (2012: 1). The authors reviewed literature from 2005-2010.

15 welcome to lament the bias towards biological reductionism,52 as well as to speculate upon the reasons for it. Depression is no doubt a phenomenon which manifests, in part, physiologically; but that does not mean that it manifests only, or mostly, physiologically.

Second, it is not true that moving beyond a biocentric model will perpetuate the stigma or harms surrounding mental illness. There is often an unchecked temptation, for instance, to think that keeping depression within the medical realm will ensure that depressed persons feel less bad about the fact that they’re depressed. If it’s a medical problem, it can’t be a character shortcoming or a flawed personality; in other words, there is no special culpability for having depression if it just is a chemical imbalance. Besides the gaps in reasoning along these lines,53 this fails to acknowledge the costs with associating depression with a strong biocentric model. The empirical data suggest that putting depression in biocentric terms can actually have the opposite effect: biological (e.g., genetic, biochemical) accounts of depression are linked to the general public’s pessimism about depression’s prognosis, because one’s biology is out of one’s agential control.54 Even

52 Even psychologists and psychiatrists have long been aware of the trend. It is significant that this issue was specifically addressed in a separate release by committee chair Robert L. Spitzer the same year the DSM-III was published, directly challenging the problematic assumption that “A biological abnormality or dysfunction within the organism fully accounts for the condition,” by pointing out three problems with it. First, “a biological abnormality cannot be demonstrated for most of the conditions that are, by tradition, listed as mental disorders.” Second, “there are other models for accounting for the disordered behavior of many conditions that have, by tradition, been included in classifications of mental disorders, as in the use of reinforcement theory to explain phobias.” And third, while there is indeed a strong tendency for research to seek out some as-yet unknown biological abnormality, “for many other disorders—for example, transsexualism—research efforts to understand their development have involved primarily psychological constructs rather than biological constructs (Green and Money 1969; Green 1975)” (Spitzer and Williams 1980: 1036).

53 Some of which I discuss in McAllister (2020).

54 Perhaps unknown to the same general public is the fact that “the biology of depression is malleable,” and a “psychoeducation intervention” in fact helps to mitigate this pessimism and increase “feelings of agency” among symptomatic individuals, according to the authors of the same study (Lebowitz, et al. 2013: 7).

granting that we should be concerned about how much our models perpetuate the stigma

and harms associated with mental illness, it is not true that moving beyond a strong

biological model is, in itself, responsible for perpetuating these.

Psychological-Cognitive models of depression (e.g., cognitive model (Beck 1974,

2008, Beck, et al. 2012, Beck and Bredemeier 2016), attribution model (Seligman, et al.

1976), self-control model (Rehm 1977)) suggest that the way in which individuals

cognitively process information can increase their risk for depression. Thus, on such

models, the presence of depression is attributed to either one’s poor cognitive outlook on

the world; an inability to process negative ideation carefully and effectively; a learned

helplessness/hopelessness (Klein, et al. 1976, Seligman, et al. 1979, Shirayama, et al.

2002); or a maladaptive anxiety (Wolpe 1958). It can be exacerbated by general stress and

increased allostatic load, negative life events, and expecting too much of oneself.

“Depression is characterized by an increased elaboration of negative information, by difficulties disengaging from negative material, and by deficits in cognitive control when processing negative information” (Gotlib and Joormann 2010: 285).

Psychological-Behavioral models of depression (e.g., Shirayama 2002, Sudak, et

al. 2014) emphasize the relationship between a person’s activities and behavior with that

person’s mood and cognitive life.55 Sudak, et al. (2014) propose that monitoring one’s

activity, together with re-engaging in activities now stopped but which once brought

pleasure (“behavioral activation”), can help treat depression.

Social and Interpersonal models of depression emphasize humans’ intrinsic need for social connection, and suggest that depression can arise from interpersonal interactions

55 Keeping in mind that “After publication of Beck’s work on cognitive therapy, the boundaries of behavioral and cognitive therapies were blurred and the two now overlap substantially” (Sudak, et al. 2014: 269).

and relations that have developed poorly or have otherwise gone awry, or it can result from lack of social support when it is expected (reasonably or not).

“Depressed individuals tend to interact with others in a way that elicits rejection, which increases their risk for future depression” (Hames, et al. 2013: 355).

Finally, there are models which are some combination of the preceding, such as the

Biopsychosocial model (Engel 1977, 1980); Beck’s unified model (Beck & Bredemeier

2016); and Bishop’s Biopsychosociospiritual approach (Bishop 2009). Beyond these formal models, there are, of course, lay explanations for depression, such as mere lack of will power or the having of a certain melancholic or brooding personality, viz., mere psycho-social models, which are said to be more a reflection of patients’ beliefs about depression than an actual model (Ogden 1999, Read et al. 2014); just as there are also lay theologies, such as personal sin or demonic oppression (Webb 2017). Much less prominent—yet trending upwards—are models and approaches which attempt to account for and even incorporate in responsible ways the religious or spiritual.

Religious/Spiritual (R/S) models of depression (e.g., Peteet 1994, 2010, 2012;

Peteet and Elderon, 2016; Johnson, 2007, 2017; Scrutton, 2015a, 2015b, 2015c, 2020;

Swinton, 2015) emphasize the spiritual dimension of human beings in the diagnosis and treatment of depression.56 On the same taken, though to a lesser extent given their

piecemeal nature, R/S interventions (e.g., church attendance (Sørenson, et al. 2012;

Maselko, et al. 2009), private prayer (Hayward, et al. 2012), feeling forgiven by God

56 Relatedly, there is Carol Ryff’s (1989, 2014; cf. Ryff and Singer, 2008) eudaimonic model of human flourishing and psychological well-being; and the tests of this model—cross-culturally in China (Cheng and Chan 2005), Sweden (Lindfors, et al. 2006), and Spain and Colombia (van Dierendonck, et al. 2008)—lend support to the existence of a remarkably resilient universal need for humans to feel a sense of purpose in life in order to flourish fully. See also Chan, et al. (2018), which found that religious beliefs used as a means of coping with everyday problems was highly predictive of higher levels of purpose in life, especially for socially disconnected individuals.

(Toussaint, et al. 2012), expressing forgiveness to others (Toussaint, et al. 2012; vanOyen-

Witvliet, et al. 2001, vanOyen-Witvliet, et al. 2010), and cultivating an outlook of gratitude

(vanOyen-Witvliet, et al. 2010)), propose the leveraging of known, specifically spiritual,

activities, beliefs, and disciplines for the purpose of alleviating depressive symptoms.

Among typical R/S measurement items, for example, are these six:

divine (negative emotion centered on beliefs about God or a perceived relationship with God), demonic (concern that the devil or evil spirits are attacking an individual or causing negative events), interpersonal (concern about negative experiences with religious people or institutions; interpersonal conflict around religious issues), moral (wrestling with attempts to follow moral principles; worry or guilt about perceived offenses by the self), doubt (feeling troubled by doubts or questions about one’s r/s beliefs), and ultimate meaning57 (concern about not perceiving deep meaning in one’s life).58

Even the DSM includes consideration of R/S concerns such as a patient who is distressed

by a loss of faith, for example, such that it warrants clinical attention (cf. the V code for

Religious or Spiritual Problem in DSM-IV).

Despite this swell of interest, there is still a dearth of R/S models of depression. In some sense, this is not surprising. Psychology, let alone psychiatry, inasmuch as they are empirical sciences, are not about the business of trafficking in the supernatural. This is because, as one researcher would have it, “psychological inquiries are about the human end of the equation, not about what, if anything, is on the other end of our perceptions.”59

However, not only is this unfortunately myopic, but, for whatever benefit it may confer, it

57 For this reason, I include existential reasons for distress within R/S, though some might distinguish these. For example: “David Karp, in Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness (1996: 165–187), tied postmodern disillusionment directly to contemporary experiences of depression” (Peteet 2010: 34).

58 Exline, et al. (2014: 208).

59 Ozorak (2005/2013: 227).

comes with some heavy costs: such as those attending psychology’s neutrality on “The

Truth Question”: psychologists qua psychologists cannot answer the question as to whether

a particular religion is true or false.

The question of whether religion is “true” or not, has haunted the psychology of religion for decades (Pargament 2002)…Most psychologists of religion have chosen to ignore this elephant in the living room. However, many good researchers are probably dissuaded from studying religion at all because they don’t want to share space with an elephant, real or not.60

This of course leads to further difficulties, such as those borne out of attempting to study

religion from an empirical, purportedly neutral, perspective. This perspective is far from

neutral, however; as there are many unchecked worldviews implicit in much psychology

and counseling, chief among them secularism and naturalism. It is no wonder, then, that

“Every attempt to define religion for purposes of psychological knowledge has failed.”61

As one supporter of R/S approaches predicts, however, “Eventually, it is hoped that there

will be increasing openness to worldview-based therapy in public mental health that will replace the current mandate of ‘worldview-neutral’ therapy (which actually promotes secularism).”62

These R/S models cast a wider vision for health, one that includes both mental

health and spiritual health. Very often, unfortunately, proposals of the religious kind will

60 Ozorak (2005/2013: 227). “Some cognitive theorists argue for a clearer focus on mechanisms, so as to avoid any suspicion of ‘defensive motives’ (e.g., Belzen 1999: 236) or a ‘metaphysical agenda’ (McCallister 1995: 314). Others have insisted that the ‘truth question’ must remain open (e.g., Argyle 2002; Ozorak, 1997)” (ibid.). Yet Ozorak does not tell us why it must.

61 Paloutzian (2017).

62 Johnson (2017: 462).

be criticized on the grounds that they only perpetuate the negative stigma surrounding

mental health: the so-called

…moralistic overmedicalization of problems in living. A number of critics have called attention to American society’s propensity to turn human problems including character flaws, unattractiveness, poverty, and violence into objects of therapeutic intervention. They point out that too often the results have been to encourage individuals to expect that they can escape unhappiness, pain, stress, or death.63

Peteet quickly clarifies: “Envisioning health to include spiritual health does run this risk if it endorses pursuing spirituality for its health benefits”64—i.e., if the goals within the

spiritual domain are treated as means and not ends. In order to avoid the risk, it appears

that such R/S interventions must include the wholesale purchase of the relevant worldview;

otherwise, it borders on the exploitative taking from a religious tradition what derivative

benefits it might confer. Peteet’s view—and one that I endorse here—is that “optimal

human functioning includes a relationship with the transcendent which clinicians need to

take into account in treating the whole person.”65 Not only can spirituality aggravate

depressive symptoms, but “depression can undermine spirituality.”66 Indeed, given the

holistic nature of human beings, ignoring the spiritual dimension borders on sheer

negligence.

63 Peteet (2010: 22-23), emphasis added.

64 Peteet (2010: 23).

65 Peteet (2010: 22-23).

66 Peteet (2010: 96). “This can reach clinical significance in at least two ways. In the first, a spiritual concern such as a loss of faith can be distressing enough to warrant clinical attention (cf. the V code for Religious or Spiritual Problem, in DSM-IV). In the second, the patient’s spiritual interpretation of his depression leads him to resist treatment because he believes that God is trying to teach him something through his suffering, which he deserves and must accept” (ibid.).

1.0.2 - How Diagnostic Practices Influence our Understanding of Depression

What is depression? As we have seen, one way to approach this question is by

discussing theoretical models of depression, which aim primarily to give an explanatory

account of what depression is. Another way to approach the same question is by examining

the descriptivist diagnostic approach and practices used to identify instances of depression

“in the wild,” as it were, or in the clinical setting. Whether we realize it or not, these practices, and the usual assumptions undergirding them (e.g., reductionistic naturalism), shape and influence our understanding of what depression is. First, I’ll explain what I mean by a descriptivist diagnostic approach,67 which characterizes what is called the “soft

medical model” for psychiatric illness.68 Then I’ll outline four ways in which this approach

and its usual assumptions shape and influence our understanding of depression, sometimes

in adverse ways: (a) telos is absent, (b) etiology is absent, (c) depression gets reified as a discrete entity, and (d) the biomedical model of depression is reinforced.69 To be clear, sometimes it is our diagnostic practices themselves (i.e., descriptivism) that are the problem, while sometimes it is rather the common assumptions behind those practices (e.g., reductionistic naturalism) which are the greater culprit. The reader should be careful to note which one I am discussing when.

67 This is the descriptivism vs. causalism debate we saw in Zachar and Kendler (2007) from Fig. 1, also known as the contextual approach vs. the symptom-severity approach as seen in Horwitz, et al. (2016).

68 Kendler (2012).

69 None of these are new criticisms. For instance, Vaillant (1984) shows that (b) and (d) have been around since at least the early 1980s, arguing that the DSM-III: (i) is reductionistic, (ii) ignores “clinical course,” (iii) ignores etiology and dynamism in favor of static symptoms, and (iv) at the expense of “validity” (truth), it overemphasizes reliability (the extent to which an experiment, test or any measuring procedure yields the same results on repeated trials).

The shortcomings of the “descriptivist” approach, trying to identify depression with just a checklist of traits and no cause, can be compared to the shortcomings of using a field taxonomy guide with no pictures: “If it flies and eats and makes noises it could be a bird, but it could also be a bat or an insect; you haven’t nailed down what the thing really is.”70

For indeed, that is how the major diagnostic systems, viz., DSM and ICD,71 proceed— using a checklist of symptoms, some (but not all) of which must be present.72 By and large, since the 1980s,73 this protocol in the United States has involved registering the presence of a familiar constellation of cognitive, affective, and somatic symptoms.74 Taking a descriptivist approach, then, we might say that for some symptom S and for some mental

70 Fallon (2013: 11).

71 Originally, at the time of their conception, the purpose of both the ICD in 1900 and the DSM in 1952 was primarily to catalogue statistics. Over time, they leaned more towards the diagnostic. The precursor to today’s ICD was called the International List of Causes of Death. Says Gary Greenberg on the DSM-I’s conception: “One of the reasons was to count people. The first collections of diagnoses were called the ‘statistical manual,’ not the ‘diagnostic and statistical manual’” (Reese 2013).

72 Alternatives to these two major diagnostic systems exist, some of which are explicitly theory- laden (e.g., PDM, or the Psychodynamic Diagnostic Manual), some of which are less explicitly theory-laden (e.g., RDoC, or the Research Domain Criteria system, currently only a research initiative, which relies upon the biomedical model; and HiTop, or the Hierarchical Taxonomy of Psychopathology, which has a lot in common with the big five personality research), and some of which actually do incorporate etiology (e.g., PTM, or Power Threat Meaning framework, which says that economic and social injustices are the root causes of emotional distress). There are also diagnostic systems that are only used in certain parts of the world, for instance, China, with its CCMD (Chinese Classification of Mental Disorders), which introduces the complex issue of culturally related diagnoses: for instance, depression in the CCMD (translated as “low spirits”) resembles the ICD’s neurasthenia (“weakness of nerves”) more than the ICD’s depression (Xu 1987).

73 With the publication of the DSM-III (1980). In fact, of all disorders in the DSM, “the DSM definition of MDD is one of the most stable in the book, remaining essentially unchanged since its initial development in DSM-III in 1980—an endurance that reflects its usefulness. But there is a fatal flaw. Because the same criteria set defines both the most and the least severe depressions, it was written to meet the needs of both. The MDD definition works well at the severe end, but at the mild end it has led to the creeping repackaging of everyday normal unhappiness into mental disorder” (Frances 2013: 140).

74 In other parlance, “operationalized in DSM-III, [it] defines psychiatric disorders as syndromes with shared symptoms, signs, course of illness and response to treatment” (Kendler 2012: 11).

23 disorder D, an S is taken to be a necessary element of a particular set of S’s jointly sufficient for the constitution (and the diagnosis) of a D. (The set itself, when its symptoms reach joint sufficiency, can be called a syndrome.)75 This descriptivist approach is largely pragmatic. In effect, it gives a working, or operational, definition to depression, one which is “arbitrary yet meaningful”—why two weeks and not four?76 Consider the descriptivist

Criterion A laid out in the DSM-5 for major depressive disorder (see Fig. 1.2).77

75 For insight into the distinction between symptom and syndrome, specifically with respect to its clinical use, see Preskorn (1999) and Preskorn and Baker (2002).

76 Take another example of an operational definition, one that is arbitrary yet meaningful, from behavioral analysis and criminal profiling. A “serial murderer” is distinguished from both a “mass murderer” and a “spree killer” on largely arbitrary grounds. For instance, “Generally, mass murder was described as a number of murders (four or more) occurring during the same incident, with no distinctive time period between the murders,” while “Serial murder required a temporal separation between the different murders” (Morton 2005: 8). Cf. Morton, et al. (2014).

77 Keeping in mind that MDD is only one of several depressive disorders in DSM-5. The above criteria are paraphrased from both the DSM-5 (2013: 155-188) and Nussbaum’s Pocket Guide to the DSM- 5, published by the APA (2013: 77-79).

Put aside for now the swelling chorus of critics who decry that “Major Depression was so

broadly defined as to be a meaningless diagnosis.”78 I will return to these critics after first

examining the diagnostic criteria.

Criterion A is the typical list of symptoms (1-9) for diagnosis. While a (finite) combination of these symptoms is possible to suffice for MDD, there is at least one necessary condition that must be met for membership in the general category of

“Depressive Disorders”: either symptom 1 or symptom 2.

The common feature of all [depressive] disorders is the presence of sad, empty, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function. What differs among them are issues of duration, timing, or presumed etiology (APA 2013: 155).

Hence the characteristic nomenclature associating sad affect with depression.

Notice the second inclusion criterion (B): one must be significantly clinically distressed by these symptoms. This entails the possibility that someone could meet all the symptoms of depression yet not be diagnosed with depression, because they are not clinically distressed by their symptoms. (Let us call this possibility, along with the next two difficulties, the “Criterion B problem.”) Criterion B exposes two further difficulties.

First, one might think it possible that having certain of these symptoms (e.g., symptom 8) can diminish the individual’s will or other faculties to the point that they are not subjectively distressed (in some sense of the word) by anything, in which case such a criterion would remain unsatisfied, in what is otherwise a paradigmatic case of MDD, raising the question as to the need for Criterion B.

78 Shorter (2008). Cf. the now-infamous “Rosenhan experiment” (Rosenhan 1974), in which experimenters pretended to experience hallucinations and other symptoms for the purpose of being admitted to a psychiatric hospital, after which they acted normally yet were still diagnosed and given drugs.

Second, a major motivating factor for the presence of Criterion B, which is general

to all psychiatric disorders in the DSM-5, is the APA’s stance as being purportedly

worldview-neutral, value-neutral with respect to the moral rightness or wrongness of

psychiatric disorders. In short, it is there to avoid moralizing psychiatric disorders, but it

removes normativity. What began as a plausible protection against stigmatizing mental

illness, certainly a worthwhile cause, has, unfortunately, now developed to a shockingly

neutral stance on such conditions as the paraphilic disorders.79 Something like pedophilia

(“sexual focus on children”) or frotteurism (“touching or rubbing against a nonconsenting

individual”80), for instance, qualifies as a psychiatric disorder only if it causes the subject

“clinically significant distress.” (Alas, one can imagine a perfectly happy pedophile or blissfully content groper.) Currently under consideration are polyamory and non- monogamy, under the auspices of the “APA Division 44 Consensual Non-Monogamy Task

Force”81 which “promotes awareness and inclusivity about consensual non-monogamy and

diverse expressions of intimate relationships.”82 Understandably, this task force has stirred up concern among conservative voices.83

79 “However, the paraphilia…must be currently causing distress or impairment in the individual, or entail personal harm or risk of harm to others, to qualify as a disorder” (Nussbaum 2013: 176). Curiously, this latter condition—that it must entail personal harm or risk of harm to others—is not a diagnostic condition in the DSM’s account of MDD.

80 Each of these descriptions are taken verbatim from DSM-5 (2013).

81 It bears noting that this task force is a project of an APA division, not of the national organization itself. Nevertheless, one need only look to the history of the formation of earlier DSMs to observe the relationship between certain “task forces” and legitimation of certain diagnostic standards in the APA’s DSM.

82 APA Division 44: Society for the Psychology of Sexual Orientation and Gender Identity (n.d.).

83 See Smith (2019). Showalter (2019), and Barillas (2019).

Criterion B, then, is not only potentially superfluous, but its inclusion is also more partisan than it is empirically sound. I mean “partisan” not in the way that it allows for progressivist agendas—though it does84—but more so in the way it assumes a sort of

secularistic humanistic existential worldview in the background.85 This presumption

precludes any notion of an objective telos of human flourishing.

1.0.2.1 - Absence of telos. While I have been picking on this particular criterion, it

is really just a foil for highlighting the larger issue here: (a) the absence of telos. The

discipline of psychiatry, as it currently is,86 is silent about the rightness, wrongness, or even sometimes the objective wellness of the having of certain symptoms—symptoms which otherwise (i.e., in a person who is clinically distressed by them) would constitute a psychiatric diagnosis. No wonder that Alasdair MacIntyre gives the name “therapist” to one of his three “stock characters…in the dramas of modern social life,”87 “those social roles which provide a culture with its moral definitions.”88 The therapist is regarded as an

84 Many psychiatrists suspect a cloak-and-dagger cabal influencing the APA, but perhaps none have put it so succinctly as Blashfield’s (1982) case for the presence of an “invisible college.” The problem, as Blashfield sees it, is not necessarily with the merits of the diagnostic criteria, but with the process by which these diagnostic criteria came into wide use. Namely, there was a snowball effect of clustered authors at a few home institutions that generated widely the citations of the article. Blashfield calls this group an “invisible college” (from Price 1963), because it represents a cadre of allegiances among researchers that is unknown to the public or more general discipline. Blashfield and Reynolds (2012) point to a specific section of the DSM-5 where this is most readily apparent—the classification of personality disorders.

85 This supposedly “‘worldview-neutral’ therapy”…“actually promotes secularism” (Johnson 2017: 462).

86 It is not this way in principle.

87 MacIntyre (2007: 256).

88 MacIntyre (2007: 31).

expert, but does not or cannot “engage in moral debate.”89 Instead, the therapist “treats ends as given, as outside his scope”; his concern is “with technique, with effectiveness in transforming neurotic symptoms into directed energy, maladjusted individuals into well- adjusted ones.”90 MacIntyre is correct; on such a narrative, there is no objective telos, only the ends, the subjective ideals for flourishing, which individual patients (or clients) decide upon and pick out for themselves, while the clinician treats such matters as “outside his scope.” The practitioner is relegated simply to cater to the demands of the patient, and to manage symptoms if they cause the patient distress. Otherwise, there is no objective end.

This is important for discussions about depression. The therapist’s aim is to get all systems back to normal functioning, whatever that may be, to the extent possible. Absent is any explicit notion of an objective telos of human beings (or of the telos of certain parts

or faculties of human beings91). Thus, if a person is depressed, let us suppose, because of

some spiritual struggle, then a therapist, in the role of practitioner of the discipline, has no

recourse to guide him to the objective ultimate telos of beatitudo as prescribed by St.

Thomas Aquinas (let alone to the objective natural telos of eudaimonia). This may make

all the difference in such a person overcoming his depression or staying depressed!

89 MacIntyre (2007: 30).

90 MacIntyre (2007: 30). Emphasis mine.

91 Consider the operational definition of mental disorder found in DSM-III-R (1987): “statistically unexpectable distress or disability.” Wakefield instead favors a definition of disorder that says it is a “harmful dysfunction” (1992, 1995). In order to say what a dysfunction is of some faculty, one would have to have some sense as to the proper functioning, and not statistically regular functioning, of that faculty. Cf. Pickard (2009) and Varga (2011) for further exploration of this approach.

1.0.2.2 - Absence of etiology. In addition, there is the (b) supposed absence of etiology on this descriptivist model of diagnosis. This is by design,92 yet the DSM does not always adhere to this design.93 While proceeding without etiology comes with some costs

(see below), there is some reasonableness to this approach. First, some think that we cannot, in principle, move from a soft medical model because of inherent, multi-level causal complexity.94 “Many in our field want to move to a hard medical model based on etiological mechanisms,” says Kendler, who goes on to explore “whether psychiatric disorders have the needed single clear level of explanation for an etiologically based nosology.”95 Second, others suggest that the move cannot be made because of our current

92 Robert L. Spitzer (chair of the Work Group to Revise DSM-III): says “Our advisory committee on affective disorders…took an atheoretical descriptive approach—one that does not prevent anyone from further speculation or classification on the basis of presumed etiology” (Spitzer 1984a: 547). I have my own doubts about whether these descriptions are truly “atheoretical”. Stoppard (2000) shares doubts specifically about the DSM-IV, arguing that the definition of “mental disorder” is not really “purely descriptive” and “atheoretical” as is usually claimed. See also Radden (2017: 85-88, 99n), as well as Horwitz, et al. (2016), for more on this descriptivist approach.

93 Even on a supposed descriptivist construal, some depressive disorders in the DSM are distinguished by their “presumed etiology” (APA 2013: 155)—e.g., premenstrual dysphoric disorder in the DSM-5. It is clear that the DSM has not stayed consistently on the path of precluding consideration of etiology. The ICD-10 published by WHO, insofar as it intends to eschew etiology for diagnosis of depression, it bears the same apparent internal inconsistencies or tensions. For example, while codes F31.0 (bipolar affective disorder), F32.0 (depressive episode), and F33.0 (recurrent depressive disorder) are entirely characterized by descriptive symptoms; etiology or context is on prominent display in code F53.0 (postnatal and postpartum depression).

94 This so-called “‘robust descriptivism’ rejects causalism in principle as a useful nosologic approach for psychiatry, asserting that the causal structure of psychiatric illness is so complex, resulting from the actions and interactions of many individual causes, each typically of small effect, as to be useless to solve nosologic questions. The causal model, they would argue, rooted in infectious diseases with one clear etiologic agent, is simply inappropriate for complex conditions such as psychiatric disorders” (Zachar and Kendler 2007: 557-58).

95 Kendler (2012: 11).

29 limitations.96 Certainly, at the time, we knew very little about depression’s pathophysiology and etiology (and perhaps this is still the case), so the authors of the DSM-

III issued a promissory note to be fulfilled once all the details come in. One can see a corollary with our knowledge about AIDS (acquired immunodeficiency syndrome). In the

1980s, we understood AIDS as a syndrome (a set of symptoms) with an as-yet unidentified etiology and unclear pathophysiology.97 Now, of course, we know much more about

AIDS/HIV (human immunodeficiency virus): we understand its viral pathophysiology, and we have a better grasp of its etiology.98 Likewise, part of the motivation for changing to a descriptivist approach in the DSM-III was to head off any premature judgments on etiology and pathophysiology.99 Not only, the committee reasoned, were theoretical assumptions about etiology “not necessary to enable the clinician to make a diagnosis,” but also the inclusion of one theoretical framework “would be an obstacle to the use of the manual by clinicians of other theoretical orientations.”100

96 This position, “best described as ‘temporizing,’ suggests that ‘We will have to settle for descriptive approaches until we understand the real causes of psychiatric illness’” (Zachar and Kendler 2007: 557).

97 We understood it as a “disease predictive of immunodeficiency in a person with no known cause for that deficit” (Lopez 1984: 229).

98 For example, although we acknowledge that there is a higher ratio of Haitians infected with HIV compared to, say, Americans infected with HIV, we no longer consider being Haitian as a risk factor for contracting AIDS—as Lopez (1984: 229) reports from the CDC.

99 This leads Zachar and Kendler to enumerate a third position, besides the “temporizing” and the “robust” descriptivist. “A third, intermediate position argues that despite the complexity of the causes of psychiatric illness, one particular class of casual factors (e.g., genes, neurochemistry, structural brain changes) might, for practical reasons, be given priority when we make particular nosologic decisions” (Zachar and Kendler 2007: 558).

100 Since, they argue, “it would not be feasible to present all reasonable theories about etiology or the underlying mechanisms involved in each disorder” (Spitzer and Williams 1980: 1055).

This segues naturally into a third reason: the authors of the DSM-III suggest that

the task of discerning etiology is better suited for either the theorists (e.g., Freudian

psychoanalysts) or the clinicians who have recourse to use their patients’ worldviews. This

sort of laxer legislation preserves and respects the authority and expertise of the clinician,

allowing for both commonsense to prevail and finer distinctions to be made in the clinic.

This arrangement reminds me of the controversy over the NFL’s “Catch Rule,” which

serves as an interesting analogy and warning against attempting to make decisions at the

level of rule manuals. In their case, the rule as to what constitutes a catch has been rewritten

and cobbled together “to the point where commonsense rulings [on the field] are overturned by letter-of-law interpretations”101—interpretations of the rule that seem to change yearly,

as the NFL tries to patch up the rule itself rather than affording more leeway for judgment

to the referees on the field. Analogously, the thinking goes, the art of the judgment “on the

ground” should be left to the clinician.

While this change to a descriptivist approach was well-motivated, the absence of

etiology comes with some costs. Most glaringly, context is sacrificed. In times past, it used

to be that “The most useful indicator for depressed mood is the tendency to weep, but it

must always be considered against the cultural background, and patients must ‘go beyond

weeping.’”102 Context—a person’s life circumstances and cultural background—was vital

101 Fittipaldo (2017). Instituted in 1938, and standard through 1982, was that a receiver had to possess the ball and “perform an act common to the game.” In recent years, the rule has undergone many onerous additions in attempts to clarify what a catch is: the receiver must “complete the process of a catch,” or has to be “making a football move,” or “must clearly become a runner,” or “the receiver must survive the ground” (ibid.). Says one frustrated coach-turned-analyst Tony Dungy in 2017, “When do you catch the ball? The rule says you haven’t caught the ball until you survive the ground. It’s not what any 11-year-old would say is the case. ‘Well, OK he never caught the ball because three steps later when he hit the ground the ball moved a little bit.’ My 11-year-old would say that’s ridiculous” (ibid.).

102 Hamilton (1960: 57), emphasis mine.

31 to understanding why that person would exhibit depressive-like symptoms, for it enabled the clinician to judge whether this weeping, for instance, was unusual or inordinate or whether it was to be expected. By contrast, on a descriptivist approach, it is the severity of symptoms that is emphasized, rather than context.103 This is problematic because it allows for ostensibly non-pathological sadness to be diagnosed as depression. Some go further to suggest that depression, understood correctly and taking context into consideration, is itself nothing more than an exaggerated form of normal human sorrow.104 Perhaps because of the uncertainty and confusion surrounding the status of depression, there is now a small but vocal contingent of philosophers and psychiatrists who deny the reality of mental disorders altogether,105 partly fueled by our present cottage industry of mental disorders and fads.106 While there was some attempt to reinject etiology at the level of rule manuals

103 This debate—what might be called the contextual approach vs. the symptom-severity approach— is catalogued in Horwitz, et al. (2016), who argue that the contextual approach is what we have relied on historically since Hippocrates to the time of DSM-III. They are careful to point out, even while criticizing the DSM-III’s descriptivist approach, that these descriptivist criteria were still very much in use prior to 1980— it’s just that they were used in conjunction with contextual and etiological considerations. This maps on fairly closely to what I have been calling the descriptivism vs. causalism debate (Zachar and Kendler 2007). An earlier, related debate was endogenous vs. reactive depression (Mendels and Cochrane 1968).

104 Horwitz, et al. (2016) argue, “the entire 2,500-year record [since Hippocrates] indicates an understanding that pathological depression is an exaggerated form of a normal human emotional response” (Horwitz, et al. 2016: 21). I assume here by “pathological depression,” they are referring to the set of symptoms that we would now refer to by that appellation. Cf. Horwitz and Wakefield (2007).

105 A notorious example is Szasz’s (1974) The Myth of Mental Illness. Cf. Pickard (2009) and Baughman (2006). For some perhaps more moderate representative proponents, see Pickering (2006) who calls mental illness a metaphor and Walker (2016) who thinks it a social construction. That being said, I would be remiss not to point out that much of the criticism against Szasz is terribly unfair. By saying that mental disorders “do not exist”, he is claiming that the conceptual scheme is mistaken; he admits that there is real pain and suffering and that the condition, whatever conceptual scheme we use to understand and explain it, is real. Yet people get hung up on the slogan “mental illness is a myth.” “Its pithiness makes it ambiguous. Its shock content makes it politically serviceable” (Pickard 2009: 83).

106 As Frances (2013) would put it. Consider two recent “faddish” diagnoses: “Rejection Sensitive Dysphoria” (Bonior 2019) and “Home Office Syndrome” (Dimitriu 2020). These—as well as more established diagnoses like “Masochistic Personality Disorder (P. J. Caplan 1995) and Multiple Personality Disorder (McHugh 2008)—may soon end up going the way of older fads, such as: “Drapetomania” (A. L. Caplan, et al. 2004), “Marching Band Illnesses” (Littlewood 2002: 67), “Ganser Psychosis” (Ganser 1897; 32

with the multiaxial system of DSM-IV (1994),107 the multiaxial system was quickly

abandoned with the publication of DSM-5 (2013).

In our current diagnostic practices, however, etiology is not absent at all. Despite what the manual says about identifying depression merely descriptively by its symptoms, clinicians too often yield to the appeal of background reductionistic naturalism when, in their usual first step and first line of defense, they reach first for the prescription pad. This is not being agnostic about etiology. It assuming that a certain kind of cause is the real cause, and that that cause is physical.

1.0.2.3 - Reifying depression. Third, the background reductionistic naturalism that commonly undergirds our diagnostic practices has: (c) set psychiatry and psychology on an adverse course of reifying depression as a discrete entity with little to no consideration of the theoretical consequences.108 This is not to say categorically that the Aristotelian approach to classification is wrong… But this is a fundamental debate at the meta- theoretical level of philosophy of science and which should not be ruled upon or dismissed

as a result of what diagnostic practices we use. To do so begs the question. Rather than

Littlewood 2002: 63), and “Gulf War Syndrome” (Littlewood 2002: 67-8). Cf. Zachar (2012), the section titled “Making-up disorders”.

107 The multiaxial system began with DSM-III (1980), was in use and the subject of heavy criticism during the reign of DSM-IV (1994), and was altogether dispensed with by the time of the DSM-5 (2013). In this multiaxial system, “an individual was diagnosed on five different domains, or ‘axes.’ In a single axis system like DSM-5 is, an individual is diagnosed in just one domain…The multiaxial system was thought to give more detail” (Salters-Pedneault 2017). These five axes were: I) clinical disorders, II) personality disorders or mental retardation, III) medical or physical conditions, IV) contributing environmental or psychosocial factors, and V) global assessment of functioning. Note Axis IV, which explicitly accounts for etiology, and Axis V which allows for some consideration of context.

108 For the sake of argument, there are some reasons to prefer that we reify depression as a discrete entity. For one, if it is reified, it is much easier to talk about. We can use a common label for it, which makes for much smoother communication.

contribute to scientific progress, the descriptivistic DSM system “created an unintended

epistemic prison that was palpably impeding scientific progress.”109 It is so widespread and endemic a problem that, for some, to diagnose just is to reify.110 Lilienfeld and Treadway

(2016) have noticed an upstream effect, “the de facto wholesale appropriation of DSM

criteria by the research community”—not clinicians—and they question whether this is

“impairing the elucidation of pathophysiology.”111

Why think that our current diagnostic practices influence the reification of

depression? This happens, albeit implicitly, as the very result of organization and nosology

of mental disorders. I hedge (“implicitly”), because there is room for a perspective to

classification which does not reify, considering that, after all, descriptivism operates by

picking out symptoms, and such a perspective would happily accept this, so long as the

analysis stayed here. But it does not. Our current diagnostic practices, contrary to their

neutral and merely descriptivist design, do not remain neutral, describing a set of symptoms

had by a person and leaving it open as to the nature of the condition. Instead, they pick out

symptoms for the purpose of labeling and classifying into kinds. These need not even be

natural kinds, with some philosophers and theorists arguing for “practical kinds”, a

pragmatic middle ground between real kinds and nominal (“social conventions”).112 Says

philosopher Somogy Varga, “The underlying supposition, according to which, other than

109 Hyman (2010: 157). “Even animal studies that purported to develop disease models…were often judged by how closely they approximated DSM disorders” (ibid.).

110 “Diagnosis is the making real [reifying] of conceptual categories” (Jutel 2011: 18). Cf. Section 5 [Ch. 13-15] “Reification of Mental Illness” in Kendler and Parnas (2017).

111 Lilienfeld and Treadway (2016: 444). Emphasis mine.

112 See, for instance, Zachar (2000, 2003, 2008) and Zachar and Kendler (2007).

natural kinds there can be no legitimate kinds that justify therapeutic attention, is

erroneous.”113 This debate about mental disorders and natural kinds, nominalism, and everything in between, takes us too far aground for the present project.114

One might object at this point, saying that descriptivism does not necessarily entail

the reification of depression. This is certainly true, and I conceded this above by noting

that these practices go against their design. The greater culprit is the background

reductionistic naturalism which drives the common interpretation of descriptivism. It is the

classifying of S’s condition as “MDD” and presuming we can now treat that entity, that ailment, with pharmaceutical drugs. Notice how this is different from treating this or that person. That said, the approach to classification which emphasizes agency over entity—let alone a “causalist” or “contextualist” approach to diagnosing depression which accounts for causation at all—can be no improvement unless it allows for personal agent causation.

Simply speaking of sub-personal mechanizing causes will not do. Agent causation is highly suspect in science. But an approach is needed which not only takes more explicitly into account the context and etiology of one’s condition, but also emphasizes the agency of the person. Allowing such a wide-ranging and holistic picture of a person’s depressive-like condition has many benefits. To name one: it invites the individual to participate more actively in his or her treatment; since personal causal explanations are now taken more

113 Varga (2015: 127).

114 Some representative camps, in the meantime, are: Wakefield’s (2007) “harmful dysfunction” approach analysis of the concept of mental disorder, as well as Lilienfeld and Marino (1995) who claim it is a “‘Roschian concept’, characterised by the fact that it is in principle impossible to provide necessary and sufficient conditions for category membership” (Varga 2011: 7). Cf. Pickard (2009) and Varga (2011).

seriously, it makes a difference what a person does, not just what one’s medication does or

what one’s body is doing, for example.

1.0.2.4 - Biomedical model reinforced. Speaking of medication… Allen Frances

said it well, “There are better ways to deal with sadness. People should have more faith in

the remarkable healing powers of time, natural resilience, exercise, family and social

support, and psychotherapy—and much less automatic faith in chemical imbalance and

pills.”115 This is all the more important now with suspicion and alarm being raised about

the efficacy of antidepressant drugs,116 with one researcher bemoaning that “there’s not ‘an iota of direct evidence’ for the theory that a chemical imbalance causes depression.”117

This leads, finally, to one more influence, that our diagnostic practices tend to: (d)

reinforce a hegemonic, reductionistic view about depression’s ontology, namely the

biomedical model of depression. To wit: “The current treatment model…reinforces the

idea that we can treat depression in a relatively narrow, mainly biological way.”118 On the

one hand, “highlighting the physical effects of depression communicate[s] the reality of an

illness that often seems abstract.”119

The feeling that people with depression simply need to pick themselves up by their bootstraps endures as a prejudice. Because a depressed person’s family and friends cannot see the injury and may not be able to empathize by calling on their own experience, the illness may not seem real. Even worse, people may call on their own

115 Ch. 4, Frances (2013).

116 See especially the meta-analysis Kirsch, et al. (2008).

117 As interviewed in Goldhill (2017).

118 Callahan and Berrios (2005: xi).

119 Callahan and Berrios (2005: 5).

experience with minor emotional upheavals and celebrate their strength in overcoming blue moods, rather than empathize…120

So placing emphasis on the physical, biochemical aspects (presumably) makes depression more concrete.121 This is important, since “For us to be able to classify a disease, it must first be visible to medicine.”122 On the other hand, the biomedical model of depression— with its assumptions, conventions, and limits—actually contributes to progress being stalled in both science and treatment. This is not mere rhetoric, with historian of psychiatry

Edward Shorter claiming that “psychiatry has not progressed as other medical specialties have, because the classification of illnesses and the medications used to treat them are inferior to the state of the art 40 years ago.”123 I cannot here assess the truth of Shorter’s claim,124 and I do not endorse this view myself; but it is startling to note that a well-known historian of psychiatry would claim such a thing.

Again, one can object that the mere act of identifying and classifying depression descriptively does not necessarily entail a biomedical model of depression—“a psychiatric

120 Callahan and Berrios (2005: 5). Goldhill (2017) adds, “It’s not hard to see why the theory caught on: It suited psychiatrists’ newfound attempt to create a system of mental health that mirrored diagnostic models used in other fields of medicine. The focus on a clear biological cause for depression gave practicing physicians an easily understandable theory to tell patients about how their disease was being treated.”

121 This is only partly true, pace this line of thinking, since many of depression’s symptoms are not physical or biochemical in nature. So identifying depression on the basis of symptoms alone should not necessarily lead to a biochemical approach.

122 Jutel (2011: 16), adding, “A diagnosis must not only be visible but also agreed on” (2011: 17).

123 Shorter (2008). Adds Hyman, “No drug today is more efficacious that the very first antidepressants such as the tricyclic imipramine” (qtd. in Goldhill 2017).

124 Just one quick comment pace Shorter’s claim: the “state of the art” need not be assessed in terms of pharmaceutical success. For many psychiatrists now, the “state of the art” includes other things such as demoralization, attention to complicated grief, moral injury, burnout, and the extent to which these overlap with how we think about depressed mood. Fortunately, many of these also come with clearer existential or spiritual dimensions to them.

37 diagnosis is not a disease.”125 This is true, strictly speaking; but, again, the practices belie something different. First, the DSM is used primarily by medical doctors and psychiatrists—who, unlike psychologists, have a medical degree—revealing a methodological commitment to the biomedical model. While there is no denying the complex reality of some mind-body relation assumed by all psychosomatic disorders, there are some mental disorders that are more “bodily” than others. For example, “organic” mental disorders or brain syndromes (e.g., some forms of amnesia or dementia) are thought to be expressly due to some brain injury, trauma, or illness. However, depression is not one of them.126 (Granted, this does not stop diagnosticians and theorists from harboring presumptions as though depression were organic or physical in nature.127) Upon a DSM diagnosis of depression, for instance, the physician will usually then prescribe the patient some pharmaceutical drug that will target the root biochemical pathology. Allow me to emphasize: relying upon a diagnostic system based in descriptivism, which is agnostic about etiology, the physician’s usual first step and first line of defense is to reach for the prescription pad—a practice which reinforces a biochemical etiology of depression.128

125 The title of Shedler’s (2019) Psychology Today article. Days later, Allen Frances, Chair of the DSM-IV Task Force, testily tweets in agreement: “Mental disorders are constructs, not diseases. Descriptive, not explanatory. Helpful in communication/treatment planning, but no claims re causality/homogeneity/clear boundaries. We wrote this in DSM-IV Intro- no one read it.”

126 “In a recent review, a consortium of experts on the biology of depression, including representatives from the [NIMH], concluded: ‘We have not identified the genetic and neurobiological mechanisms underlying depression and mania, nor do we understand the mechanisms by which nongenetic factors influence these disorders’ (Nestler, et al. 2002)” (Callahan and Berrios 2005: 6).

127 This is despite the fact that the lack of an organic explanation is one of the first criteria for diagnosing major depression, because there are other conditions related to substances or hormones that can mimic or look very much like it.

128 There are some, perhaps many, practitioners who are loathe to promote pharmaceutical drugs. I grant that, in these cases, reaching first for the prescription pad is not necessarily an endorsement of the biomedical model, but may instead, for instance, reveal a commitment to whatever stopgap solution is needed for the most urgent or extreme cases, such as when a patient is suicidal. I recall one practitioner telling me 38

Second, it is commonly thought, “from the time of Koch’s postulates” [in bacteriology, c. 1880s], that something is not truly a disease without an identifiable cause.129 (Set aside for the moment that, by “identifiable cause,” they mean a physical cause.) This is why the APA’s DSM is careful to avoid altogether using the term

“disease”—rather, they are “disorders”.130 Some critics have argued, however, that this is merely “a rhetorical device. It's saying ‘it's sort of like a disease,’ but not calling it a disease because all the other doctors will jump down their throats asking, ‘where's your blood test?’”131 This sort of thinking along medical lines—diagnosis, treatment, cure—has gone towards cementing psychiatry’s status as a respectable medicine.132 Yet psychiatry’s diagnostic practices often beg the question with respect to direction of causation. While direction of causation is easily identifiable when it comes to organic mental disorders, especially those that are the result of brain injury, it is much less certain with mental disorders like depression. Or at least it should be, given descriptivism! While depression

bluntly, “I’d rather have you alive and on drugs than dead.” This underscores the primacy and fundamentality of life over other goods. Once you are stabilized, then we can pursue those other goods such as physical exercise and social support, which will go a long way for your mental health.

129 Zachar and Kendler (2007: 557).

130 Cf. APA (2013) and Nussbaum (2013). Says DSM critic and practicing psychotherapist Gary Greenberg: “The difference between disease and disorder is an attempt on the part of psychiatry to evade the problem they're presented with. Disease is a kind of suffering that's caused by a bio-chemical pathology…But in many cases our suffering can't be diagnosed that way. Psychiatry was in a crisis in the 1970s over questions like ‘what is a mental illness?’ and ‘what mental illnesses exist?’ One of the first things they did was try to finesse the problem that no mental illness met that definition of a disease. They had yet to identify what the pathogen was, what the disease process consisted of, and how to cure it. So they created a category called ‘disorder’” (Reese 2013).

131 Gary Greenberg, interviewed in Reese (2013).

132 “‘Psychiatry has always had a tenuous position in the prestige hierarchy of medicine,’ says [Allan] Horwitz. ‘They weren’t regarded by doctors and other specialties as being very medical. They were seen more as storytellers as opposed to having a scientific basis’” (Goldhill 2017).

39 qua diagnosable syndrome may have underlying neural correlates that manifest in similar patterns across different people (in common parlance, a “chemical imbalance”133), and while some people may respond well to pharmaceutical drugs (not a foregone conclusion, by any means134), these facts neither establish direction of causation nor entail the truth of the biomedical model. And yet this is how our diagnostic practices proceed. This sort of perceived disingenuity, among other reasons, has led some of the more outspoken and skeptical from within the field of psychiatry itself to call psychiatry a “pseudoscience”135 and psychiatric diagnoses as “scientifically meaningless.”136 At the very least, lest continued scientific progress be stalled, critics urge that physicians “need not and should not receive treatment guidelines passively.”137

The overwhelming consensus among experts in psychiatry and psychology is that depression is multifactorial,138 yet that is not represented in either its studies or in

133 A notion itself under intense scrutiny. “The fact that practicing physicians and leaders of science bought that idea, to me, is so disturbing,” says Steve Hyman (Goldhill 2017).

134 Kirsch (2014) puts it bluntly, “The serotonin theory is as close as any theory in the history of science to having been proved wrong. Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.” Cf. the meta-analysis done by Kirsch, et al. (2008), which generated a storm of backlash, as well as Turner, et al. (2008).

135 I am presently thinking of retired psychiatrist Lee Coleman (though he is far from alone), who even went so far as to testify in over 800 legal cases as an expert witness—not to the competency of anyone’s mental state—but to the state of the discipline of psychiatry, namely, that psychiatry is not fit to provide reliable testimony about a person’s state of mind in the past (at the time a crime was committed), present (to determine whether one is competent to stand trial), or future (to determine whether one will reoffend). See Coleman (1984), especially Chapter 3, “The Insanity Defence, Storytelling on the Witness Stand.”

136 Allsopp, et al. (2019).

137 Callahan and Berrios (2005: xi). “Instead, they must embrace their central role in the care of patients with emotional disorders” (ibid.).

138 Goldstein and Rosselli (2003), to put it a different way, say that there is no consensus as to what causes depression, that is, if we are looking for a single-cause etiology. Cf. Kendler (2019).

practice.139 Diagnostic practices, along with the assumptions they operate upon, have a

tendency to reinforce the biomedical model of depression. It is a problem that not only

DSM authors,140 but also clinical psychologists lament:

One reason that mental disorders are described as brain diseases by scientific authorities, despite failing to meet the basic definition of a disease—an abnormality in bodily structure or function—is the reductionist philosophy that abnormal psychological phenomena are the product of a disordered brain.141

This is precisely right. This background reductionist philosophy bleeds through into

diagnostic practices and should not remain unchecked.

I have discussed four major ways in which current diagnostic practices and the

background reductionistic naturalism influence our understanding of depression: (a) telos

is absent, (b) etiology is absent, (c) depression gets reified as a discrete entity, and (d) the

biomedical model of depression is reinforced. Before examining the historical conditions,

which are prima facie similar to depression, in the following chapters, I briefly outline

some strategies for incorporating the wisdom of the past with contemporary theory.

1.1 - Recovering the Past (& What to Do with it Once it’s Recovered)

In 1931 fisherman aboard the trawler Colinda about 50 miles off the northeast coast of Norfolk, England, between the Leman and Ower Banks in the North Sea, dredged up a lump of peat containing a spear point or harpoon made from red deer antler. The following

139 Jenkins and Goldner (2012).

140 Spitzer and Williams (1980).

141 Deacon and Lickel (2009: 115), emphasis mine. Yet another motivation to relabel a mental disorder as a brain disease is that “Changing the definition could unlock more money for cures” (Ehley 2019). Again, it is a matter of respectability. In one recent report, for example: “Mental health advocates are lobbying Congress to help them get schizophrenia classified as a brain disease like Parkinson’s or Alzheimers, instead of as a mental illness, a move that could reduce stigma and lead to more dollars for a cure” (ibid.).

decades saw many other discoveries among the slopes and depressions in the area known

as Dogger Bank142: submerged archaeological forests, human artifacts (e.g., flints and

spearheads), animal remains (e.g., mammoth and rhinoceros teeth), and even structures.143

In 1988 scientists definitively dated the Colinda spear point to c.11,950 B.C.-9500 B.C.144

Since peat forms only in freshwater, this and the other discoveries provided strong evidence

to support a long-submerged dry land mass in the North Sea, large enough to be inhabited

by big game and the humans who hunted them. This so-called “Doggerland”, before it was

submerged by melting glaciers, once connected Britannia to mainland Europe. It is said

that the Thames and the Rhine once used to meet into a super-river running along the

English Channel and emptying to its southwest!145

How could something be forgotten for so long? Accompanying our Post-

Enlightenment sensibilities is an unchecked tendency to believe in the unyielding progress of knowledge, always adding discovery after discovery, never a step back, never losing knowledge. But this, along with many other examples, reminds us that this is not true. We can lose knowledge.146 More 10,000 years may have passed without any human being

knowing that much of the North Sea was once dry land.

142 Named for the “dogger” Dutch fishing vessels which found success here.

143 See Coles (1998), Flemming (2002), Gaffney, et al. (2007), Ward, et al. (2006).

144 Hedges, et al. (1990: 105). It was originally considered to be consistent with “Maglemose type” and other Mesolithic harpoons found elsewhere under peat at Holderness in Yorkshire. Cf. Watkins (2014).

145 Doggerland research was conducted using the following sources: Branagan, et al. (2012), Coles (1998), Flemming (2002), Flemming, et al. (2017), Gaffney, et al. (2007), Hedges, et al. (1990), Spinney (2008), Ward, et al. (2006), and Watkins (2014).

146 I do not hold the view that a group, over and above the individuals that constitute that group, can have knowledge. I think that the claim “Humans have lost knowledge of p” can be analyzed simply in terms of (a) “there is no longer any individual human being that knows p,” perhaps coupled with—as is true in the 42

What do we do with recovered knowledge? In certain disciplines, such as history,

the answer is fairly simple: history books will be rewritten. In other disciplines, and with

respect to complex theories for how we understand the world and ourselves, it is not so

straightforward. In our case, we have a couple of options—which I will sketch only briefly

here, before returning to them along with more general strategies in the concluding chapter.

1.1.1 - Opening the Door to Spiritual Etiology

The notion that depression is a chemical imbalance is a superficial caricature that

shouldn’t be in our vocabulary. Steve Hyman, director of the Stanley Center for Psychiatric

Research at Broad Institute of MIT and Harvard, claims that there is not “an iota of direct evidence” for the theory.147 Kirsch (2014) puts it bluntly, “The serotonin theory is as close

as any theory in the history of science to having been proved wrong.” When asked what

causes depression, Hyman answers, “No one has a clue.”148 Thus, one strategy is to incorporate the recovered historical knowledge for the sake of developing a model of depression on which depression has a spiritual etiology. Assuming that many, if not all, of these historical conditions, understood correctly and within the proper context, have some recognized, irreducible spiritual etiology,149 then this (together with certain views

Doggerland case, but which may not be necessary, but surely provides more support for the claim—(b) “there is no extant written record of p.”

147 As interviewed in Goldhill (2017).

148 As interviewed in Goldhill (2017).

149 What do I mean by “recognized, irreducible spiritual etiology”? This does not necessarily mean that some demon or rogue spirit is the cause (although such explanations have been given: cf. for example, Johann Weyer’s (1515-1588) De praestigiis daemonum [Of Deceiving Demons]). My account is consistent with, but does not entail, such explanations. Instead, by “spiritual etiology” I mean to include at least God’s agent-causal interaction with humans in conjunction with the spiritual nature of humans (that spiritual part of a human person that we call the soul, whatever the soul ends up being). By “recognized” I mean to include those types (and tokens) of God’s agent-causal interaction with humans that are acknowledged by Christian 43

about human nature and continuity) provides reason to think that at least some instances of

what we now call “depression” can sometimes have a spiritual etiology or be spiritual in

nature.150 To be clear, claiming that depression has a spiritual etiology certainly does not entail that all cases of depression are spiritual in kind—as others may have a biochemical

etiology, an allostatic etiology, or a systemic social inequality etiology.

As I have pointed out before, there have already been many proposed R/S models

of depression, as well as recent clinical and empirical studies that explore possible R/S

aspects of depression. On this strategy, the recovered knowledge from this project would

provide more support for such frameworks, but by being an historico-philosophical case

for a spiritual etiology of depression which dovetails with those R/S models and studies.

This strategy is consistent with many tropes from the experts on the current state of

psychiatry’s understanding of depression: depression is multi-causal, and yet we are not sure what exactly it is that causes depression. Thus, proposing a model of depression with a spiritual etiology would advance the state of the art, not least because of its push for exploring etiology.151 Now, all this being said, there is something very bodily or physical

about the experience of severe depression, even if you don’t think that it is primarily caused

tradition. By “irreducibly spiritual” I mean to affirm that God’s being the explanation for x cannot be reduced to, or accounted for in terms of, a more fundamental explanation for x (e.g., religion as social construction, one’s own neurobiology, etc.). So, examples of recognized, irreducibly spiritual etiologies, as we shall see, can range anywhere from spiritual trials to demonic oppression, from one’s own sinful culpability to God’s withdrawing of His felt affection.

150 To argue for this more fully, one desideratum might be a coherent account of the similarity relation between depression and these historical antecedents: whether one of direct ancestry, indirect influence, or some hodgepodge independence yet family resemblance.

151 Long have we known its symptoms, we have identified and classified these into a syndrome (i.e., depression), and in recent research we have sought to understand its pathophysiology. The only thing that remains, in order to gain a complete understanding, is to understand its etiology. Cf. Preskorn and Baker (2002), especially the pyramid diagram in Figure 1.

or explained by something physical or biological, even if you think it is spiritually caused.

So proposal of depression’s spiritual etiology needs to account robustly for this fact.152

1.1.2 - Pluralistic Kinds of Depression

This second strategy follows from the first but is a distinct project. This strategy

would be to develop, contra a model which assumes that depression is univocal (albeit with

diverse factors), a pluralistic model of depression on which there are different kinds of depression. The DSM already reflects this to some degree: there is not only MDD as distinct from dysthymic depression, but also certain conditions like premenstrual dysphoric disorder which are classified under depressive disorders. The strategy here would be to expand the classification further to distinguish kinds of depression according to etiology: whether spiritual, biochemical, allostatic, systemic social inequality, and so on. This

“pluralistic” approach would venture into “splitting”, but would have the virtue of explaining why a given treatment may work for some people and not for others: because multiple etiologies, contexts, or causes (not limited to efficient cause) can produce the same or similar set of symptoms. This in turn could lead to the development and use of treatments that are more efficacious and tailor-made to a specific kind of depression. For kinds of depression with a spiritual etiology, this may involve spiritual direction, discipleship and mentorship, pastoral counseling, or the practice of spiritual disciplines, which go toward

152 We see something like this even in Thomas Aquinas’s holistic picture of the self. The soul is not made of separable parts (e.g., the appetitive part, the sensitive part, etc.), but is an intimately unified whole, such that if you move one part, the other parts will necessarily be affected. For instance, if you are affected in your passions, then there is going to be some corresponding movement in one’s physical or bodily parts.

mending the spiritual side of a person (and thus the whole person) as opposed to merely

treating it biochemically.153

1.1.3 - A Non-Pathological Fallow Season

Depending on how things shake out, some of the historical conditions surveyed

here may not be pathological at all. They may instead actually contribute to one’s own

growth and flourishing. Thus, a third strategy to account for this recovered historical

knowledge would be to demarcate a depressive-like condition (or conditions) as distinct from those kinds of depression which are pathological or malignant. Again, we have some precedent to draw upon here as well. There were a great many poets and authors in history who were said to be afflicted by melancholy or depression, and this was often seen as a mark of genius.154 More recently, sociologists Horwitz and Wakefield (2007) have

expressed concern over the Loss of Sadness, the pathologizing of normal sorrow into a medical condition. Elsewhere, they point out that “the entire 2,500-year record [since

Hippocrates] indicates an understanding that [what we consider to be] pathological depression is an exaggerated form of a normal human emotional response.”155 Joining in

their chorus is chairman of the Task Force for DSM-IV Allen Frances (2013), who is just

as worried about the growing medicalization of ordinary life.

153 Cf. Johnson (2007, 2017), Peteet (1994, 2010, 2012), Peteet and Elderon (2016).

154 More recently, there are the Victorian melancholic muses and current-day memoirs One can see a good sample of such writings in depression memoirs. Radden and Varga (2013) argue that we should employ caution in drawing inferences as to the epistemological value from depression memoirs. Cf. Horton’s (2014) edited volume, Affective Disorders and the Writing Life: The Melancholic Muse.

155 Horwitz, et al. (2016: 21).

This concludes a brief survey of some strategies for incorporating the “old” with

the new. I return to this issue in the concluding chapter of this dissertation. There I can speak more about specific historical conditions than I can here.

1.2 - Conclusion

The body of the dissertation takes the shape of an historical survey, as it is largely reserved for examining these symptomatically similar conditions, each of which gets its own chapter. Each chapter follows a recognizable pattern: I first provide a prima facie

rationale for inclusion of the condition in this study, viz., its descriptive symptomatic

similarity to contemporary depression. In the body of each chapter I look more closely at

the condition, examining primary and secondary textual sources in order to uncover a more

thorough picture of the condition’s symptoms, etiology, and treatment. I close each chapter

with a revised consideration of the condition’s relation to depression.

In order to proceed in the way described above—surveying history for conditions

that are symptomatically similar to contemporary depression—I proceed methodologically

assuming descriptivism, assuming that depression is sufficiently diagnosable in descriptive terms (i.e., of the presence and absence of certain symptoms), and then work backwards to compare and contrast it with prima facie descriptively similar historical conditions. I do not presuppose any conceptual continuity between these historical conditions and depression, or between each other. Rather, at the end of each chapter, I set out to make a

considered judgment about what the relation between depression and these might be,

whether that relation be continuity, identity, overlap of some sort, or something else. In my

concluding chapter, I change course methodologically.

At the closing chapter, my historical survey will have revealed a wide variety of

conditions, and the goal then is to make sense of the data. Hence, my return to a discussion

of strategies for incorporating forgotten knowledge. At the very least, I hope to have made

a convincing case that what we call “depression” as described by the DSM can be many

different things, one of which can be of a spiritual nature. Not that every instantiation of it

does have a spiritual nature, but that some might, and that there are good historical reasons to think this.

CHAPTER TWO

Acedia

“To replace the complex acedy by sadness or sloth is to evade a difficulty.”

— Rev. Charles Taylor1

The purpose of this chapter is twofold: (1) to describe acedia and (2) to determine the relation acedia has to depression. Section 2.0 lays out the rationale for considering acedia in this dissertation. Then, in service to (1), I describe the nature of acedia as a spiritual affliction with psychological symptoms as understood by the Desert Fathers, in its transmission to the Latin West, and by the Scholastics (Thomas Aquinas) in Sections 2.1 and 2.2, then summarize acedia’s main features in 2.3. Finally, I take up (2) in Section

2.4, bringing all this evidence to bear upon discerning the relation acedia has with depression (MDD). In the big picture, Chapter Two covers only one of five historical conditions in this dissertation. In the final word (Chapter Seven), I return to discuss depression the wider implications this study has for our understanding of depression.

2.0 - Rationale for Inclusion

There has been a bevy of recent interest in acedia, both from a scholarly academic perspective and from a psychiatric perspective.2 Though it has a long history, acedia is an

1 Taylor (1908, I: 66), the entry “Accidie.”

2 Some recent, comprehensive, scholarly treatments of or conceptual histories of acedia can be found in Wenzel (1960a, 1960b), Bloomfield (1952), Forthomme (2000, 2005), Nabert (2005), Nault (2005, 49

oft-misunderstood concept. This is probably due to the various meanings the term “acedia”

has connoted from its earliest usage in the desert monastic communities, through the

scholastic period, on down to the present-day popular notion of slothfulness. It is true that

acedia is a multifaceted concept with a long and complex history. In my view, most

misunderstandings stem from a failure to look beyond popular or surface-level notions to

fully grasp the complex concept of acedia. To take one example, the psychiatrist Mark D.

Altschule3 (1965), in his bid to trace the development of acedia from a deadly sin to a

psychiatric disorder, seems entirely to neglect or dismiss the spiritual context of acedia,

even though he takes himself to be narrating the tradition from Evagrius and Cassian. The

result is a stripped-down and simplistic, if not fictitious, version of acedia. Altschule states

laconically, “according to Cassian, feelings of anger, acedia, and depression were deadly

sins; however, today they are regarded as psychiatric symptoms.”4 As support, Altschule

points to two other instances of when psychiatric understanding replaced a sin paradigm:

witchcraft in the 16th century5 and insanity in the 19th century.6 But even if both of these

were accurate assessments—I myself find them dubious7—it would not follow that the

2006, 2015), Luciani-Zidane (2009), Newhauser (2007), Newhauser and Ridyard (2012), Rivas (2018), and Bunge (2011). I discuss some of the psychiatric literature just below.

3 The late Mark D. Altschule, M.D. (1906-1988) was Clinical Professor of Medicine at Harvard.

4 Altschule (1965: 117), italics mine.

5 Especially Reginald Scot’s (1584) “Not Witchcraft But Melancholie” in Hunter and MacAlpine’s (1963).

6 Altschule (1965: 118) points to Feuchtersleben’s (1874) Principles of Medical Psychology, in which the author says “...‘the old Adam’ appears” (Altschule 1965: 166).

7 Witchcraft hysteria and overreaction is well-known, and, in any case, it is not a mark against a sin paradigm to say that level-headed contemporaries were offering better alternative explanations for alleged witchcraft behavior. As for Altschule’s other source, Feuchtersleben’s (1874) quote appears in the context of a larger discussion concerning the nature of dreams, not insanity, as Altschule claims. And, pace Altschule, 50

capital vice acedia can expect to befall the same fate, viz., theory replacement, let alone to do so and remain unscathed.

Because of this common confusion, it would do well to consider the concept in its original milieu, beginning with the origins of the word. The classical meaning of the word acedia (transliterated from Greek ἀκηδία or ἀκήδεια) is “without care” (from ἀ- “lack of” and κῆδος “care”), which connotes something like “negligence” or “indifference.”8 Acedia

has come to carry mostly negative connotations, likely because of its identification as one

of the seven deadly sins or capital vices, but the word originally had more general

application. The term itself “was not invented by the monks,” as one author puts it; it has

“a long history in Greek literature, from a work attributed to Hippocrates down to

Hellenistic writers, although it apparently had never been in frequent use.”9 It enjoyed continued usage among Latin authors writing the word in Greek, like the Roman orator and statesman Cicero (1st c. BC) and the satirist and rhetorician Lucian of Samosata (2nd c. AD).

Conceived broadly, then, and according to its pre-monastic usage, “‘lack of care’ can mean

his concern is well-placed: “But that dreams may, nevertheless, become psychologically and even ethically of deep importance as respects an individual, follows from the above-mentioned power of obscured ideas. Through this power, dreams may give a man historical information respecting himself...This observation likewise points to the delicate affinity of dreams with pathological states of mind, where, too, as it were, ‘the old Adam’ appears” (Altschule 1965: 166).

8 This “care” can also carry connotations of funerary rites, as in Aeschylus’ Agamemnon (699). See Forthomme (2005: 16). Rivas (2018) takes up this topic in his chapter on the archaeology of acedia; see especially p. 101, where he discusses the duty to bury one’s dead and care for the grave.

9 Wenzel (1960b: 6). As Forthomme (2005: 16-17) notes, “acedia” in one form or another can be found in Plato (Laws 913c), Herodotus (7, 189), the Iliad (24, 554; 1, 145), the Odyssey (20, 130; 4, 108), and various Septuagint passages (Ps. 118:28, 60:3, 101:1, 142:4). Wenzel (1960b: 6) notes nine occurrences in the Septuagint.

a negative as well as a positive state: carelessness or freedom from sorrow, and both uses

are attested.”10

Later, of course, the concept of acedia took on its much more robust mantle in the

desert monastic communities where it was transformed from an evil thought to, eventually,

a capital vice. And this, the more well-remembered usage of the word, is the one I aim to focus upon. Though sometimes the Greek word is translated as “sloth” or “listlessness,” I

prefer to retain the original language as much as possible to avoid any premature

associations with, for example, mere laziness or mere idleness.

The principal thinkers and primary texts from which I will be drawing in this

chapter are Evagrius of Pontus (Praktikos, Antirrhetikos), John Cassian (Institutes,

Conferences), Gregory the Great (Moralia in Iob), and Thomas Aquinas (Summa

Theologiæ). We shall see that even within the Christian capital vices tradition itself there

is some divergence in the ways acedia is understood. To take but one small example, in

Thomas Aquinas and in some authors that he cites, such as Peter Lombard and John

Damascene, acedia can be understood neutrally as a passion, a species of sorrow which is

neither normatively good nor normatively bad. In Gregory and elsewhere in Aquinas,

however, acedia is a capital vice, one of the seven deadly sins. In Evagrius and Cassian, it is one of eight logismoi (λογισμοι, “evil thoughts”).

There is already good prima facie reason to analyze acedia in this dissertation as

an historical condition that predates and bears some resemblance to depression, given its

familiar associations with listlessness, lack of care, and sorrow. There is even more reason

once we consider how psychiatry has taken a recent interest in the concept of acedia.

10 Wenzel (1960b: 6).

Looking at the psychiatry and psychology literature, we can immediately notice

three ways in which authors engage with or pronounce upon the relationship between

acedia and depression or other psychological ailments. First, some authors take care to

distinguish acedia from depression (Daly 2007; Flanagan 1965a, 1965b; Jackson 1981).

Second, far more commonly,11 some authors see a natural conceptual evolution from acedia to some contemporary disorder, in that what we thought was acedia is very likely

just what we now know as depression, anxiety, or some other mental pain or psychological

disorder (Altschule 1965; Azzone 2012; Mora 2008: 204, 221). Lastly, there are some

authors who, despite giving an account of historical roots of modern psychiatry, pass over

acedia altogether (Simon 1978).12

The sensitivity of this question over acedia’s relationship to depression and other

psychological disorders can be seen in the following exchange in the British Journal of

Psychiatry from 1965. In response to Mark D. Altschule’s (1965), “Acedia: Its Evolution

from Deadly Sin to Psychiatric Syndrome,” H. M. Flanagan writes:

In common with many psychiatric authors, Dr. Altschule…pays little attention to those for whom the spiritual disorders he discusses are not reducible to psychiatric syndromes. There are still many people for whom the title of the paper might contain the word “devolution” rather than “evolution,” because of a debasing and falsification of concepts…

11 Perhaps unsurprisingly, the reverse is true in the humanities disciplines, literary studies, theology, and so on, which boast a wide variety of authors who support a strong distinction between acedia and depression or other contemporary psychiatric conditions. See for example Crislip (2005: 145) Forthomme (2000, 2005), DeYoung (2009, 2013), Langum (2016), Luciani-Zidane (2009), Nault (2005, 2006), Norris (2010), Paget (1891), Pieper (1948/1952), Volf (2008), and Wenzel (1960a, 1960b). However, there are a few in these disciplines who appear to see a natural evolution from past to present—for example, see Bringle (1984), Feld (2005), and Irvine (1999). Or who simply think that the relationship between them is more complex—Jehl (2005) and Theunissen (1996).

12 Though I should note that, first, Simon (1978) is giving a history of classical antiquity, a time period that would have seen the usage of the word “acedia” but not as a deadly sin. Second, Simon’s (2008) appears in a volume in which acedia is given due attention.

Authors dealing with such matters might give more weight to the fact that there is still much alternative theory embracing issues of choice and moral responsibility; theory often closer to the original concepts, towards which a patronizing attitude is too often shown in psychiatric writings.13

Flanagan’s criticism is insightful and well placed. The 20th century was one that saw

psychiatry rapidly come into its own as a discipline. With the fin de siècle came the

publication in 1900 of the ICD,14 now in its 11th edition, which continued a trajectory

towards more medicalization of mental phenomena.15 From the 1960s to the 1980s,

although we see more “formalization” of mind phenomena into medico-biological

categories, there is at least some heterogeneity among models and theories tolerated.

However, it is not always welcome: “too often,” Flanagan insists, met with “a patronizing

attitude.” In his second reply to Altschule, Flanagan puts it aptly:

I am pleased that Dr. Altschule agrees with me “in the main” and sorry that he finds most of what he agrees with (i.e., all but the last paragraph) to be irrelevant. The charge of irrelevancy is precisely what I am criticizing…16

The rift between Flanagan’s and Altschule’s positions can be summarized as follows.

Flanagan clearly thinks that acedia is a spiritual malady or temptation that is not reducible

to a psychiatric syndrome. Altschule, on the other hand, assumes those ancient and

13 Flanagan (1965a: 550).

14 The ICD was first published under the title “International List of Causes of Death” (ILCD). In its first edition, it includes the following mental conditions as causes of death: 86. insanity, 155. puerperal mania (now we would call this postpartum depression, mania, or psychosis—“mania,” as with “insanity,” originally had a wide connotation). Also included were conditions that some might even today consider of mental nature, given that, in different ways, they are accompanied by physical symptoms as a result of mental goings- on: 58. alcoholism, 59. opium habit, and 85. general paralysis of insane (catatonia). Awareness of the mental effects of even ordinary disease is documented as early as Fothergill (1874).

15 This represents a continued maturation of psychiatry as a discipline from the 1840s onward, for example, with the formation of the RCP in 1841, APA in 1844 and The Asylum Journal (now The British Journal of Psychiatry) in 1853. The first international congress leading to the drafting of the first ILCD (which would later become ICD) was also in 1853. Cf. DIMDI (2018) and Jetté, et al. (2010: 1105-6).

16 Flanagan (1965b: 909).

54 medieval writings about acedia to “refer to psychiatric matters that are currently being discussed,” such as depression, anxiety, and boredom.17 (It is unclear whether Altschule considers acedia to be identical with or merely a primitive ancestor to one of these.)

In this chapter, I endeavour to clarify the concept of acedia in the monastic tradition of the Desert Fathers and the Scholastic tradition of Thomas Aquinas, for the purpose of engaging more honestly the relation between acedia and depression. Along the way, I will show the following key theses. First, acedia is not identical with depression. Second, acedia is not merely a primitive psychological predecessor to depression, but it marks off significantly different ways of being, not least because of one’s spiritual relation to God.

As Lucrèce Luciani-Zidane (2009) has put aptly, “acedia is entangled in the heart (or life) of Christian dogma.”18

2.1 - Acedia in the Monastic Tradition of the Desert Fathers

Acedia began in the desert. It was among these early monastic communities that the concept of acedia as a capital vice first entered the Christian tradition. Rather than a mere accident of history, these humble origins serve as the foundational bedrock for the

“unbroken mainstream” of acedia’s later conceptual development in the history of the

Christian Church.19

It is too daunting to attempt, in this context, a careful exegesis of primary sources or a comprehensive account of each of the important thinkers on acedia. The good news is

17 Altschule (1965: 119).

18 Luciani-Zidane (2009: 13), translation mine.

19 Wenzel (1960b: 179).

that neither of these is necessary—let alone desirable since doing so can easily result in

myopia—in order to look very closely at the concept of acedia.20 In what follows, then, I

will draw attention to both how that concept has changed and how it has remained constant.

Broad views have their benefits. “In looking over the whole medieval period,” says one

author, we can “distinguish three types of acedia: monastic, Scholastic, and popular.”21 I begin with the original monastic “type” in Section 2.1, then continue with the Scholastic and popular in Section 2.2.

2.1.1 - The Desert Fathers

The received tradition names Evagrius of Pontus (345-399) and John Cassian (360-

435) as the earliest compilers of what would become the Seven Deadly Sins. Evagrius and

Cassian are often included among an early group of ascetic monks called the “Desert

Fathers.”22 Evagrius is sometimes also included among the “Greek Fathers.” However, because Evagrius’ writings were feared to teach a heretical kind of Origenism, they were

condemned at the Council of Constantinople II (553); hence, he is sometimes

understandably omitted from this esteemed group.23

20 Wenzel (1960b) makes the following succinct case against taking such a myopic approach. “[T]he concept of acedia one meets in the longer treatments of the fourteenth and fifteenth centuries is a comprehensive one, embracing elements from all stages of acedia’s past life. One must be aware of those stages and the just-mentioned forms of the vice…[I]t will not do to consult a single source (such as Cassian or Thomas Aquinas) or a few selected texts which contain only a segment of the total and rich picture of acedia” (Wenzel 1960b: 179-80).

21 Wenzel (1960b: 179).

22 Harmless’s (2004) Desert Christians is an excellent recent introduction.

23 Migne’s massive, multi-volume cursus completus divides into the Greek Fathers (PG) and the Latin Fathers (PL). Evagrius is placed in the PG, while Cassian is placed in the PL. Interestingly, although Origen’s writings were also condemned at the same council, he retains a prominent, though controversial, standing in Church History. What one thinks about Origen comes down to whether or not one considers Origen’s actual views are distinct from the kind of Origenism condemned in Constantinople II (553). Cf. 56

Evagrius was “probably not the first to list the seven chief sins; but the unknown

originator of the list must have been a product of this Eastern matrix” of intellectual Egypt

of the late 4th and early 5th centuries, which itself was influenced by earlier Gnostic

thought.24 It is likely that such a list was known to other Desert Fathers prior to Evagrius.

The “Desert Fathers” were those wise men from the monastic ascetic communities of the

patristic era whose teachings were regarded as particularly important for spiritual living.

Bloomfield (1952) describes one early Desert Father as “gentle, kind, and sane,” then goes

on to point out how unusual this was: “he has an appealing quality lacking in many other

desert fathers, who, in spite of great spirituality, often repel us by their harshness.”25

Evagrius’ own spiritual father was an elderly priest of Kellia, St. Makarios of Alexandria,26

considered to be among the first generation of Desert Fathers.27

Geographically, the early Christian monastic community in the 4th century

consisted of three main hubs in the northwestern Egyptian desert south of Alexandria:

Kellia, Nitria, and Scetis (Scetes, Skete).28 Evagrius first lived at Nitria then Kellia, while

Clark’s (2014), where she recounts Origen’s fall “with economy and vigor, but with an eye for the wider social implications and the longer-range doctrinal ones” (O’Donnell 1993).

24 Bloomfield (1952: 58-59).

25 Bloomfield (1952: 57).

26 “St. Makarios of Alexandria, who died c. 393-4, aged nearly a hundred, was priest and superior at the monastic centre of Kellia, not far from Nitria (Egypt). Evagrios became his disciple when he settled at Kellia in 385” (Palmer, et al. 1979: 53n1).

27 “It is probable that he also knew St. Makarios the Egyptian, the priest and spiritual father of Sketis. In the person of these two saints, he came into contact with the first generation of the Desert Fathers and with their spirituality in its purest form” (Palmer, et al. 1979: 29). Some scholars have speculated that this same Makarios may have been Evagrius’ immediate source, as “there are a number of sin lists in Macarius, one of which (Homily XV.50) contains six sins, all in the later tradition” (Bloomfield 1952: 349n.128).

28 Cf. Dysinger (1990). While Nitria and Kellia were abandoned in the 7th and 9th centuries, respectively, Scetis (modern-day Wadi El Natrun) is home to a handful of currently active monasteries.

Cassian stayed some time in Nitria and Scetis.29 It is more accurate to call these “monastic

settlements” than “monasteries”, given that the latter term may evoke images of European

cloisters filled with chanting. These settlements were not entirely eremitic (ἐρῆμος, erêmos, “uninhabited”, “solitary”; whence is derived “hermit”) or anchoritic (ἀναχωρέω, anakhōréō, “I withdraw, retire”), but neither were they truly cenobitic (κοινός, koinós,

“common”; βίος, bíos, “life”) if we mean by that term the closely-knit ways of living we see in later monastic communities. Rather, these desert monks are often referred to as

“semi-anchoritic”: in 4th-century Kellia (κελλία, “the cells”), each monk’s cell was a very primitive dwelling, essentially a trench in the ground with mud-brick walls and mud-brick roof,30 and the scattered cells remained in proximity to a central church.

We shall see that this unusual living environment had implications for how the concept of acedia was understood and applied, namely, with broad application even beyond the hermit’s cell. “Indeed, in a semi-eremitical setting, the monks are obliged to leave their cell, since there is a modicum of community life.”31 Even at this earliest

monastic stage, it is apparent that acedia encompasses a broad range of activities and is

“not limited to the temptation to leave one’s cell.”32

29 Cf. Palmer, et al. (1979: 29, 53, 91, 94); Wenzel (1960b: 18).

30 Dysinger (1990).

31 Nault (2015: 50).

32 Nault (2015: 50).

2.1.2 - Evagrius of Pontus (345-399)

Evagrius of Pontus was a name relatively unknown, even in scholarly circles, until

the 1950s.33 This 4th-century monk is often recognized as presenting the “first coherent

doctrine” on acedia, although acedia itself was only one among eight “evil thoughts”

(λογισμοι, logismoi) or “principal faults”, a list which would later become the seven deadly

sins.34 The word λογισμοι itself is generic and neutral. It is as ambiguous as the word

“world” in the New Testament, for example. Within this context, and “in a subtle way,

however, thoughts can become a vehicle for fixing one’s aim not in accordance with

creation. Then they gain the connotation of ‘evil thought,’ in the sense of an enticement to

evil. As such they are revelations of the condition of our ‘heart,’ and they make visible its

malice, its being uninterested in God, and its self-ruination.”35 Once an evil thought festers

and gains hold, “evil grows roots in us, and it becomes a ‘habitus’ (habit) and then a passion

(pathos) of the soul. The soul truly suffers then as from a disease.” 36

Although he had probably inherited “this sin-list from a Gnostic source,” Evagrius

himself had “purged it of its pagan and unorthodox associations.”37 In the Praktikos,38

33 Harmless, S.J. William (2004: 312, 318ff, 334ff). Indeed, Francis Paget, in his rich historical summary of “accidie” (1891), cites Cassian and then St. John Climacus, not Evagrius, when describing the classic Evagrian description in the block quote to follow.

34 Evagrius “calls them ‘thoughts,’ not sins” (Harmless 2004: 312, cf. 218).

35 Bunge (2011), Ch. 2.

36 Bunge (2011), Ch. 2.

37 Bloomfield (1952: 59).

38 Probably written in either Syriac or Greek, and preserved in Greek (cf. Bloomfield 1952: 59n.123). Part of a larger work which includes Gnostikos and Kephalaia gnostika, though only a portion of the original for both of these is extant (cf. Dysinger's (1990) English translation and commentary of the Praktikos).

Evagrius offers a picture of the monk beset by acedia in the form of the temptation to avoid

work and quit the cell.

The demon of ακηδία, which is also called the ‘noonday demon,’ is the most burdensome of all the demons. It besets the monk at about the fourth hour (10 am) of the morning, encircling his soul until about the eighth hour (2 pm). [1] First it makes the sun seem to slow down or stop moving, so that the day appears to be fifty hours long. [2] Then it makes the monk keep looking out of his window and forces him to go bounding out of his cell to examine the sun to see how much longer it is to 3 o’clock, and to look round in all directions in case any of the brethren is there. [3] Then it makes him hate the place and his way of life and his manual work. It makes him think that there is no charity left among the brethren; no one is going to come and visit him. [4] If anyone has upset the monk recently, the demon throws this in too to increase his hatred. [5] It makes him desire other places where he can easily find all that he needs and practice an easier, more convenient craft. After all, pleasing the Lord is not dependent on geography, the demon adds; God is to be worshipped everywhere. [6] It joins to this the remembrance of the monk’s family and his previous way of life, and suggests to him that he still has a long time to live, raising up before his eyes a vision of how burdensome the ascetic life is. So, it employs, as they say, every [possible] means to move the monk to abandon his cell and give up the race. No other demon follows on immediately after this one, but after its struggle the soul is taken over by a peaceful condition and by unspeakable joy (Evagrius, Praktikos 12).39

Here we receive a descriptive picture of acedia as the “noonday demon.” We have no

reason to take this other than at face-value, viz., literally and not metaphorically. The label

of “noonday” seems to suggest that acedia was a kind of affliction that seized the monk at

the same time each day—one can imagine the fittingness of this description in a desert

climate with its reliably oppressive heat every day at midday.40 As for the association of a

temptation with an evil spirit, we, with our modern sensibilities, might consider such a

thing peculiar. But in general, “the fight against demons looms so large in the teachings of

39 Dysinger (1990). The Greek edition, Ευαγριου Περι των οκτω λογισμων προς Ανατολιον, is preserved in Migne’s (PG, 40, 1863a: 1271-79).

40 Cf. Radden (2002: 69, 70).

the desert fathers that it forms a basic and quite distinctive trait of their spirituality.”41 Why

do demons attack monks in this way? Evagrius asks this question in his Treatise on Prayer.

With what purpose do the demons excite us in gluttony, fornication, greed, anger, resentment, and the other passions? [They want] our intellect, thickened by these [passions], not to be able to pray as it ought. For the passions of the irrational part [of the soul], once they have acquired sovereign power, do not allow the intellect to function properly and search for God the Word (De 61ration tractatus, 50).42

When the intellect is overrun by ungoverned passions, it cannot function properly as it

ought in order to pray or to work or to be attentive to God and others.43 As Bunge (2011)

puts this matter succinctly, “What is meant is that the intellect succumbs to the weight of

the body.”44

In other places, Evagrius describes acedia as an atonia (ατονία) or “relaxation of

the soul.”45 This relaxation is not the good kind; it is a languor or lack of spiritual energy

“not in accord with nature” and which “does not resist temptations nobly.”46 This

temptation assaults the monk who ought to be resigned to his cell in faithful prayer. Another

stark characterization of the demon of acedia can be found in the Antirrhetikos:

[T]he soul, discouraged by the persistent thoughts of toil (or fatigue; κάματος) and acedia, falls asleep, grows weak, and becomes exhausted by bitterness. Her strength is devoured by great despondency, and she thinks of abandoning hope because of

41 Wenzel (1960b: 12).

42 The English translation here is a combination of Bunge (2011), Ch. 2 and Sinkewicz (2003: 198).

43 This is why, as we shall see later in Thomas Aquinas, acedia is said to destroy caritas (or friendship with God and love of neighbor).

44 Bunge (2011), Ch. 2, n.15.

45 De octo spiritibus malitiae 6.1 (PG, 79, 1863b: 1157-58D, under Chapter XIII). See Sinkewicz (2003: 83) for an English translation.

46 Sinkewicz (2003: 83).

the violence of this demon. She loses control and, like a child, cries passionate tears and groans without hope of comfort (Antirrhetikos VI.38).47

Additional traits can be found scattered throughout Evagrius’ several works.48

Already in Evagrius’ work we can identify the twofold effect of acedia (which

Cassian will elucidate more explicitly): listlessness and restlessness. On the one hand,

acedia produces listlessness: despondency, lethargy, boredom, idleness,49 lack of energy

or interest, disinclination to exert effort. On the other hand, acedia also produces a

restlessness or distractedness that makes the monk want to leave his cell, that makes him

hate his cell and his brethren. “In the end ακηδία causes the monk either to give in to

physical sleep, which proves unrefreshing or actually dangerous because it opens the door

to many other temptations, or to leave his cell and eventually the religious life altogether.”50

According to Evagrius, the chief remedy against ακηδία is to practice endurance

and patience, hope and perseverance. “Under no circumstances must one flee one’s cell.

Insistent prayer, reading, the recitation of psalms, and shedding tears are helpful practices.

So is the remembrance of, and meditation on, relevant verses from Scripture.”51 Evagrius

47 The English translation here is a combination of Dysinger’s (1990) and Rivas’s (2018: 118, 140).

48 Capita practica, I, 14.18.19.25 (PG, 79, 1863b: 1213ff.); Tractatus ad Eulogium, 6.8.12.28 (PG, 79, 1863b: 1101ff.); Antirrhetikos; De oratione, 75 (PG, 79, 1863b: 1184); De malignis cogitationibus, 12.18.25 (PG, 79, 1863b: 1213ff.); Institutio ad monachos (PG, 79, 1863b: 1236); Speculum monachorum 55 and 56; Speculum virginum, 39; Rerum monachalium rationes, 8 (PG, 40, 1863a: 1260); and Capita cognoscitiva, 28.

49 On the one hand, “ydelnesse“ and its variants can connote being unoccupied or engaged in vain things, even a lack of devotion and inner joy (cf. Wenzel 1960b: 81, 85). On the other hand, the Old English “ídelnessa” (pl.) can be translated as simply “sins” (cf. Bloomfield 1952: 109). In this way, it may be more closely etymologically related to “idolatry”, given that it also carries connotations of “worthlessness”, “a worthless, useless thing, a vanity”, “a vain, false religion”, “superstition” (Toller and Bosworth 1921: 588).

50 Wenzel (1960b: 5).

51 Wenzel (1960b: 5).

62 provides an example of the latter in Antirrhetikos VI.28, “Against the λογισμός of ακηδία which throws away the work of one’s hands and makes the body lean in slumber against the wall: ‘How long wilt thou sleep, o sluggard…’” [Prov. 6:9ff.].

Some modern-day readers are tempted to think of acedia as a problem specific to monks in isolation, and there is some evidence that Evagrius himself thought that the eremitic life was especially susceptible to acedia. Consider a treatise attributed to Nilus of

Ancyra but thought to be either Evagrius’ own or influenced by Evagrius: “The vice of acedia wages war above all on those who remain in seclusion.”52 Stanley W. Jackson

(1981) points to isolation as a clear aggravating factor, noting that “today we might wonder about the impact of isolation on the anchorites, and about the effects of the loss of customary human relationships and usual social comforts on both anchorites and cenobites.”53

Indeed, it is true that acedia for the monastic will look different than acedia in a lay context, but this is not necessarily a difference in seclusion. Evagrius unequivocally states in other places, for example in his letters to cenobites of urban settings, that “acedia

52 See Bunge (2011), Ch. 1. Two treatises under the same name (De octo vitiosis cogitationibus) appear in Migne’s PG. For Nilus of Ancyra’s passage, see PG, 79, 1863b: 1435-90. For Evagrius’s passage, see PG, 40, 1863a: 1271-79. Complicating matters is a separate treatise by Nilus with a similar title (De octo spiritibus malitiæ) which one author, Coleterius, published together with De octo vitiosis cogitationibus as if they were of the same work. Fessler-Jungmann (1851: 597n) seem to think that Coleterius was mistaken in this, and suggest that, while De octo spiritibus malitiæ may actually be an original work of Nilus, the larger De octo vitiosis cogitationibus we receive in Nilus’s writings is too riddled with interpolations to belong originally to him. Bloomfield (1952: 60) is convinced that Nilus is influenced by the earlier Evagrius: “In the next generation, Nilus (d. c.430) deals with the Sins, although he too is of little importance in the history of the concept.” Wenzel (1960b: 4) sums up the Evagrian authorship this way: “Today, Evagrius’ writings lie scattered under different authors’ names (mostly Nilus, but apparently also Origen) and in a variety of languages: his original Greek as well as Armenian, Syriac, and Latin. Authorities still disagree on the attribution of a few treatises, but a basic corpus Evagrianum has been established which enables us to gain a clear and full picture of Evagrius’ teaching—or at least reporting—of the ‘wisdom of the desert.’”

53 Jackson (1981: 180).

is by no means an exclusive disease of anchorites.”54 Rather, we should understand that

the difference between the monk’s acedia and the lay believer’s acedia lies in a difference

in vocation, in the kind of meaningful work the believer is called to engage in. “So then, if

it is a question of the monastic life in general, acedia is not just one temptation among

many, it is quite simply the temptation, the calling into question of one’s entire existence,

the major identity crisis, in which the very foundations of everything are severely

shaken.”55 It is the temptation for monastics, because in his day-to-day activities, the monk is starkly aware of God’s claim and calling upon his life, and any aversion to his own day- to-day activities can easily arise to a doubting of the rationale behind the life he has

undertaken. The general contours of acedia, however, can still be seen regardless of the

believer’s vocation.

The more aware an individual is of God’s calling on his life, the more deeply the

effects of acedia can penetrate. The prophet Jonah is a clear example of someone who

knows the good work he is to do yet deeply resists this calling and flees his task (Jon. 1:1-

3). After Jonah finally, reluctantly carries out his task of prophesying to Ninevah,

whereupon Ninevah repents and God relents from destroying the city, Jonah becomes

angry (Jon. 4:1) and wishes for death (Jon. 4:4). There are no less than three separate

occasions in the book of Jonah where Jonah expresses flagrant uncaring for his own life or

suicidal ideation: when he asks to be thrown into the sea (Jon. 1:12), when he learns that

Ninevah has repented (Jon. 4:1), and when God withers a shade plant (Jon. 4:8-9). In some

ways, it is not at all surprising that Jonah comes to this existential impasse at the same time

54 Cf. Bunge (2011), Ch. 1 for a lengthier account with more corroboration of this claim.

55 Joest (2004: 144). Italics and bold in original.

he is aware both of God’s specific calling on him and his own unwillingness to carry it out.

It is this disharmony between God’s will and his own that leads him to say, “death is better

to me than life” (Jon. 4:3), for as long as he remains alive, he will be alive to feel this terrible, reverberating dissonance.56

Evagrius warns against suicide as a dangerous possibility for the individual mired in acedia and grief.57 W. E. H. Lecky makes this same connection in his History of

European Morals, Vol.2 (1869).

A melancholy leading to desperation, and known to theologians under the name of ‘acedia,’ was not uncommon in monasteries, and most of the recorded instances of mediæval suicides in Catholicism were by monks. The frequent suicides of monks, sometimes to escape the world, sometimes through despair at their inability to quell the propensities of the flesh, sometimes through insanity produced by their mode of life, and by their dread of surrounding dæmons, were noticed in the early Church,58 and a few examples have been gleaned from the mediæval chronicles59 of suicides produced by the bitterness of hopeless love, or by the derangement that follows extreme austerity.60

Notice that Lecky connects acedia to the melancholy of his day, a perhaps forgivable

oversight that was and is all too common.

56 Biblical scholars and psychologists have speculated about Jonah’s actual condition, whether depression (Kruger 2005: 192) or something else (Fingert 1954), but it is clear that Jonah harbored at least minimal suicidal ideations (Koch 2005: 170) that were either active or passive but vocalized.

57 See esp. Evagrius’ Sch. 27 in Job 30:24. I say more about grief and tristitia—or ”sadness, the schoolmate of acedia” (Joest 2004: 145n.103; PG 79:1141D)—in the following chapter.

58 Lecky’s original footnote: “This is noticed by St. Gregory Nazianzen in a little poem which is given in Migne’s edition of The Greek Fathers, tome xxxvii. p. 1459. St. Nilus and the biographer of St. Pachomius speak of these suicides, and St. Chrysostom wrote a letter of consolation to a young monk, named Stagirius, which is still extant, encouraging him to resist the temptation. See Neander, Ecclesiastical Hist. vol. iii. pp. 319-320.”

59 Lecky’s original footnote: “Bourquelot. Pinel notices (Traité médico-philosophique sur l’Aliénation mentale (2nd ed.), pp. 44-46) the numerous cases of insanity still produced by strong religious feeling, and the history of the movements called 'revivals,’ in the present century, supplies much evidence to the same effect. Pinel says, religious insanity tends peculiarly to suicide (p. 265).”

60 Lecky (1869: 55-56).

It deserves repeating that acedia is truly a spiritual phenomenon, albeit one with psychological symptoms, which is unsurprising given a holistic understanding of human beings as both spiritual and physical beings. Its historical roots in monasticism and its stark realization in the monk’s life, moreover, is perhaps to be expected, given the intense single- mindedness the monastic life demands.

If we give credence to the monks, we are therefore dealing with more than bad moods, psychic fluctuations or moral defects. It is a question of the resolve that arises in the wake of a decisive choice for which the monk has risked his life and to which he must hold no matter what: to realize one’s full potential in oneness with God. He has bet everything that he has and everything that he is on this. Acedia is therefore so dangerous for him since it causes him to throw away everything and thus to miss out on what matters most in the realization of his full potential, which is the primary purpose of the monastic life.61

At the same time, we see already as early as Evagrius that, while the monk might be a prime target, he is not the only target of the demon of acedia.

2.2 - Acedia from the Desert to the Wider World

Acedia does not stay in the desert. In this section, I briefly trace how acedia spread from the Egyptian desert monastic communities to the new monks of Gaul thanks to the travels of John Cassian (360-435), then how acedia becomes entrenched in the Western mind as a capital vice thanks to Pope Gregory I (540-604). We notice little significant conceptual change until we reach the Scholastics, which I take up in the next section.

Nevertheless, besides there being little conceptual change, this period reflects the widening scope of who could be susceptible to acedia, and is thus worthy of some attention.

61 Bamberg (1991: 87). Translated in Joest (2004: 144n.100).

2.2.1 - John Cassian (360-435)

A close contemporary and student of Evagrius, Cassian is responsible for

transmitting the concept of acedia, quite literally, beyond the eremitic monk’s cell.62 While

in the East “the characterization of the vice remained static,” it was “[n]ot so in the West,

where the transmission of the concept immediately led to changes,”63 including new insightful phenomenological descriptions Cassian gave to the condition. “What the Greeks called acedia may be called a tedium or anxiety of the heart.”64 This has reverberating

effects because of Cassian’s great influence on Western monasticism. “If Benedict created

the institutional frame of Latin monasticism, then Cassian helped define its inner life, its mystical aspirations. At the same time, Cassian’s quite distinctive interpretation of Egypt became normative—the definition of desert spirituality. Cassian, more than anyone else, brought Egypt to the West.”65

We have already seen from Evagrius’ works that acedia has noticeably two

characteristic effects: listlessness and restlessness. Cassian echoes and emphasizes this

twofold effect, in a chapter titled “How the attack of accidie is twofold”:

62 There is a dispute worth noting. Tzamalikos (2012: 4-5), for one, has concluded, upon comparing codices from the seventh and ninth centuries, that there are actually two Cassians. He argues that the “John” Cassian (360-435) known to history as the student of Evagrius, traveler and disseminator of Greek and desert monastic traditions to the West, is actually a historical fiction. The real Cassian, he maintains, was a Greek monk intellectual living much later (470-548). Here, I attempt to take no particular stance on this dispute, since it has little bearing on my project.

63 Wenzel (1960b: 18).

64 “...quod Græci ἀϰηδίαν vocant, quam nos tædium sive anxietatem cordis possumus nuncupare.”

65 Harmless (2004: 373).

And so the true Christian athlete66 who desires to strive lawfully in the lists of perfection, should hasten to expel this disease also from the recesses of his soul; and should strive against this most evil spirit of [acedia] in both directions, so that he may neither fall stricken through by the shaft of slumber, nor be driven out from the monastic cloister, even though under some pious excuse or pretext, and depart as a runaway (Institutes, X.5, emphasis mine).

And in an earlier chapter titled “Of the different ways in which accidie overcomes a monk,”

Cassian again unambiguously sets out the twofold effect of acedia.

And so the wretched soul...is disturbed, until, worn out by the spirit of accidie, as by some strong battering ram, it either learns to sink into slumber, or, driven out from the confinement of its cell, accustoms itself to seek for consolation from these attacks in visiting some brother, only to be afterwards weakened the more by this remedy which it seeks for the present (Institutes, X.3, emphasis mine).

This latter effect of restlessness is a kind of busyness, but should not be mistaken for productive busyness. It is characterized by a deep, inarticulable aversion to the meaningful, spiritually-imbued work of the cloister, in favor of other tasks that either are not as urgent, are not as important, or are simply not the task given to this individual monk. Whereas the first effect produces sorrow, this latter effect of restlessness may actually result in activities that are “entertaining,” or, as we would say in English, “diversions.”67 This entertainment,

however, is not lasting. Instead of gaining consolation by visiting the brothers, the monk is

weakened all the more by this very supposed remedy.

66 As in ἀθλητής, or one who competes for a prize. Cf. 1 Cor. 9:24; Acts 20:24; Phil. 3:14; 2 Tim. 4:7-8.

67 The Romance languages preserve this connection even more clearly: such as “divertir” (Fr., Sp., Pt.), from “divertere” (Lat.), which can mean variously “to divert/distract” or “to entertain”; as well as the derived adjectives “divertente” (It.) and “divertissant” (Fr.), which mean “entertaining”, “funny”, or “amusing”. A similar etymological connection might be preserved in the word “lustig” (Ger., Swed.) for “funny” or “amusing”, in the words “lustig” (Dut.) and “lystig” (Dan.) connoting “merry” or “cheerful”, and in the now-obsolete Middle English word “lusty” for “pleasant”, “merry”, or “delightful”. That is to say, given the clear connection to its other meaning “lustful”, each of these iterations can suggest the mind’s fleeting away to pleasurable yet frivolous objects.

The former effect of listlessness is not as obvious in Cassian’s treatment of acedia,

but it is nevertheless present in the form of laziness and somnolence. At one point both

effects are verbally conjoined as a synonym for acedia: “somno otii vel acediae” (“by idle

slumber or by acedia”) (Institutes, X.21).

Beyond these developments, of specific interest is Cassian’s abundant use of

medical language in his writings on acedia, which “leads us to ask whether acedia is a sin

or an illness.”68 However, we should understand these as medical metaphors rather than as

medical language with literal descriptive application:

Cassian’s writing about acedia makes use of medical metaphors, but it is important to recognize that they are metaphors. In emphasizing the link with noontime, he likens acedia to a fever that seizes a person at the same time each day. Later he speaks of this condition as a “disease.” Yet these are not a literally medical interpretation such as we find in later writing about states of despondency [outside the Cassian corpus]. Moreover, in quoting the psalmist David, whose condition he recognizes (“My soul slept from weariness”), Cassian makes clear that acedia is a disorder not of the body but of the soul.69

We do not see significant medicalizing of “states of despondency” until the time of the

Enlightenment with the prominence of mechanistic science.70

We do, however, see a systematizing mind in Cassian’s works. One characteristic

that sets his treatment of acedia apart from Evagrius’ is Cassian’s tendency to systematize

acedia and the other logismoi. He introduces the distinction between natural and non-

natural vices, and another distinction between vitia carnalia and vitia spiritualia, then ranks the logismoi accordingly. He renders a new Latin phrase that serves as a fixed

68 Nault (2015: 50).

69 Radden (2002: 70).

70 Radden (2002: 10).

formula for the Greek ακηδία: “anxietas sive taedium cordis” (“anxiety or tedium of the

heart”) (Institutes, X.1, V.1; Conferences, V.2). He expands acedia’s twofold effect to

include several different offspring or sub-vices; in fact, he establishes a fixed progeny for

each of the logismoi. Thus,

From acedia [are born] idleness, somnolence, rudeness, restlessness, wandering about, instability of mind and body, chattering, inquisitiveness [de acedia otiositas, somnolentia, importunitas, inquietudo, pervagatio, instabilitas mentis et corpis, verbositas, curiositas] (Conferences, V.16).

Since there is no model or analogue for such progenies in earlier Church Fathers, it is likely

that Cassian’s source for these progenies, in the case of acedia, goes all the way back to

the biblical testimony of Paul writing to the Thessalonian church. Cassian devotes roughly

half of Book X to commentary on Paul’s epistles to the Thessalonians (Institutes, X.7-

16).71 In these passages and others we see admonitions against idlers, gossipers, and

busybodies, and Paul instructs believers to live quietly, to be busy at work, and to earn a

living with one’s own hands, minding one’s own affairs. All of these specific exhortations

emphasize not only the dignity of work, the idea that manual labor could be just as noble

as brotherly love (1 Thess. 4:9), but they also reveal how acedia (inquietudo, otiositas,

anxietas sive taedium cordis) could be quieted and the heart made tranquil by a renewed,

purposeful focus on meaningful work.

Finally, Cassian identifies the virtue opposed to acedia: fortitudo (strength,

courage) (Conferences, V.23). This echoes Evagrius and other Egyptian monks who had

advised that the “main remedy against ακηδία was to keep the cell, to practice endurance,

71 The relevant passages are 1 Thess. 4:9-11 and 2 Thess. 3:6-15 An additional source might have been 1 Tim. 5:13, where we get the grouping “idlers, gossipers, and busybodies.” Cf. Wenzel (1960b: 21).

to nourish supernatural hope, and so on.”72 However, Cassian arguably places more point

of emphasis than did previous writers on a second chief remedy: work by hand. In fact,

while Cassian “recommends cultivating fortitude and keeping the cell” in the Conferences,

he goes through the whole Institutes “[speaking] only of manual work.”73 This difference

is easily explained by Cassian’s purpose for writing and the audience he had in mind for

each of his works. “[T]he Collationes [Conferences] treats of the monk’s ‘inner dispositions,’ whereas the Instituta [Institutes] is concerned with the external regulations given to a [cenobitic] monastic community in need of a rule.”74 Therefore, the remedy for

acedia with respect to one’s inner life is to practice endurance, while the remedy for acedia

with respect to one’s outer life is to practice manual work.

2.2.2 - Pope St. Gregory I (540-604)

More than a century and a half after Cassian introduced the logismoi to western

Europe, the capital vice tradition begins to solidify as the Seven Deadly Sins. “This was

the work of Gregory the Great, last of the Latin Fathers of the Church, the great pope who

never lost his nostalgia for the monk’s solitude.”75 Gregory discusses the Capital Sins in

his exegesis on Job. “Although this work was written for monks, it achieved such general

popularity that it was chiefly responsible for broadening the application of the Sins so that

72 Wenzel (1960b: 21-22).

73 Wenzel (1960b: 22), emphasis mine.

74 Wenzel (1960b: 22). Cf. Conferences, Pt. I preface.

75 Wenzel (1960b: 23). It is worth noting that, despite this list not coming into being under this name until the 6th century, the distinction between a deadly sin and a sin that is not deadly is present in the New Testament (1 John 5:16, 17).

they were no longer considered primarily monastic but became part of the general

theological and devotional tradition.”76

Acedia’s tendency to produce further vicious actions no doubt provides some

impetus for the tradition to designate it as a capital or principal vice. Gregory likens such

capital vices to generals of an army, with pride as their queen:

For the tempting vices…some of them go first, like captains, others follow, after the manner of an army. For all faults do not occupy the heart with equal access … For when pride, the queen of sins, has fully possessed a conquered heart, she surrenders it immediately to seven principal sins, as if to some of her generals, to lay it waste. And an army in truth follows these generals, because, doubtless, there spring up from them importunate hosts of sins (Moralia in Iob, VI.31.45.87).

In the case of acedia, we again find evidence of both tendencies—listlessness and

restlessness—among its “daughter” vices:

From tristitia [or acedia] there arise malice, rancor, cowardice, despair, slothfulness in fulfilling the commands, and a wandering of the mind on unlawful objects [De tristitia, malitia, rancor, pusillanimitas, desperatio, torpor circa præcepta, vagatio mentis erga illicita nascitur] (Moralia in Iob, VI.31.45.88).

While the actual word written by Gregory’s hand is “tristitia,” which is often translated as

“melancholy,” it is fair to infer that Gregory is referring to the same condition that the desert monks called acedia. First of all, this is how the later tradition reads him: Aquinas refers to the above passage in his ST II-II.35.4.arg2, saying that “Gregory assigns six

children to acedia [Assignat autem Gregorius, XXXI Moral., sex filias acediae].” The common view is that Gregory “pared the list of capital vices from eight to seven, the biblical number symbolizing completeness, by subsuming sloth [acedia] under sadness

[tristitia], making envy a standard member, and separating pride as their root.”77 So we

76 Bloomfield (1952: 72).

77 DeYoung (2009: 28).

can, and should, read Gregory’s “tristitia” as a certain kind of sadness, viz., acedia. We also know that the monastic authors had an immense influence on both Gregory’s writing—

“His Latin style is not classical, but ecclesiastical and monkish”78—and his thinking—the

mere fact that Gregory included progeny, or offspring, for each vice is significant since, as

noted above, this practice very likely began with Cassian.

The concept of sloth, or acedia, is certainly present in Gregory’s Moralia. John

Henry Parker’s 1844 English edition translates as many as six Latin words into the English

“sloth”: torpor, pigritia, desidia, ignavus, hebetudo, and inertia. Many passages reminisce

of that old monastic concept of acedia such that it should leave no doubt what Gregory is

meaning. We see the great religious significance attached to slothfulness:

Whence it very often comes to pass, that the mind of the person so striving, being exhausted by its own weakness, either giving over prayer, is lulled asleep in sloth [desidia torpeat], or if it continue long in prayer, the mist of rising images gathers thick before its eyes (Moralia in Iob, II.8.6.9).

Here we also are presented with that familiar dual effect that acedia can have, that of either

being lulled to sleep in torpor and fatigue or being distracted by thoughts running through

one’s mind.

We also see in Gregory’s Moralia in Iob the contrast of religious sluggishness with

its antidote, a longing after the Creator, which “gives over the sloth of negligence [cum

torporem negligentiæ], and kindles the frost of former insensibility with the fire of holy love” (I.4.23.42). Feeling drawn in this way, the soul “girds itself up to walk in the way of

righteousness, shakes off sloth [torporem discutit], and is so transported into heavenly

78 Schaff (1882: 226). Immediately following, Schaff adds, “it abounds in barbarism; it is prolix and chatty, but occasionally sententious and rising to a rhetorical pathos, which he borrowed from the prophets of the Old Testament.”

73 realms in affection, that it well nigh seems that there is nothing of it left here below”

(II.10.6.105).

Sloth may well be understood as bodily fatigue, but it is also an apt metaphor for one slack in righteousness. “For he slept, as it were, whilst he reposed at rest in the corrupt heart. But he is ‘roused,’ in challenging the fight, when he loses the right of wicked dominion” (I.4.23.42). One affected by the spiritual sin of sloth could even be physically wide awake, as “when the overpowering delight of temporal objects possesses our minds, and oppresses the eyes of our mind with the sleep of sloth [in somno torporis premit],” in need of being “roused suddenly by the hand of the Divine favour, we open at once those eyes, which have been long closed, to the light of truth; we call to mind the sins we have committed” (V.27.17.33). Indeed, Christ’s very Incarnation compels us to rise from our slothfulness.

[F]or did not the Lord first intercede with the Father through His Incarnation, and pray for our life, our insensibility would never rouse itself to ask for those things which are eternal. But the entreaty of His Incarnation came first [preceded our prayers, præcessit oratio], that our awakening from sloth [torporis nostri] might afterwards follow (Moralia in Iob, IV.24.5.9).

Gregory notes that, while awaiting and longing for our union with God, we may be prone to become discouraged, our soul “weighed down below [inferius depressum tenet], as if it had not yet reached aught of things above” (II.10.6.105). Because we cannot be satiated fully while still in this life (V.24.8.17), we can turn our attention onto things that will dispel despair and invigorate hope. Gregory recommends in particular two candidates as objects of our attention. First, we look to the saints and heroes of the faith, that we may “be refreshed with the examples of the righteous…Let us see then how beautiful is the activity of those who pursue their course, and learn how disgraceful is the sloth of the sluggish

[hebetudo pigrorum]79 (Moralia in Iob, V.24.8.17). Second, we must also look to the cross, our own salvation, and the glory to come.

But these things are very marvellous, and very awful, that a man, born on the earth, and condemned, as his deserts demand, to separation from his heavenly country, is not only brought back to the state of his creation, but is even exalted to a more glorious condition; that he who has lost paradise obtains heaven, and that so far from the guilt of his debt being binding on him, gifts are heaped upon him more abundantly even after his sin; and that that despiser of God, and imitator of the devil, if he returns to fruitful penitence, ascends even to the loftiness of contemplating the inward light. Whose sloth [torpor] would not be startled at the elevation of so high a thought? (Moralia in Iob, V.27.15.30)

What results is a virtue, indeed, “that the subtilty of angelic virtue appears itself, as it really is” (VI.28.1.9). The “mind is raised up,” “no longer slothful and sluggish below [non jam pigra torpensque in imis jaceat], but, filled with inspiration within, ascends on high”

(VI.28.1.9). To sum up, then, in many ways, acedia, or sloth, serves as an ever present antagonist and theme in the Christian life.

One question remains that I shall only note here as a problem, to return to in a later chapter. If acedia and tristitia were merged together, then where did tristitia go? Why is acedia, rather than tristitia, now a standard member of the Seven Deadly Sins? Bloomfield summarizes the matter this way:

Gregory’s scheme gradually supplanted Cassian’s, but in one respect,...Cassian won out. His term acedia gradually replaced tristitia, under which name Gregory had merged acedia and tristitia. Tristitia also referred to attitudes which were not at all sinful, and this ambiguity probably accounts for its terminological submergence.80

I will return to tristitia in more detail in the following chapter.

79 A separate codex reads “tepitudo pigrorum.” See PL 76:296, fn.e.

80 Bloomfield (1952: 356n25).

2.2.3 - Sloth’s Lost Familiarity in Recent Times, which Coincides Historically with the Advancement of Psychiatry

After the Scholastic period (i.e., from the 13th century onward), the vice of acedia

would reemerge periodically as an object of practical devotional interest, or as an item of

theological study within the larger framework of virtues and vices, and emphasis was

typically (though not always) placed on acedia’s external effect of laziness and slothfulness

(to the neglect of its other effect, restlessness). Wenzel explains,

The shift from a state of mind [taedium] to external behavior [ydelnesse in servitio Dei] pervades and informs the entire popular image of acedia, which emphasizes, not the emotional disorientation of disgust for the divine good, but rather the numerous observable faults which derive from such a state.81

So even at this early point in history, we start to see a diluting of the old capital Sin—from

its twofold effect to a single effect, laziness, from a focus on internal character and

emotional disposition to external acts.

Over time, the capital vice of acedia, de dicto, would be more or less forgotten.

When sighted, de re, one might recognize what the thing is, yet we would have no name for it. It is perhaps easy to understand why, since acedia is, after all, very difficult to

identify in a person. As a nameless vice, it creeps in slowly and unseen, in true logismoi

fashion. Boudon does not use the term “acedia”, but his description is vividly similar:

The venom of this vice consists of numbness, which sinks into the senses, by which the soul is made to slumber and remain in an idle state…It is recognized quite late…[and] almost no one knows it, because it does not lead directly to evil.82

81 Wenzel (1960b: 88).

82 Boudon (1683: 337–338). Cf. Surin (1829: 102–103)

All the while, it seems a good number of us can recall having “had something of this vice,

as all men have it, being a strong general malady.”83

In the 19th century, Søren Kierkegaard’s character Judge Wilhelm in Either/Or was familiar with the old deadly Sin, as such, directly referencing it in his diagnosis of A the aesthete:

Nero’s nature was depression [Tungsind]. In our day, it has become somewhat prestigious to be depressed [tungsindig]; as far as that goes, I can well understand that you find this word too lenient; I hold to an ancient doctrine of the Church that classifies depression [Tungsind] among the cardinal sins.84

I return to Tungsindighed in Chapter Six.85 For the present point, it is clear that Kierkegaard

has in mind—by having some obscure, inarticulable notion in the mouth of Judge

Wilhelm—both the vice of acedia and Romanticism’s melancholy, the latter of which is seen as “somewhat prestigious” to have, and the former of which is clearly undesirable. By the end of the 19th century, from a psychiatric perspective, “melancholy” had become

virtually synonymous with “depression”. While the complicated relation of likeness

between acedia and a melancholic disposition was indeed not lost on the melancholy Dane,

acedia has come to be misunderstood by more recent authors.86

83 Surin (1636/1829: 103).

84 EO II:185, emphasis mine. See also Kierkegaard’s 1839 journal entry, which directly touches upon this passage (EO II:381).

85 Unfortunately, the Hongs’ translation, though it is the standard translation today, renders the Danish Tungsind (“heavy-mindedness”) as the more loaded and presuming term “depression.” Kierkegaard, of course, did not use the term “depression,” which would not have been in common usage at that time, but neither did he elect for the contemporary Danish word “Melancholi,” opting instead to give a descriptive and general label of heavy-mindedness. So it is a mistake to identify Kierkegaard’s usage of “Tungsind” with our notion of depression on the basis of the Hongs’ translation alone.

86 See my criticism (McAllister 2020) of these authors’ varying understandings of acedia: Altschule (1965), Webb (2017), Daly (2007), Radden (2002), and Jackson (1981).

2.3 - Acedia’s Main Features

To summarize, here I briefly discuss two main features of acedia which will aid in

forming a proper comparison between it and depression.

2.3.1 - Acedia is Irreducibly Spiritual

By claiming that acedia is irreducibly spiritual, I am not claiming that it is merely

spiritual, nor that it is an entirely spiritual phenomenon. Instead, it has a spiritual

component that is both essential to it and which is irreducible. It is essential in the sense

that acedia cannot be understood apart from its spiritual import. Moreover, this spiritual

sine qua non is irreducible in that any attempt to analytically reduce it in simpler terms

(such as its affects, an individual’s psychological states) will be hopelessly incomplete.

Moreover, acedia also has a proximate spiritual etiology.

Acedia is a capital vice, one of the Seven Deadly Sins. That does not mean deadly

in the sense that it is the worst possible sin that one can commit, but in how it can

surreptitiously take root and lead to further sins. Its origins from among the 4th-century desert monastics as one of the logismoi, or evil thoughts, shows us how it tempts the monk away from prayer and devoted religious life. However, importantly, it is not unique to monastics. It can also be resisted. For Evagrius, the demon of ακηδία was to be countered with fortitude and perseverance, and “after its struggle the soul is taken over by a peaceful condition and by unspeakable joy” (Praktikos, 12). Cassianic remedies for acedia divide into two: (1) keeping the cell via cultivating fortitude (cf. Conf.) and (2) manual work (cf.

Inst.). This latter remedy, of course, accords well with how we understand sloth today. If the connection from spiritual to manual work is not clear, manual work here is included because it is the external work of the monk, which itself is tied deeply to his religious

vocation [vocatio]. Even the sweeping of floors can be a deeply religious activity.87 When

transmitted to English as early as the 10th century, Ælfric abbot of Eynsham cites Gregory

as a main influence and uses the word “slæƿð” (an early version of “sloth”), making no

secret that the referent here is the vice of acedia.88

Aquinas in the 13th century follows this tradition of acedia as a capital vice, adding

that “acedia, as we understand it here, denotes sorrow for spiritual good [acedia…nominat

tristitiam spiritualis boni]” (ST II-II.35.1.co). Previously, Cassian had distinguished

between acedia and tristitia, while Gregory had acedia subsumed under tristitia; here,

Thomas considers acedia a species of tristitia.89 Acedia becomes a mortal sin, and is most

destructive, when it “reaches to the reason, which consents in the dislike, horror, and

detestation of the Divine good [quae consentit in fugam et horrorem et detestationem boni

divini], on account of the flesh utterly prevailing over the spirit” (ST II-II.35.3.co). Here,

just as it was in the desert, the problem is centrally a lack of love or disconcern for the

things of God. From its sapling stage as a logimos to its fully-grown stage as a mortal sin,

acedia is an irreducibly spiritual phenomenon.

87 As we are taught by Brother Lawrence, for instance. Outside of the religious life, one need only to think of C.S. Lewis’s description in the sermon “Learning in War-Time” (1939/1976), who likens the student to a priest: each has to undertake dreary, monotonous tasks which are far removed from, yet consistent with, the telos of his vocation.

88 Ælfric (1966: XVI, XXI). According to Wenzel (1960b: 165), Ælfric characterizes this vice as aversive “unwillingness to do any good.”

89 Thomas’s proposal is a classic example of the Scholastic synthesis of disparate views. It is consistent with each of the previous views while offering a further nuanced distinction.

2.3.2 - Acedia Has Especially Notable Psychological Manifestations

From Evagrius to Cassian, Gregory to Aquinas, acedia has maintained a

characteristic twofold effect: listlessness and restlessness. On the one hand, acedia evokes

certain affects and behavior like sorrow, torpor, laziness (idleness), languor, lethargy,

tepidity, and inertia. On the other hand, acedia evokes a certain restlessness: diversions

(idleness), unwillingness to work, roaming of the mind on vain or trivial things,

procrastination, and boredom.90

Acedia is neither mere laziness nor mere busyness;91 it is the affective dimension

underlying these external behaviors. At the core of acedia is a deep, inarticulable aversion

to one’s vocation and meaningful, spiritually-imbued work. No amount of rest or frivolity

will ever deeply satisfy the person plagued by acedia, since, as we saw, acedia is

irreducibly spiritual and its roots lie much deeper than where temporary distractions can

penetrate. This must be kept in mind even as we acknowledge that acedia characteristically manifests psychologically as either listlessness or restlessness.

2.4 - Considered Judgment on Relation to Depression

It is possible that the passion acedia, in its disordered mode, along with sadness, may be an affective component of depression, though it is unclear how central or necessary such a component would be. However, the matter is more complex with respect to the vice

90 Even if we do not know the newly coined word, we are all familiar with the idea of “procrasti- baking”, doing anything (in this case, baking) to avoid the more important work we are supposed to be doing.

91 Or being a busybody. Busyness, taken in a different sense, can be considered an opposing virtue to acedia, so long as the work is important, meaningful, and tied to one’s spiritual vocation, whatever that may be. This virtue is present not only in Cassian’s remedies above but also is “fairly frequent in Middle English devotional literature and…allegorical works and medieval drama. Even Chaucer follows this trend: ‘This firste stok was ful of rightwisnesse…and loved besinesse, Aȝeinst the vyce of slouthe, in honestee’” (Wenzel 1960b: 89).

or sin of acedia, which has been our focus, not least because it risks moralizing something

pathological—or pathologizing something spiritual! This highlights one of the major

conceptual differences between acedia and depression: a person is potentially culpable in

the case of acedia, whereas culpability runs contrary to most models of depression.

So what is the relation of acedia to depression? By way of example, I will develop in the following a view I have advanced elsewhere (McAllister 2020). But note carefully: this is only one possible way of faithfully (i.e., assuming one has a correct and proper understanding of both acedia and depression) construing the relation,92 and divergence at

this point on the issue depends largely on one’s prior philosophical commitments. For

instance, below, I assume an approach to classification which places emphasis on the agent

and denies that disorders or diseases are discrete entities. Also, below, I consider the matter only from the perspective of assuming the DSM’s descriptivist definition. One may proceed differently methodologically, taking, for instance, this or that model of depression as a starting point instead. In the concluding chapter of this dissertation, I will discuss more generally the various approaches and ways of synthesizing the older wisdom with contemporary understandings of depression—including how to rank these comparatively.

In the following I am giving priority to acedia’s tradition and being revisionist about depression.93

92 There are many more ways of unfaithfully characterizing the relation, if one does not have a correct or proper understanding of either acedia or depression.

93 This—giving priority to, or space for proper context and interpretation, to the historical condition—has been an operative assumption of mine throughout this dissertation, but I add it to the list here with these others. One might vehemently reject this assumption, but then such a person will likely not be receptive to much else of what I advance throughout this dissertation.

Let us begin by distinguishing between (1) the concept of acedia and (2) an instance

of acedia (and likewise for depression). First of all, we can see clearly that the concept of

acedia is not identical with the concept of depression. This is likely the reason why most

writers have not taken a strong position of strict identity on the matter. Indeed, Daly writes,

“Any thesis that simply identifies acedia with melancholia or depression is not credible.”94

One century prior, in 1908, the Rev. Charles Taylor writes, “To replace the complex acedy

by sadness or sloth is to evade a difficulty.”95 The APA’s DSM descriptivist account of

depression is largely silent on the matter of etiology, whereas the Desert Fathers,

Scholastics, and spiritual writers are far from silent about the etiology of acedia. In

addition, however one comes to acquire or be in a state of acedia, it was never regarded as

merely a set of psychological and somatic symptoms, as a descriptivist (or naturalist) would

write it up. No, an instance of someone afflicted by acedia was viewed through the theological lens of (monastic) Christianity. So the two concepts are not the same, and thus what they describe may be entirely different goings-on.

This, of course, does not rule out the possibility that the two concepts might operate as different terms that, at times, pick out the same token instance.96 This leads to a second

main point: it is possible for an instance of acedia to be coextensive with an instance of

depression, in whole or in part, where an instance of one might be an instance of the other.

94 Daly (2007: 45).

95 Taylor (1908, I: 66).

96 “Spiritual phenomena are radically different from psychological phenomena, although they may coincide in their manifestations” (Rivas 2018: 156, translation mine).

In other words, despite using different descriptive information (i.e., diagnostic symptoms),

each term may refer (roughly, i.e., in whole or part) to the same object.

Since, however, the terms “(an instance of) depression” and “(an instance of)

acedia” function more like definite descriptions than rigid designators,97 the problem is a

little more complicated. While a rigid designator will invariably refer to the same object,

and while an object can have multiple names rigidly designating it (e.g., “Hesperus” and

“Phosphorus”), definite descriptions may or may not always pick out the same object.

Take, for example, these two definite descriptions: “the United States president” and “the

leader of the free world”. While they may at times designate the same individual, it is

certainly not necessary that they always do so, as the latter, while it has sometimes

designated the former, it may also genuinely designate—at various times, past, present, or

future—some other head of state (though presumably not two individuals at once).

Moreover, these designations are not arbitrary, since both descriptions have determinate content that either applies to an object or does not. My contention is that sometimes both descriptions apply to the same object.

The matter is further complicated by the fact that we are dealing not with an object

like a human person, which we can easily see and identify, but with an object that is a state

of affairs, diachronically continuous yet seemingly ephemeral when it comes to identifying

and naming. Let us call this state of affairs one’s “condition”. I do not mean the having of

a specific condition or other, as when one “has bronchitis”, for instance; I mean, rather, the

condition of, or current state of, one’s mental states, affects, neurochemistry, dispositions

97 See Saul Kripke’s (1980) Naming and Necessity for the distinction between rigid designators and definite descriptions.

83 to interact with the world, and so on. The having of a condition in the former sense is an inexact and loose, although common, way of speaking about depression.98 We can usually get away with such verbal shorthand, but sometimes it goes awry.

This is very apparent when discussing mood disorders. When we say that a person

“has depression”, there remains a looming ambiguity. For this could mean that a person possesses either (1) the kind itself of depression, or (2) an instance of that kind,99 or (3) a particular state of affairs such that it can genuinely be called or labeled (an instance of) depression. This ambiguity is no small matter since each claim says something different about what the individual possesses. The first option is nonsensical if it means that a person uniquely possesses the entire kind to himself,100 while the second, as I said above, is a common yet inexact way of speaking about depression; the third is ideal, since, I believe, it is a more exact way of speaking about what the individual possesses.101 On this view, to

98 Depression is not like a bacterium, virus, or infection. We might say of these (only when using shorthand) that an individual has E. coli, for instance. [We, of course, would never say that someone has “the E. coli”. This awkward construction seems to connote a reference to the genus; our acknowledgment that this is an incorrect way of speaking likely reveals that we are not claiming the individual owns the genus in itself.] But if we wished to be more precise, we would say that he has in his possession or his body a specific strain or instance of E. coli, for example: an instance (e.g., ~50 CFU, or colony forming units) of E. coli O157:H7 (cf. Lim, et al. 2010: 3). That is because the former is a kind and the latter is an instance of that kind.

99 A person can indeed be said to possess a kind by having an instance of that kind. I can say here only that I believe this is yet another case of speaking loosely; however, it may be acceptable to speak this way in some cases, as when discussing certain properties like red, since there is no loss of meaning. For example, on certain views of universals: in some sense, the kind red is truly fully present in an instance of red (i.e., it lacks none of its brilliance, hue, and shade); though in another sense, it is also true that the kind red is not fully present in an instance of red (i.e., one instance of red does not account for the entire kind of red).

100 This seems strange whether it be understood on a Platonist-type view, since a thing participates in a Form but never fully appropriates it; or on an Aristotelian-type view, where, even though a substantial form may be fully present in a thing, one instance of a substantial form rarely ever (unless, perhaps, it is sui generis) accounts for the entirety of that kind of form.

101 Note that we do not get this third option with communicable diseases, bacteria, viruses, because in those cases, an individual actually does possess an instance of the kind in the form of a particular strain of 84

say a person “has depression”, what he possesses is a certain state of affairs (i.e., the current

state of his mental states, affects, neurochemistry, dispositions to interact with the world,

and so on). We called this state of affairs his “condition” (used here in the spirit of option

(3), rather than option (2)). Thus, one’s condition, used in this sense, need not be

pathological. One’s condition might be such that we may call it “normal sadness”, or it

might be such that we ought to call it “depression”.102

This groundwork prepares the way for us to see how an instance of depression can

also be an instance of acedia. We begin with the condition a person is in, the current state

of his mental states, affects, neurochemistry, dispositions to interact with the world, etc.

Suppose that these are such that we can correctly call his condition (an instance of)

depression. If the person has come to be in his state via some spiritual etiology, and some

of his symptoms are the same as those of acedia as chronicled by the spiritual writers,103

then we can correctly call his condition (an instance of) acedia. Thus, our person has both

an instance of depression and an instance of acedia (or, we might say—though we would be going off-script from the DSM’s descriptivism at this point—that our person has a religious kind, or form, of depression, assuming by this that we incorporate into that concept a robust understanding of acedia). Of course, I point here only to the cases in which

the foreign organic substance that, once external to and independent from the body, has entered and is dependent on the body. This is not the case with depression.

102 Another upshot of using this third option is that if theoretical concepts come to change, one’s condition will not. For instance, S.T. Coleridge does not cease to “have melancholy” when the concept of melancholy becomes outdated. Some might object that this approach is too precise to be useful, given its inability to generalize, and this may be right. On the other hand, it has the upshot of capturing what a person has, emphasizing the condition rather than the labels du jour.

103 I say “some” because it is reasonable to think, concerning both depression and acedia, that a person may present with only some of the characteristic symptoms and yet the corresponding term would still correctly apply. One certainly need not check off all the symptoms.

they overlap. There are presumably several cases where they do not, where there is an

instance of only one and not the other. We would need empirical data to determine the

frequency of occurrences of each.104

There are dangers with associating sorrow with sin. This had led some, such as

Webb (2017) to deny categorically that sin causes psychological disorders. This concern resonates with me, and I can see the harm it can cause. While well-intentioned, however,

this categorical exclusion is much too hasty, for it may not be true. Webb is correct, citing

Daly, that we cannot “simply identify” acedia with depression (by this, I assume she means we cannot identify the concepts).105 But, although the concepts may not be identical, this

does not rule out overlap in their instances. There are many relations beyond strict identity

available to choose from. For example, we may have overlap, in that an instance of

depression is also an instance of acedia, a possibility which I have described above. Other

cases may just be epistemically underdetermined: even if one denies that sin causes

psychological disorder, properly speaking, we can certainly admit that it can cause

symptoms that mirror psychological disorder. The epistemic opacity inherent in reliable

diagnosis is a sufficient reason not to categorically rule out the possibility that a person’s

condition—for which they may even be receiving prescription medication—is actually

rather (or also) an instance of acedia.

104 A certain stripe of Kierkegaardian might venture to say that all instances of depression are instances of acedia, since all of life is to be lived before God. “The stage is eternity, and the listener, if he is the true listener (and if he is not, it is his own fault), is standing before God through the discourse” (UDVS: 124).

105 Webb (2017: 77).

Again, here I have given only an example of how to resolve the relation between

acedia and depression. One’s receptivity to this particular proposed synthesis will largely depend upon prior philosophical views. I return to the issue once more in the concluding chapter, where I discuss, more generally, various approaches for synthesis.

CHAPTER THREE

Tristitia

“Tristitia, inter omnes animæ passiones, magis corpori nocet.” [“Of all the passions of the soul, sorrow [tristitia] is most harmful to the body.”] — St. Thomas Aquinas1

A sad mood is the characteristic symptom of depression, followed by its close

cousins an empty mood and an irritable mood. This chapter takes a look at tristitia (sorrow, sadness) in its historical context, looking specifically for modes and species of tristitia that serve as good prima facie candidates for forebears to depression.

The purpose of this chapter is thus twofold: (1) to describe tristitia and (2) to determine the relation tristitia has to depression. Section 3.0 lays out the rationale for considering tristitia in this dissertation. Then, I set out to fulfill the task in (1). First, in

Section 3.1, I examine a kind of sorrow which is proper to have, in particular sorrow over one’s own sin. Section 3.2 on Thomas Aquinas’s view on tristitia and one of its species acedia takes up a large portion of the chapter, as there are many complexities to account for: tristitia immoderata (Section 3.2.1), aggravatio animi and tristitia aggravans (3.2.2), moderate acedia (3.2.3), and, finally, the species of tristitia, acedia and anxietas, alongside specific kinds of fear, segnities and agonia (3.2.4). This allows us to make careful distinctions and clear the way in Section 3.2.5 to discuss Thomas’s view of the capital vice of acedia as acedia immoderata and as a kind of tristitia spiritualis boni. I round out the

1 Summa Theologiæ I-II.37.4.co.

chapter with Section 3.3, returning to Cassian and Gregory, since there are remnants of

fruitful concepts and themes concerning tristitia that were not examined in the previous

chapter: the former role of tristitia as a member in Gregory’s list of Capital Vices (Section

3.3.1) and Cassian’s logismos de spiritu tristitiæ (3.3.2).

Finally, I undertake my second task (2) in Section 3.4, informed by all of the preceding rich content, to make a considered judgment on the relation between tristitia and

depression. Just as before, this present chapter covers only one of five historical conditions

in this dissertation. In the final word (Chapter Seven), I apply my findings to depression

itself and explore the wider implications this study has for our understanding of depression.

3.0 - Rationale for Inclusion

There is of course reason enough to include tristitia (sorrow, sadness) in this

dissertation on prima facie historical antecedents to depression, since depression includes,

perhaps even as a necessary component, the affective symptom of sadness. But there are at

least two other important reasons for choosing to include this medieval tristitia of the Latin

writers.

First, Thomas speaks of a way in which tristitia could manifest [tristitia

immoderata] that made it particularly deleterious and even deadly, such that it reminds one

of clinical depression’s symptoms and its unfortunate high correlation with suicide.

Thomas says that tristitia immoderata is a “sickness of the soul” or “disease of the mind”

[animae ægritudo] (ST I-II.59.3.ad3). It is a sadness that “absorbs” and “immobilizes the

mind, making it difficult to avoid what is bad [malum]” (ST I-II.39.3.ad1). Already, this

reminds us of the affective symptoms of depression and dysthymia—sadness, emptiness,

loss of pleasure (anhedonia)—as well as its cognitive symptoms—negative ideation,

diminished ability to think or concentrate (DSM-5). Thomas goes on to add that tristitia

immoderata “kills many, and there is no usefulness in it” (ST I-II.39.3.arg1). By

comparison, depression is often marked by recurrent thoughts of suicide (DSM-5). Crona,

et al. (2013: p.1) gives a summary of the recent data on this correlation:

Suicide is a feared outcome of depressive disorders...Different studies have shown that 43% to 60% of all suicide victims suffered from mood disorders,2 and, when dysthymia was included, 90% of the suicide victims were shown to have suffered from a depressive disorder according to one study.3 Severe depression (major depressive disorder with melancholic or psychotic features/endogenous depression) has been shown to predominate in the depressive group of suicide victims.4 Attempted suicide is important in the study of suicide since it is the most important known risk factors for completed suicide.5 Different studies have shown rates of attempted suicide between 15%6 and 34%7 for patients with major depressive disorder. Subjects with major depressive disorder who have attempted suicide have an increased risk of reattempting.8

Clearly, Thomas Aquinas did not have in his vocabulary these much later psychiatric terms

(e.g., dysthymia, endogenous depression), and it remains to be seen (namely, in Section

3.4 and throughout this chapter) what the relationship of tristitia is to depression, but these

initial strong commonalities between tristitia immoderata and depression provide good

reason to include tristitia in our investigation.

2 Arsenault-Lapierre, et al. (2004); Bertolote, et al. (2004); Mann, et al. (2005); Cavanaugh, et al. (2003).

3 Cheng (1995).

4 Brådvik, et al. (2010); Thomson (2012).

5 Ahrens, et al. (1995); Holma, et al. (2010); Nordström, et al. (1995); Brådvik and Berglund (2002).

6 Holma, et al. (2010).

7 Azorin, et al. (2010).

8 Sokero, et al. (2005).

Second, recent critical work in psychology and psychiatry has drawn attention to the contemporary tendency to take a normal human emotion like sadness and pathologize it when it becomes excessive.9 Consider the work of Thomas Szasz and his watershed essay

“The Myth of Mental Illness” in which he argues that mental illnesses are pathologized

“problems in living.” Diseases of the mind they are not, according to Szasz; rather, they are everyday problems in living that we have wrongly referred to using medical language.

While I have argued that mental illnesses do not exist, I obviously did not imply that the social and psychological occurrences to which this label is currently being attached also do not exist. Like the personal and social troubles which people had in the Middle Ages, they are real enough. It is the labels we give them that concerns us and, having labelled them, what we do about them.10

While Szasz is a figure of notoriety in the history of psychiatry—the anti-psychiatry movement think him something of a guru—and we do not have to agree with him on everything, his arguments deserve our attention. Here, Szasz clearly does not deny the reality of social and psychological suffering that constitutes would-be mental illnesses.

Ultimately, then, this is a dispute over the terminology used to describe this suffering, which directly impacts the way that suffering is perceived and treated.

Szasz is right that psychiatric labeling can directly affect our perceptions. Some psychiatric labels have come to be harmful, even outright slurs,11 and that is why we no

9 Consider Horwitz and Wakefield’s (2007) The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder. Elsewhere they write, “the entire 2,500-year record [since Hippocrates] indicates an understanding that [what we consider to be] pathological depression is an exaggerated form of a normal human emotional response” (Horwitz, et al. 2017: 21). They call this the contextual view of depression and argue that it was supplanted by the descriptivist view of depression.

10 Szasz (1960: 117). Cf. Szasz (1974).

11 See, for example, Bolinger’s (2020), where she discusses the boundaries of slurs generally, including naïve and non-derogatory slurs, and Bolinger (forthcoming), where she discusses the harmful, slur- like epithets within the domain of mental health specifically.

longer use them. Terms like “retarded” (from Lat. tardus, “slowed,” “delayed”) and “idiot”

(from Gk. ἴδιος, “self”, whence is derived “idiosyncratic”) are no longer psychiatric terms,12 despite their seemingly innocuous origins; whereas others like “arrested”

development (from Lat. restare, “stopped,” “halted”) are still in use. The mere usage of

psychiatric labels in itself can change perceptions, especially considering the medical

language and expertise it connotes. A word like “disease” has come to have specifically

biological or medical connotations, even though one can plainly see that its literal meaning

suggests nothing more than an “uneasiness.” However, nowadays, to call one’s sadness or

depression a “disease” clearly means that it is biologically influenced, if not determined,

and that one legitimate method of treatment is some form of medical treatment.13

Whether or not Szasz and others are right in arguing that mental illness per se does not exist, is it responsible to consider to what extent excessive or abnormal sadness (or

tristitia) has been overmedicalized through the improper application of psychiatric

language. While this is not the space for a comprehensive study of this change in language-

use over time, we can nevertheless take a good first step in considering some earlier

historical thinkers and concepts that treat of sadness in isolation to mine their judgments

on this distinction between normal and abnormal sadness. Not only do we get such a

distinction with Thomas Aquinas’s moderate and immoderate tristitia, we see the

12 From the DSM-IV to the DSM-5, “mental retardation” was revised to “intellectual disability” or “intellectual development disorder.” While the terms “idiot” and “idiocy” were used freely as official designations in 19th-century psychiatric publications, today these terms are not used in formal-speak in psychiatry. (They are seldomly even used in popular culture, and, when they are, in an unserious or self- deprecating manner (e.g., The Complete Idiot’s Guide to…).)

13 While his focus is on addiction rather than mental illness, Dunnington (2007, 2011) takes to task the “disease model” of addiction in contemporary addiction studies. Some of the matters he covers there may apply to biologically focused models of depression.

distinction present, either explicitly or implicitly, in St. Paul the Apostle’s godly sorrow

over against “excessive sorrow” which works unto death, replicated in places such as

Richard Baxter’s “overmuch sorrow,” and, as I will argue, in the capital vice of tristitia we

see in Gregory and the logismos de spiritu tristitiæ in Cassian.

Thus, we have good reason to undertake an historical investigation into that sorrow

which the Latin writers called “tristitia.” Of course, space does not permit an exhaustive examination of all the various historical philosophical accounts of sadness (e.g., in the

Stoics, Spinoza, Hume, etc.).14 So, in being selective, I restrict my study to the Christian,

specifically Thomistic, understanding of tristitia, which has enjoyed a prominent place in

Western thinking since the 13th century. Not only does Thomas provide us with a robust

account of tristitia, with its species and modes, the schoolman and doctor of the Church is

in conversation with, continuing and synthesizing the tradition of, the earlier writers I have

already discussed in Chapter Two.

This specifically Christian focus also allows and invites an examination at the

outset in Section 3.1 of the proper mode of sorrowing over one’s own sinfulness before

God. Along with the distinction noted above by St. Paul the Apostle between godly sorrow

and a sorrow which worketh death,15 a state of spiritual sorrow is a well-developed topoi

in the Old Testament and appears in prominent Christian writings, for example, in St.

Augustine’s City of God.

14 Not only do these philosophies of emotion differ from Aquinas’s, they also each hail from different time periods in history: Stoics from the 3rd century B.C. to the 2nd century A.D., Spinoza in the 17th century, and Hume in the 18th century. For a comprehensive recent account of Stoic emotions, see Graver (2009). For an account of Spinozan affects, see Spinoza’s Ethics. For an account of Humean passions, see Hume’s Treatise.

15 Cf. Schmidt (2007: 22-23).

In some ways, this chapter continues certain themes began in the previous chapter, since, historically, tristitia and acedia are linked closely together. We shall see in the following sections the complex relationship between tristitia and acedia, looking first at godly sorrow over one’s own sin in Section 3.1, then at Thomas Aquinas’s complex views regarding tristitia in Section 3.2, and then returning to Gregory and Cassian in Section 3.3.

3.1 - Sorrow Over One’s Own Sin

Sorrow is not necessarily bad. In some ways, it can actually be good, as when a person properly sorrows over the death of a loved one or the loss of a friendship. For

Christians, there is another, distinct proper kind of sorrow: when one properly sorrows over one’s own sin.

St. Paul the Apostle contrasts a kind of sorrow that works unto death, on the one hand, with godly sorrow or a sorrow of repentance, on the other hand (2 Cor. 7:8-10

KJV).16 (It is worth noting that Thomas Aquinas, whose views on tristitia I discuss in depth later in this chapter, points to this same passage to distinguish godly from worldly sorrow

(ST I-II.37.3).)

8 For though I made you sorry with a letter, I do not repent, though I did repent: for I perceive that the same epistle hath made you sorry, though [it were] but for a season. 9 Now I rejoice, not that ye were made sorry, but that ye sorrowed to repentance: for ye were made sorry after a godly manner, that ye might receive damage by us in nothing. 10 For godly sorrow worketh repentance to salvation not to be repented of: but the sorrow of the world worketh death.

16 See Schmidt’s discussion of this passage in (2007: 23), on which I rely for my commentary.

To be sorry, in this sense, is to feel genuine sorrow for having done wrong.17 Paul does not rejoice merely that the Corinthian church were sorrowed, but that they were sorrowed in a certain kind of way: “in a godly manner,” “to repentance,” “to salvation.” It is clear, from the care he takes to explain and distinguish, that Paul is aware that bringing sorrow to another person is generally bad—or at least can be received as such. To cause sorrow in another person is, in some way, to harm that person. And when the reason for one’s sorrow is one’s own sin, as when another person points it out, that harm can feel amplified. Yet

Paul rejoices that he has brought the Corinthian church to a godly sorrow over their own sins, a kind of sorrow which leads to repentance and salvation. This kind of sorrow may be harmful, but only as a means to a greater good, just as the physician may have to hurt in order to heal.

Bringing oneself to sorrow over one’s own sin can be considered just as unusual.

Isn’t this just overdoing it? Isn’t it sufficient that the sinner feels some remorse for what he’s done, and then moves on? Yes and no. While the indulgement in “overmuch sorrow” for its own sake is clearly bad,18 we must be careful not to assume that a life without pain or sorrow is superior to one with it—even if that pain or sorrow is self-induced. If it is the right kind of sorrow, done in the right way, viz., a godly sorrow which leads to repentance and salvation, then it is good. Thus, later readers of St. Paul call this distinction between a

17 The English “sorry” derives from Old English “sarig,” meaning “distressed, grieved, full of sorrow.” This is distinct from physical pain found in the word “sore.” This same distinction is present in Thomas’s use of “dolor” for pain generally and “tristitia” for sorrow, a species of pain.

18 Richard Baxter discusses this topic in his (1682) “The Cure of Melancholy and Overmuch Sorrow.” The phrase also appears earlier in Paul’s second letter to the Corinthians: “...lest perhaps such a one should be swallowed up with overmuch sorrow” (2 Cor. 2:7 KJV). Other translations render it “excessive sorrow” (NIV, NASB).

positive sorrow and a negative sorrow “tristitia secundum Deum” and “tristitia saeculi”, respectively, “the one leading to penance and salvation, the other to death (II Cor. 7:10).”19

We might ask ourselves which philosophy of emotion or view of suffering we are

assuming if we feel inclined to question or protest the permissibility of bringing oneself to sorrow. Such a position would be at home within Stoicism and Epicureanism, for example.

“[T]he cultivation of sorrow was entirely perverse from an Epicurean perspective, and seemed equally contrary to the Stoic goal of indifference, or apatheia.”20 The Christian view we see in St. Paul and in Augustine, however, is in clear conflict with this, seeing sorrow over one’s own sins as a good—at least with respect to this earthly life.

Augustine agreed with the Stoics that the ideal of [apatheia] “a life without those emotions which arise contrary to reason and which disturb the mind...is clearly a good and desirable condition.” But although Augustine achieved a substantial measure of peace of mind through his conversion, in The City of God he argued that the Stoic state of apatheia [Bk. XIV,Ch.9] “does not...belong to this present life.” Humans remain in a condition of sin, and rightly feel “pain for their sins,” [Bk. XIV,Ch.9] as well as pain and anxiety in their temptations to sin.21

Augustine concludes, “This condition of apatheia, then, will come to pass only when there

is no sin in man” (City of God Bk. XIV, Ch.9), when he reaches heaven.22 In the meantime,

passions—including sorrows and pains—are necessary as guides to teach us to live rightly

according to God. Indeed, Augustine says that the alternative would be terrible.

Moreover, if apatheia is to be defined as a condition such that the mind cannot be touched by any emotion whatsoever, who would not judge such insensitivity to be the worst of all vices?...if apatheia is a condition such that there is no fear to terrify and no pain to torment, then it is a condition to be avoided in this life if we wish to

19 Wenzel (1960b: 45).

20 Schmidt (2007: 22). Augustine discusses apatheia in Bk. XIV, Ch.9 (Dyson 1998: 600).

21 Schmidt (2007: 22).

22 Dyson (1998: 600).

live rightly, that is, according to God. But it is clearly to be hoped that this condition [“free from the pangs of fear and from any kind of grief”] will prevail in that life of blessedness which, it is promised, will be eternal (City of God Bk. XIV, Ch.9).23

Even the life of blessedness that Augustine imagines is not completely passionless; it is limited with respect to the scope of passions that one is free from: “those emotions which arise contrary to reason and which disturb the mind.” Certainly it is not completely passionless in the sense that we experience no love or desire or joy. But we shall be “free from the pangs of fear and from any kind of grief.”

In the meantime, these fears and pains are good—taken in some way. We should take Augustine to mean not that these are goods in themselves, but that they are instrumentally good. These pains and sorrows, when properly understood and taken on, when properly suffered, they lead us to a life of repentance and salvation. (I have said when they are “properly suffered.” Though I do not have a full account worked out, I think it is not coincidental that “pati-” (“to suffer”) is the root for both “passion” and “patience”— which may provide some insight as to how to suffer properly.) “Paul’s ‘godly sorrow’ [the proper sorrowing over one’s own sin, which leads to repentance and salvation] is a good rather than an evil, Augustine argued…, because it is derived from the love of God.”24 It is so related to the love of God in this way, because loving God means loving God’s laws

(cf. Ps. 19, Jn. 14:15). Loving God and His laws, while having a stark recognition that one has transgressed those laws, causes a person to sorrow. According to Thomas Aquinas, this

23 Dyson (1998: 600). Notre Dame Professor of Theology David W. Fagerberg (2016: 67-68) writes that Augustine’s notion of “purity of heart...to will one thing” (Matthew 5:8) is akin to Cassian’s interpretation of Evagrius’s “apatheia” or “dispassion.” Indeed, this may not be a state that we are ever able to reach in this life. See also Kierkegaard’s “Purity of Heart Is to Will One Thing” in UDVS.

24 Schmidt (2007: 22-23).

“sorrow which is according to God,” rather than weighing or burdening a person down, it

actually uplifts the soul “because it brings with it the hope of the forgiveness of sin” (ST I-

II.37.3.ad1).

3.2 - Thomas Aquinas on Tristitia and Acedia

We turn now to the 13th-century theologian and philosopher Thomas Aquinas and

his complex treatments of tristitia and acedia. (Both must be understood together.) In

Thomas Aquinas’s writings on the passions, we see a synthesis of previous thinking

coupled with uniquely Thomistic original contributions, which make for a portrait of

immense psychological depth.

Immediately we see an apparent contradiction in Thomas’s portrayal of acedia:

there is (1) the “acedia” which is a passion, a species of tristitia (ST I-II.35.8), and there is

(2) the “acedia” which is a capital sin or vice (ST II-II.35; de malo XI). The former is normatively neutral in itself; what determines whether it is normatively good or bad is whether it is governed by reason or not, respectively (ST II-II.35.1.ad1). The latter is a

habitus that is always bad (ST II-II.35.1.co), a grave and mortal sin (ST II-II.35.3) because it destroys the effect (joy) of caritas, and one of the seven deadly sins or capital vices (ST

II-II.35.4) because of its propensity to give rise to other vices.

We shall see that the contradiction between these two uses of “acedia” is only

apparent. The reality requires a bit of nuance. In this Section 3.2, I argue that keeping the

following major distinctions in mind is the key to understanding with nuance. First, there

is the specific tristitia that is acedia, and there is the more general tristitia. Second, tristitia

is good when governed and directed by reason, but it can go awry when unregulated or

unmoderated [immoderata] by reason. It follows from these that the passion of acedia can

be good when governed by reason and bad when it is unmoderated by reason, and it is the

latter of these that we call the capital vice of acedia.

3.2.1 - Aquinas’s View on Tristitia Immoderata

I begin with a discussion of Thomas Aquinas’s view of the passion tristitia

understood generally and how it can go awry, which brings us to tristitia immoderata. It is

worth looking more closely at tristitia if we are to understand its phenomenology and, ultimately, judge whether it, in any of its manifestations, can be considered an historical predecessor to depression. For Thomas, tristitia is a species of dolor (pain). Dolor

manifests when two conditions are met: (a) the conjoining of something bad [to oneself]

and (b) the perception of this conjoining (ST I-II.35.1.co). Tristitia is the specific kind of

dolor that is caused by an interior apprehension on the part of the intellect or the

imagination (as opposed to an apprehension on the part of an exterior sensory power) (ST

I-II.35.2.co). So tristitia, the passion of sorrow, has a distinctive mental or cognitive

phenomenological feel to it. What’s more, tristitia has noticeable bodily effects: “Of all the

passions of the soul, sorrow [tristitia] is most harmful to the body” (ST I-II.37.4.co). The

reason is because “sadness [tristitia], unlike the other passions of the soul, is opposed to

[repugnat] human life because of the very species of its movement and not just because of

its measure or quantity” (ST I-II.37.4.co).

Thomas allows for individuals to sorrow even over good things. One can sorrow

over something good, as when the “something bad” that is conjoined to oneself is not in

itself [in re] bad but is apprehended as bad. This might happen when one falls into some kind of error of reason, in which case his apprehension is actually a misapprehension.

Another way this might happen when one is disordered or malformed, such that the passion of tristitia is not properly governed by reason.

The result of such a disordering, or any disordering in which sorrow is ungoverned or unmoderated by reason, Thomas calls tristitia immoderata (immoderate sorrow).

Ungoverned sorrow can manifest as, but is not limited to, inordinate, overwhelming, or excessive sorrow where the circumstances do not warrant such a strong response. Indeed,

Thomas’s comments on tristitia in general, namely in its effects (ST I-II.37),25 suggest that tristitia is already a passion that demands caution. Just by its very nature, it is the kind of passion that can deprive one of the power to learn or even to recall what one already knows

(ST I-II.37.1),26 it burdens the soul (ST I-II.37.2), it impedes virtually all action (ST I-

II.37.3), and it is the most harmful of all passions to the body (ST I-II.37.4).27 How much more so when it is ungoverned by reason! Tristitia immoderata is so bad that Thomas calls it a “sickness of the soul” or “disease of the mind” [animae ægritudo] (ST I-II.59.3.ad3); a sadness that “absorbs” and “immobilizes the mind, making it difficult to avoid what is bad

[malum]” (ST I-II.39.3.ad1). While Thomas is willing to consider the benefits of tristitia

25 Effects of tristitia in general, many of which it shares with dolor (Thomas uses the phrase “dolor vel tristitia” in ST I-II.37). Even so, one must be careful to notice when Thomas is distinguishing between the two throughout the question. A helpful guide is the commentary on Q.37 by Miner (2009: 199-203).

26 Miner (2009: 200-1) argues that Thomas’s emphasis in Article 1 of Q.37 is on dolor rather than tristitia. “What is evidently true of pain cannot be attributed to sorrow without qualification. ‘Moderate sorrow’ [tristitia moderata] (37.1.ad1), as long as it excludes the mind’s wandering, can enhance learning.” Miner’s point here is correct. There are exceptions. But it does not follow from the fact that tristitia, in some cases, can contribute to learning that tristitia, generally speaking, does not impede learning.

27 Thomas argues that these effects can occur even when tristitia is governed by reason (i.e., when tristitia is rightly used). For instance, a healthy sorrow over one’s own sin can burden the soul (ST I-II.37.2). This is true, even considering that this same sorrow, in another sense, can have the effect of “uplifting of the soul…because it brings with it the hope of the forgiveness of sin” (ST I-II.37.2.ad1). Either Thomas means that these opposite movements happen in succession, or he is using them metaphorically and mean they happen simultaneously. If the latter, it would nevertheless be no contradiction, “For certain things, taken metaphorically, imply one another, which taken literally, appear to exclude one another” (ST I-II.37.2.ad3).

100 in general, he reserves no such treatment for tristitia immoderata, which, he says, “kills many, and there is no usefulness in it” (ST I-II.39.3.arg1, ad1). Tristitia, when gone wrong, is the “most harmful to the body” among all other passions (ST I-II.37.4.co).28 Whatever we say about the relation of tristitia immoderata to depression, Thomas’s claim here concerning the affect of sorrow is echoed in a recent study (Edlund, et al. 2018), surveying

5,653 individuals 18 and older, that found that mood disorders in general, and depression in particular, tend to be associated with the greatest functional impairment in an individual’s day-to-day living.29 In particular, the authors note that “in our study, the NCS-

R, and the DALY study, major depression and mania tended to be associated with the greatest functional impairment.”30

It is important to note that tristitia immoderata is not a species of sorrow; it is a mode of sorrow, a way in which sorrow manifests in the individual. What makes it

28 To understand this notion of “most harmful” (from noceo, “to harm”, “injure”, “damage” whether physical or emotional), one must understand that Thomas distinguishes between passions which are opposed to [repugnat] the “vital movement” in the appetite of the soul (e.g., fear, despair, sorrow) and those that are not opposed (e.g., love, joy, desire). The latter kind may still be “repugnant to life” in the measure of its quantity or measure, but not with respect to its species. The former kind can be “repugnant to life” in both respects. Aquinas’s claim here is that, when it comes to those passions that are “opposed to life”, tristitia, is the strongest in this respect simply due to its species. It is because “sorrow,” Thomas says, “weighs down the mind because of a present evil, the impression of which is stronger than is that of a future evil” (ST I- II.37.4.co), as with fear (ST I-II.41.1.co) or despair (ST I-II.40.1.co, I-II.40.4.co). And since tristitia can be even more harmful with respect to its quantity or measure, it follows that tristitia immoderata is the most harmful among any passion.

29 As the authors define impairment to one’s functioning, “Such disability could result from symptoms of many disorders, such as the unmotivated state of depression, the fatigue of congestive heart failure, or paralysis from a neurological disorder” (Edlund, et al. 2018: 1266, emphasis mine). This unmotivated state reminds one of the “weighing down” of aggravatio animi, to be discussed next. (While impairment can include a range of things from physical to psychological, they modified their measures to be specific to mental health.)

30 Edlund, et al. (2018: 1273), emphasis mine. Depression and mania each scored highly, and both are in the category of mood disorders, making mood disorders as a group score highly. For comparison, depression scored, with respect to impairment of general functioning, similar to mental disorders such as: social phobia (Edlund, et al. 2018: 1269), psychotic symptoms (e.g., delusions, hallucinations) (Edlund, et al. 2018: 1268-69), mania (Edlund, et al. 2018: 1269), and alcohol-use disorder (Edlund, et al. 2018: 1273).

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normatively bad [malum] is that it is not moderated by reason. Of course, being ungoverned by reason is not specific to tristitia; it is a general feature of all passions (e.g., fear, desire,

hope) that they are can be governed or ungoverned by reason. The same can be said of a

passion in any of its various species. This means, importantly for our purposes, that the

passion of acedia can be either governed or ungoverned by reason. It is this ungoverned

acedia (acedia immoderata), qua species of tristitia, that is the capital vice of acedia.

3.2.2 - Aggravatio animi: Tristitia aggravans, Anxietas, and Acedia

Before moving on to acedia as a capital vice, I should draw attention to a few different issues that will allow cleaner distinctions to be made as we look at Thomas’s views of both tristitia and acedia. This, of course, will ultimately position us to make an informed judgment on the relation between tristitia and depression. I shall return in Section

3.2.5 to discuss tristitia as a capital vice. In the sub-sections preceding that, I discuss, first, aggravatio animi; second, moderate acedia; and third, tristitia alongside agonia.

There is another phenomenon of tristitia we find in Thomas which intersects very closely with acedia qua passion. This phenomenon appears both as an effect of tristitia in general and as a species of tristitia. It is aggravatio animi, a kind of “weighing down of the mind,” that is sure to draw comparisons to depression. Indeed, the translation by The

Fathers of the English Dominican Province renders aggravatio animi as simply

“depression” (ST I-II.37.2).31

31 Perhaps the reason why this has been more closely associated with depression than with acedia can be explained by returning to acedia’s twofold effect of listlessness and restlessness. Aggravatio animi captures only a being weighed down, a listlessness, hence it is more easily (though, I maintain, incorrectly) associated with depression.

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A cursory reading of this phenomenon qua effect of tristitia, being weighed down due to sadness, might lead one to think that Thomas has in mind something like our contemporary depression. But closer inspection reveals that Thomas is fully aware that he is using this kind of “depression” only metaphorically.

The effects of the passions of the soul are sometimes named metaphorically because of a likeness to sensible bodies, given that the movements of an animal appetite are similar to the inclinations of a natural appetite. It is in this way that intense heat [fervor] is attributed to love, being widened [dilatatio] is attributed to pleasure, and being weighed down [aggravatio] is attributed to sadness (ST I-II.37.2.co).

The notion of being “weighed down” also appears earlier as a different species of tristitia, in the phrase tristitia aggravans (“sorrow that weighs down”). It is used to describe anxietas (or angustia), a species of tristitia (ST I-II.35.8.arg3). This is not the only kind of sorrow that weighs down, however, as Thomas later distinguishes in the respondeo between two instances of the mind’s being weighed down. He explains that the proper effect of sorrow is a kind of fuga appetitus (“flight of the appetite”).32 When only the first

part is affected, and flight is restricted, “we thus have anxiety [anxietas; or angst, angustia]

which weighs on the mind, so as to make escape seem impossible” (ST I-II.35.8.co). In this

case, one still desires flight but cannot attain it. When both parts are affected, both flight

and one’s desire for it, then it is torpor or listlessness (Thomas uses the Latin word

“acedia”) where “the mind is weighed down so much, that even the limbs become

motionless” (ST I-II.35.8.co).

32 It is difficult to reconcile this “flight of the appetite” as being the proper effect of sorrow (ST I- II.35.8.co), with what Thomas Aquinas later says of sorrow as being a resting or completion of appetitive motion (ST I-II.25.4.co). Here I merely mention the discrepancy, with no prepared resolution in hand. In any case, however, the discrepancy here does not seem to have any ill effect on my case for tristitia.

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It is important to note that Thomas’s characterization of acedia is purposely strong.

He is picking out by ostension paradigmatic instances of acedia. That is, it is possible for

acedia to manifest to a less extreme degree, viz., where it weighs down but (i) not

dramatically so or (ii) not in any way that makes it a true impediment. Thus, this allows us to see (i) how one could experience an acedia immoderata which, though it weighs down the body in some respect or with respect to only certain objects of attention (e.g., one’s meaningful work), it has no such effect on certain other bodily activities (giving rise to the second part of acedia’s twofold effect: restlessness); and (ii) how one could have a normatively good moderate acedia, which is governed by reason. This is the topic of the next section.

3.2.3 - Moderate Acedia

At this point, it is worth exploring how the passion of acedia can be considered

good when it is properly ordered within a person. If indeed acedia, considered as a species

of tristitia (ST I-II.35.8.co), is like all other passions, then it is not sinful in itself but is

good when governed by reason. As I have said, tristitia immoderata is not a species of

tristitia, but a mode of tristitia, a way in which tristitia manifests. Since acedia is a species

of tristitia, then we can think of tristitia immoderata as a genus, one species of which is

acedia immoderata. If this is right, then there are good, or moderate, instances of acedia

that we should be able to identify. Let us begin in the place we are likeliest to see a

candidate emerge, Article 1 of ST II-II.35 where Thomas discusses whether acedia is a sin, and let us consider what Thomas has to say in his reply to the first objection. I have italicized the parts bearing attention.

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Passions are not sinful in themselves; but they are blameworthy in so far as they are applied to something evil, just as they deserve praise in so far as they are applied to something good. Wherefore sorrow, in itself, calls neither for praise nor for blame: whereas moderate sorrow for evil calls for praise, while sorrow for good, and again immoderate sorrow for evil, call for blame. It is in this sense that sloth [acedia] is said to be a sin. (ST II-II.35.1.ad1)

So a moderate acedia for evil [malum] calls for praise. What would this look like? As I

noted above, these more properly governed, more properly ordered, instances of acedia

may not have all the same characteristics of those paradigmatic strong instances of acedia

that Thomas gives us in ST I-II.35.8. That is, it is possible that a moderate acedia does not

cause the mind to be “weighed down so much, that even the limbs become motionless” (ST

I-II.35.8.co). There must certainly be a kind of weighing down, a torpor or listlessness, but not to such an extreme degree, and certainly not in any sense that it is harmful. In effect,

this torpor or listlessness will be for evil [malum] things—that is, it will manifest when the

object of attention is something bad.

I imagine it is similar to those kinds of cases we hear of when a man who, for a

long time was often very besotted or drunk, but has now turned away from the bottle. Some

men, who are merely continent, to use Aristotle’s term, still strongly desire the drink,

perhaps just as much as before. But our man has so progressed in virtue that he no longer

feels even the slightest desire for the drink. If this is not an actual case of moderate acedia, it is a corollary of what happens with moderate acedia. What once was a strong, excessive, desire for some bad (or good) object has now abated to almost nothing—or rather, I should say, has been ordered rightly. It is the growing weary of old, tired, hammy jokes; it is the decrease in being solely energized by, and in pursuit of, eros, as when one was a young lover; it is the growing unconcern for petulant partying, cavorting, and drinking. In short, it is the feeling that unvirtuous things are simply tiresome.

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A simple moderate acedia would exclude any strong dislike or hate for these once- loved objects. It is not a crusade against or active hatred of these things, but manifests more moderately as a diminishing interest in them. One promising example of moderate acedia that springs to mind can be found in Plato’s Symposium, in which young Alcibiades, headstrong with eros, is attempting to seduce Socrates, but Socrates appears frankly uninterested in any frivolous pursuits of this sort. Such things no longer stimulate him, if they ever did; he instead sees them as petulant, irritating, annoying distractions from higher things truly worthy of pursuit.

3.2.4 - Tristitia Alongside Agonia, Segnities

We have seen that anxietas (often translated “anxiety”, sometimes called angustia,

“angst”), shares similarities with acedia in that both are species of tristitia that “weigh down” the mind. There is yet another passion Thomas discusses which can also be translated as “anxiety”, or even “agony”: agonia. Agonia is not a species of tristitia, as

Thomas distinguishes them; it is a species of fear. Fear is a passion whose object is (i) future, (ii) bad, (iii) arduous or difficult to overcome, and (iv) cannot be resisted (ST I-

II.41.2 and 42.1). Agonia is fear “in the way that future misfortunes are feared…by reason of its unexpectedness [ratione improvisionis, unforeseen], viz., since it cannot be provided for ahead of time [provideri non potest]” (ST I-II.41.4.co). One can see how fitting a translation “anxiety” or “anxious” is, given its forward-looking nature and that it connotes one’s worry over, perhaps due to one’s inability to prepare or account for, what’s to come.

But the question remains: why include a species of fear here in a discussion on sorrow? There are a couple of reasons. First, there is some rough correspondence between the species of sorrow (ST I-II.35.8) and the species of fear (ST I-II.41.4). Although Thomas

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acknowledges that they do not correspond exactly with one another (ST I-II.41.4.ad1),

there are some corollaries to be found: anxietas (ST I-II.35.8.co) and agonia (ST I-

II.41.4.co), torpor (ST I-II.35.8.co) and segnities (ST I-II.41.4.co). Second, comparing fear and sorrow provides an instructive example of how the human person is a holistic, unified being. We are reminded that Thomas’s parts of the soul are not separable parts, the virtues rise and fall together, and a movement of one passion will correspond with movements of other passions. Third, looking at agonia and tristitia immoderata in particular may also produce fresh insight into possibly solving a recent psychiatric puzzle: the high comorbidity of anxiety and depression.

There are two facts we must take into account:

(A) General anxiety disorder (GAD) and major depressive disorder (MDD) are highly comorbid, or frequently co-occur.33

(B) Yet the DSM-5 categorizes them differently: GAD is an anxiety disorder, while MDD is a mood disorder.

There is an explanatory gap between (A) and (B), a gap which challenges the utility of the

demarcations set forth in (B). When multiple disorders are present, reliable diagnosis can

be difficult. Some have called for recategorizing GAD and MDD,34 but, as of yet, the

current demarcations remain in place. I am less worried about the explanatory gap between

(A) and (B); my interest lies with explaining (A), viz., giving a satisfactory explanatory

account of why GAD and MDD are highly comorbid. (And, of course, the mere fact that

the gap exists shows that we need to think more about the relationship between GAD and

33 Cf. Zbozinek, et al. (2012), Sunderland, et al. (2010), and Watson (2005).

34 Consider just one example, and the bibliography therein: Mennin, et al. (2008), “Is Generalized Anxiety Disorder an Anxiety or Mood Disorder? Considering Multiple Factors as We Ponder the Fate of GAD.”

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MDD.) It is my conviction that Thomas’s understanding of the relationship between fear

and sorrow can help towards providing such a satisfactory explanatory account. As for the

relationship of GAD to agonia or of MDD to tristitia, for or the present purposes, we need

not make any judgment beyond this. Even if Thomas’s concepts of agonia and tristitia do

not fully account for GAD and MDD—for instance, perhaps he’s neglected the important biochemical aspects of these psychiatric disorders—we must admit that “anxiety” is the operative emotion or characteristic symptom of GAD, and “sadness” for MDD. And if

Thomas’s account concerning the relationship between the two passions is a coherent and useful one, we should consider applying it to these psychiatric disorders.

Thomas names four “principal passions” [principales passiones] from tradition: joy, sorrow, hope, and fear (ST I-II.25.4).35 We can pair these in a few different ways. Most

obviously, joy and hope pair together in that they incline us towards objects we love; while

in the case of sorrow and fear we undergo aversion or withdrawal with respect to objects

we hate or dislike.36 (It would be far simpler to say that joy and hope are good, while fear

and sorrow are bad, but the reality is more complicated than that, since passions in

themselves are neither morally good nor morally bad.) Another pairing, less obvious than

the first, couples together joy and sorrow in that both are culminating and final

35 Not only does Thomas say that these four “are commonly said to be the principal passions,” he also names Augustine and Boethius as among those who have held these to be the principal passions.

36 In Thomas’s thinking, “love” and “hate” are technical terms denoting specific passions. They are each passions that are inclinations, or abiding dispositions, to feel drawn to or repulsed from something, respectively. They are inclinations in the sense that one can love x without currently thinking about, and hence desiring x. Desire and its corollary aversion are more than inclinations, which remain at rest; these, rather, are affects in motion whereby one is moved or compelled toward (or away from) the object of attention.

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[completivae et finales] with respect to all other passions (See Fig. 3.137). In other words, all other passions eventually culminate or resolve into either joy or sorrow. Take, for instance, hope. The prince may hope for the princess in a faraway castle, but he does not continue to hope once he has attained to the object of his hope. No, his hope rests or resolves into joy, if he has attained her, or into sorrow, if he has not.

For both joy and sorrow to be completive means that there is a resolution of appetitive motion altogether; where once there was appetitive motion, or striving for an object, there is now a ceasing of that motion and a resting in either joy or sorrow. But while joy and sorrow are both completive simpliciter, hope and fear are only relatively completive. Miner

(2009) explains:

Superficially, hope and fear resemble joy and sorrow in that they are “completive” [completivae] of the appetite’s motion. But completiva is equivocal; hope and fear do not terminate the appetite’s motion in the same sense as joy and sorrow do. They

37 Taken from Miner (2009: 86).

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are relative termini. Far from bringing the appetite to rest, they generate other passions.38

Rather than being completive absolutely speaking, Thomas teaches, hope and fear are

“completive in the genus appetitive movement toward something [in genere motus

appetitivi]” (ST I-II.25.4.co).39 He then gives examples of this completive movement for

both hope and fear:

For with respect to the good, the movement begins in love [amor], continues in desire [desiderium], and terminates in hope [spes], whereas with respect to the bad, the movement begins in hatred [odium], continues in withdrawal [fuga], and terminates in fear [timor]. (ST I-II.25.4.co)

For both hope and fear to be relatively completive means that there is a resolution of

appetitive motion towards the object; this is not the same as the ceasing of all appetitive

motion altogether, but it is a ceasing of certain kind of appetitive motion. This is, so to

speak, the last stop on the train before it shuttles to the coach yard. There is appetitive

motion (i.e., activation of further passions) after hope and fear, but hope and fear are

termini in their own respect; they are the last stops at which one experiences appetitive

movement towards an object, as when the object is future. With all other subsequent passions, the object is present. This introduces yet another pairing worth bearing mention, a distinction between hope and fear, whose object is future, and joy and sorrow, whose object is present…

…taken in accord with the differences present and future: For a movement has to do with the future, whereas rest is in something present. Therefore, (a) with respect to a present good there is joy; (b) with respect to a present evil there is sadness; (c) with respect to a future good there is hope; and (d) with respect to a future evil there is fear. (ST I-II.25.4.co)

38 Miner (2009: 87).

39 Freddoso’s translation italicizes the English phrase.

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Using Thomas’s understanding of the relation between fear and sorrow, we are now in a

position to try to make sense of the relationship between GAD and MDD. First, we may

say that GAD and MDD are highly comorbid because fear, especially agonia (of a future

bad), often generates sorrow (perception of this bad being conjoined with me). Second,

Thomas’s distinctions may help clarify why certain intuitions separate GAD into anxiety

disorders and MDD into mood disorders. A prima facie rationale is simply to consider all

the differences that separate agonia and tristitia: agonia is a species of fear, while tristitia

immoderata is not a species, but a mode of sorrow; fear is of a future bad, while sorrow is

of a present bad. Third, speaking of modes, it is probably more correct to say that agonia

immoderata, a passion which is disordered or ungoverned by reason, is the operative

emotion or characteristic symptom of GAD, especially if we consider GAD to be a disorder

contrary to the telos of a well-functioning human individual. After all, fourth, we can

imagine good, well-ordered instances of agonia under the direction of reason. Recall that

agonia, simply speaking, is fear “in the way that future misfortunes are feared…by reason

of its unexpectedness [ratione improvisionis, unforeseen], viz., since it cannot be provided

for ahead of time [provideri non potest]” (ST I-II.41.4.co). When well-ordered, agonia can

be beneficial by giving a person a healthy fear of the unknown to come.40

40 Thomas gives us other examples of healthy species of (the passion of) fear in stupor and amazement (admiratio), which humans are apt to feel in the presence of God (cf. ST I-II.41.4.co). Although Thomas is clear that not every instance of admiratio and stupor are species of fear, since fear has as its object something bad (ST I-II.41.4.arg1), it would seem that stupor and admiratio in this case would be, since they concern the great and unwonted or unfamiliar, respectively, that is apprehended as bad or potentially harmful to oneself (ST I-II.41.4.ad1). To complicate matters, Thomas distinguishes between the passion of fear and the gift of fear “as ordered toward God” (ST II-II.19.2.ad1), or “insofar as through it we are in some sense turned toward God or turned away from Him” (ST II-II.19.2.co). This gift of fear pertains to the theological virtue of hope (ST II-II.17.pr).

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3.2.5 - Aquinas’s View on Acedia as Capital Vice (Acedia Immoderata)

Heretofore, we have seen that acedia considered as a species of tristitia has the following features. Tristitia immoderata is a genus according to a mode; one species is acedia immoderata. As a passion, tristitia is morally neutral in itself; it is morally good when guided by reason and morally bad when it is not. Characteristically, acedia weighs upon the mind to the extent that it can produce bodily effects, “that even the limbs become motionless” (ST I-II.35.8.co). Although this description can connote a laziness or prompt one to think of depression, we have seen that this passion, when governed by reason, can actually be a good, as in the case of a moderate acedia for an evil [malum], such as when a virtuous person’s formerly excessive petulant desires come to appear wearisome and undesirable to her.

Now it is time to discuss Thomas’s view of acedia considered as a capital vice.41

We immediately see that there is much overlap with acedia the vice and acedia the passion.

But so long as we keep in mind that it is acedia immoderata, the passion gone awry, which

is the principal vice that Thomas has in mind, we can begin to understand the overlap and

keep distinct the good from the bad instances of acedia. In short, it seems that Thomas has

simply identified the old evil thought [logismos] of acedia or tristitia,42 that original seed

which begets so many other vices, with the disordered passion of acedia immoderata. This

seemingly innocuous passion can become a seminal vice from which other vices are born.

41 On interpretive issues in Aquinas’s treatment of acedia, DeYoung (2011) is a helpful read.

42 I shall return below to discuss the preference Gregory had for using the term “tristitia” over “acedia”, and to discuss a separate but related logismos, de spiritu tristitiae (spirit of sadness), which we receive from Cassian.

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One feature of acedia which has yet to arise in our previous examinations is the

idea of acedia as a sorrow over the divine good [tristitia boni]. This feature is key to

Thomas’s understanding of acedia as a capital vice. (From this point forward in this

section, unless otherwise noted, I shall use acedia simply to mean acedia immoderata, the

capital vice.) Thomas situates acedia as a vice opposed to caritas (charity, love),

specifically because it undermines joy (ST II-II.35.1), itself one of the outward effects of

caritas (ST II-II.28). Acedia undermines joy and destroys the theological virtue of caritas

in that it detracts from love of and friendship with God. In this respect, it is similar to envy

(invidia), itself a different species of tristitia, which, when it comes to roost, also

undermines joy and destroys caritas, because it detracts from love of the neighbor (ST II-

II.36).

Not only does acedia dampen caritas, acedia also has a close relationship with

despair (ST II-II.20.4.co),43 and despair [desperatio] is a vice opposed to the theological virtue of hope [spes] (ST II-II.20).

[T]he object of hope is a good, difficult but possible to obtain by oneself or another. Consequently the hope of obtaining happiness may be lacking in a person in two ways: first, through his not deeming it an arduous good; secondly, through his deeming it impossible to obtain either by himself, or by another. (ST II-II.20.4.co)

Acedia is responsible for the second way (lust, the first). Thomas goes on:

[T]he fact that a man deems an arduous good impossible to obtain, either by himself or by another, is due to his being over downcast [perducitur ex nimia deiectione], because when this state of mind dominates his affections [quae quaedam in affectu hominis dominatur], it seems to him that he will never be able to rise to any good. And since sloth [acedia] is a sadness that casts down the spirit [tristitia quaedam deiectiva spiritus], in this way despair is born of sloth [acedia]. (ST II-II.20.4.co)

43 If I understand Thomas correctly, when he says that “despair arises from acedia,” acedia is a necessary but not a sufficient condition for despair.

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Notice that when a man’s affections are thus dominated by such a dejected state of mind,

it can only mean that his affections are disordered or ungoverned by reason—hence, acedia

immoderata.

Briefly, Thomas’s remarks about the role of volition are worth special attention,

not only because one’s volition makes a difference as to whether acedia is a venial or

mortal sin, but also because of the debate that rages in contemporary circles concerning

one’s volitional control, or lack thereof, with respect to depression. Acedia is a mortal sin,

properly speaking, when it is “complete” [perfecta]—i.e., when one’s reason has consented

to the act (ST II-II.35.3.co). Otherwise, “if the sin be a mere beginning of sin in the

sensuality alone, without attaining to the consent of reason” (ST II-II.35.3.co), then it is merely a venial sin. Of course, noting this important distinction does not entail that all cases of depression are sinful. In fact, it does not even entail that any case of depression is sinful, since it is a distinction applicable to acedia and other sins, and I have said nothing about its applicability or not to depression. In order to make this judgment, one would need to accomplish the further task of connecting depression to acedia in a meaningful way.44

Nevertheless this distinction is instructive.

Let us look again at acedia’s sluggish effects, this time through the lens of understanding acedia as a capital vice, keeping in mind, especially, that acedia as a mortal

sin must include the “consent of reason,” while acedia as a venial sin includes only the

beginnings “in the sensuality alone, without attaining to the consent of reason” (ST II-

44 I have tried one way of accomplishing this task in the previous chapter, viz., examining cases in which an instance of depression is (i) coextensive with or (ii) mistaken for an instance of acedia. Surely in the first case, the condition or instance, qua acedia, is sufficient to trigger the venial/mortal distinction.

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II.35.3.co).45 First, we see that acedia the capital vice is still essentially a kind of sorrow:

“a sorrow over what is genuinely bad is bad in its effect if it burdens [aggravet] a man in

such a way that it draws him back totally from good works [totaliter a bono opere

retrahat]” (ST II-II.35.1.co).46 This is clearly excessive sorrow, and Thomas later directly

clarifies this as “tristitia immoderata” (II-II.35.1.ad1). Second, acedia is a sadness which burdens to the point of loss of pleasure, or anhedonia. Acedia is a certain “sort of heavy sadness [quaedam tristitia aggravans] that presses down on a man’s mind in such a way that no activity pleases him” (ST II-II.35.1.co).47 Third, acedia “involves a sort of

weariness with respect to acting (or “weariness of work” (O.P.) [taedium operandi])” (ST

II-II.35.1.co). Fourth, “acedia is a listlessness of mind [torpor mentis] that neglects to undertake good things” (ST II-II.35.1.co). Thomas then summarily concludes that this kind of sorrow is always bad [Huiusmodi autem tristitia semper est mala] (ST II-II.35.1.co). He means this kind of tristitia, viz., acedia; but not acedia simply: acedia when it has these

deleterious effects.48

45 Though the reader may notice without my pointing it out, I draw most, if not all, of the following descriptions of acedia from Thomas’s Question on Sloth (Acedia), in the Secunda Secundae, at which point he is directly focused on acedia considered as a capital vice.

46 Immoderate acedia over what is bad, as demonstrated here, is merely one instance of bad or sinful acedia. Another would be moderate acedia over what is good, and, another, immoderate acedia over what is good (ST II-II.35.1.ad1).

47 Freddoso’s translation. Another translation puts it: “...an oppressive sorrow, which, to wit, so weighs upon man’s mind, that he wants to do nothing” (O.P., ST II-II.35.1.co).

48 The standard translations do not seem to preserve the spirit of specificity, especially the O.P.’s simple “this sorrow”. Freddoso improves greatly on this—“a sadness of this sort”—but could stand to be more specific; nonetheless, in his defense, qua translator and not commentator, Freddoso is remaining true to the letter of what Thomas has written.

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It cannot be overstated that there is also a close association of acedia with tristitia

boni, or sorrow over the divine good, in Thomas’s thinking. Thomas says simply that

“acedia, as we understand it here, denotes sorrow for spiritual good [acedia...nominat

tristitiam spiritualis boni]” (ST II-II.35.1.co). Rebecca Konyndyk DeYoung emphasizes this feature when she casts acedia, in her words, as “resistance to the demands of love.”49

This resistance manifests not simply as an aversion to the Lover’s demands; rather, it is a

weighing down that begins, first, in the affections, and then, as it festers, attains to the level

of reason where it becomes willfully disobedient. It is here when acedia, the mortal sin, is

most destructive, when it “reaches to the reason, which consents in the dislike, horror, and

detestation of the Divine good [quae consentit in fugam et horrorem et detestationem boni

divini], on account of the flesh utterly prevailing over the spirit” (ST II-II.35.3.co).

3.3 - Back to Cassian & Gregory

It is worth briefly revisiting Cassian’s and Gregory’s accounts of the Deadly Sins

(or logismoi), since both include a kind of “tristitia” in their lists. Paget tells us that much of what “other writers link with accidie is assigned by Cassian to sadness.”50 This is

problematic for Thomas’s position if it means that I have misidentified either of the two. I

have argued thus far that tristitia, generally speaking, that is, the mere feeling of sadness,

is not sinful in itself. (Neither, for that matter, is acedia.) It is only when tristitia goes awry in one of a few ways. This is consistent with Thomas’s teaching: “Wherefore sorrow, in itself, calls neither for praise nor for blame: whereas moderate sorrow for evil calls for

49 DeYoung (2013).

50 Paget (1891: 10).

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praise, while sorrow for good, and again immoderate sorrow for evil, call for blame” (ST

II.II.35.1.ad1). However, their inclusion of “tristitia” by name and without modification as

a Deadly Sin suggests a conflict with Thomas’s view, so I must briefly consider it.

3.3.1 - Gregory’s Capital Sin of Tristitia

I argued in the preceding chapter that we can, and should, read Gregory’s “tristitia”

as a certain kind of sadness, viz., acedia. This aligns with the common view that Gregory

had subsumed “sloth [acedia] under sadness [tristitia].”51 But suppose that neither of these

points resolves the troubling worry that Gregory overtly names tristitia—rather than

acedia—as a Capital Sin. My analysis in the preceding chapter indicated that, despite

Gregory’s choice of terminology, he certainly had acedia in mind among the many

conditions that plague believers in the Christian life. Nevertheless, he does not give the

name “acedia” to any Capital Sin. The inclusion instead of tristitia raises serious concerns

for depression sufferers. What kind of sadness are we talking about? I can only briefly take

up the subject here, and so, beyond what I have already said in the preceding chapter, I will

make four additional remarks germane to this problem in hopes that it resolves any pressing

qualms.

First, any passion that is not governed by reason is bad [malum] and contrary to

one’s flourishing. So, tristitia qua passion is no more problematic in this respect than are

anger, pleasure, or any other passion. Sorrow, like many passions, is morally neutral in and

of itself (when considered apart from a particular object or degree).52 Sorrow goes awry

51 DeYoung (2009: 28).

52 Not all passions in themselves are morally neutral. Cf. Miner (2009: 93) who says, "This Article [I.II.24.4] qualifies any simple view according to which Aquinas regards the passions as neither good nor evil in themselves." For example, "Envy is a passion that is evil in its species. Defined as sorrow for another’s 117

when either (a) a person, in her sorrow, misperceives a genuine good as evil [malum], or when (b) sorrow is immoderate, or ungoverned by reason.53 Second, even though tristitia

is strongly associated with depression, tristitia is not the only passion operative in depression. In the concupiscible part is not only tristitia, especially tristitia immoderata

(ST I-II.37.4), but also unnatural, avid desire (ST I-II.30.3.co), for instance, to punish oneself or to be alone, as well as unnatural aversion to real goods. In the irascible part, we can find despair (ST I-II.40.1), for instance, over one’s prognosis or against hope for improvement, as well as fear, especially segnities (“sluggishness”) (ST I-II.41.4.co). Since tristitia is not the only culprit in depression, then, it should not particularly trouble us that

“tristitia”—at least in name—is also named among the Deadly Sins.

Third, there is strong evidence to indicate that the Capital Sin that Gregory means to demarcate is not any and all kinds of tristitia, tout court, but only a specific kind of tristitia. Recall Gregory’s starting point and reliance upon St. Paul, who had condemned tristitia saeculi (II Cor. 7:10) as a negative kind of sorrow which leads to death.54 Space

prohibits me from building a case that Gregory has in mind this particular kind of tristitia;

but all that is needed for the current point, in any case, is that he does not have all kinds of

good, envy is evil per se. It is impossible to suffer envy toward the right person, at the right time, and in the right way.”

53 “Wherefore sorrow, in itself, calls neither for praise nor for blame: whereas moderate sorrow for evil calls for praise, while sorrow for good, and again immoderate sorrow for evil, call for blame. It is in this sense that sloth [acedia] is said to be a sin” (II.II.35.1.ad1, emphasis added). The same goes for tristitia as well as (nearly) all other passions.

54 Cf. Wenzel (1960b: 45-46). In addition, recall that Gregory certainly followed Cassian in the manner of identifying progenies of each capital vice (see Sec. 2.2.2). And recall that Cassian’s source for those progenies, at least in the case of acedia, was most likely St. Paul (see Sec. 2.2.1). Cf. Wenzel (1960b: 21).

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tristitia in mind.55 Fourth and finally, it entirely depends on our conceptual framework of

sin how we receive the news that tristitia is a sin. On one understanding of sin,56 sin is a

forensic transgression of the law: “Thou shalt not,” and if you do, you receive the

punishment. On another understanding of sin, prominent in virtue theory, sin is anything

that is antithetical to one’s flourishing. If, as on Christian versions of eudaimonism, God is

the ultimate end of our pursuit of the good, then sin, in the final analysis, is apartfulness

from God. So to interpret Gregory’s schema charitably, one could understand Gregory as

claiming that sorrow—at least some kinds of it—is not healthy or good for us.

Thus, hearing that tristitia is named a Capital Sin is not so surprising and is actually

quite reasonable if we also affirm that either a certain kind of tristitia (for example, St.

Paul’s tristitia saeculi) or simply tristitia when it is immoderate and ungoverned by reason,

is actually antithetical to our flourishing. We need not be told, since we all know by

intuition and experience, that to sulk too long in sorrow is not good for our health. And

calling it “Capital”, recall, does not entail that it is the worst of the worst; this nomenclature

only points to this vice’s tendency to surreptitiously creep into one’s life unnoticed and

unmonitored until it has laid a nestful of other vices or ills—for example: self-loathing,

despair, unnatural aversion to the good, etc.

55 A later Doctor of the Church, St. Francis de Sales, seems to pose a problem for this, saying “Oppose vigorously the least inclination to sadness” (Introduction to a Devout Life, as quoted in Kozlowski (1998: 41)). Surely this means all kinds of sadness? Not necessarily. We have to ask who the audience is. Just as we would advise an alcoholic, for instance, to oppose all desire to drink alcohol, it does not necessarily follow that all desiring of alcohol is bad.

56 These are admittedly simplistic characterizations. In reality, the two views I bring up may not be mutually exclusive.

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3.3.2 - Cassian’s Logismos de Spiritu Tristitiæ (Spirit of Sadness)

Virtually the same can be said with regards to Cassian’s “spirit of sadness”,57 one

of the eight logismoi he enumerates.58 That is to say, Cassian’s tristitia is either only a subset of general tristitia or it is acedia (these are not mutually exclusive). Wenzel notes, perhaps in frustration that, in certain passages, “it is almost impossible to tell which of the two is portrayed,” since there are sometimes effects that are “common to both tristitia and acedia.”59 This is certainly consistent with Thomas’s position that one is the species of the

other. Such a “severance of sadness is deliberately censured by St. Thomas Aquinas,” says

Paget.60 Paget considers Cassian’s essential description of tristitia as “sullen gloom” in

Inst.IX to form “a congenial and integral part in the complex trouble which accidie

generally denotes.”61 Perhaps the translator Gibson (1894) had good reason to call this

logismos the “spirit of dejection, ” for recall what Thomas had said of acedia being a

sadness which casts down the spirit: “And since [acedia] is a sadness that casts down the

spirit [tristitia quaedam deiectiva spiritus], in this way despair is born of [acedia]” (ST II-

II.20.4.co).

57 Although some translations, such as Gibson’s (1894), render this ailment as the spirit of “dejection”, a look at the original Latin removes any doubt about Cassian’s usage of “tristitia”. See Cassian (1846: 1338) in Migne’s PL.

58 In the Instituta [Institutes], while Bk.X is comprised entirely of Cassian’s treatment of acedia, the preceding Bk.IX is reserved wholly for this “spirit of sadness”.

59 Wenzel (1960b: 45). In particular, Wenzel quotes the following passage: “[The vice] does not allow it [the mind] to say its prayers with the usual gladness of heart, nor permit it to rely on the comfort of reading the sacred writings, nor suffer it to be quiet and gentle with the brethren; it makes it rough and impatient in all the duties of work and devotion” (Inst.IX.1; cf. Wenzel 1960b: 45).

60 Paget (1891: 10).

61 Paget (1891: 10).

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On the same token, we again see directions against only a certain kind of tristitia,

with Cassian also drawing explicitly upon St. Paul’s distinction between godly sorrow and

worldly sorrow.62 He includes it among the logismoi, because in true fashion, one

succumbs to such thoughts slowly, “by falling through a long course of carelessness” (Inst.

IX.6). What kind of sadness in particular? According to Paget, “the sadness of which

Cassian speaks is the gloom of those who ought not to be sad, who wilfully allow a morbid

sombreness to settle down on them; it is a mood which severs a man from thoughts of God,

‘and suffers him not to be calm and kindly to his brethren.’”63 Whether he is referring to

acedia or some other kind of tristitia, we can be sure that Cassian does not have in mind tristitia in general.

3.4 - Considered Judgment on Relation to Depression

I am inclined to think that, among all the historical conditions surveyed here,

tristitia immoderata comes the closest to depression. It surely has many similarities: it is

sadness gone wrong, ungoverned by reason, to the point of despondency, catatonia, even

death. On the one hand, we must be careful to note that Thomas is identifying by “tristitia”

only the sad affect (had in a certain way — “immoderata”). So “tristitia immoderata”

strictly speaking can refer only to the sad affect or mood that partly constitutes depression.

Thus we only have one piece of the puzzle. On the other hand, there is no doubt that, for

Thomas, the human person is a unified whole; a distinction of reason (e.g., parts of the

62 See Inst.IX.10 and Inst.IX.11. Cf. Wenzel (1960b: 46).

63 Paget (1891: 11).

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soul) does not entail a real distinction (e.g., separable parts).64 Thus, any drastic changes

in one’s affects, such as to an excessive or immoderate level of sorrow, would inevitably

bring about somatic and neural changes as well.65

One caveat remains. All of the authors I have discussed here thought of immoderate

sorrow (and its cohorts) not merely in properly pathological terms, the way a physician

would with a patient, but in the greater context of the human’s proper relationship with

God. This, together with the unity of the human person, requires a discussion of the proper

ordering of affects such as sorrow. This greater context must never be lost. Insofar as

psychiatry and psychology remained entrenched in naturalism, then tristitia immoderata is

just not the same as depression. To argue otherwise is either to ignore the entire human

experience or to be reductionistic.

64 To clarify: “p is a separable part of some whole W = def. p is a particular and p can exist if it is not a part of W.” Cf. Moreland (2008: 11).

65 We see some somatic effects of this sad affect, namely, a weighing down or immobilization. We of course do not have, nor can we expect, access to any neural changes in Thomas’s account of tristitia immoderata.

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CHAPTER FOUR

Noche Oscura

« C'est un purgatoire avant la mort, mais un purgatoire où l'âme mérite et où son amour grandit beaucoup. » [“It is a purgatory before death, but a purgatory where the soul merits and where its love grows much.”] — Réginald Garrigou-Lagrange, O.P.1

In this chapter, I examine noche oscura (“dark night of the soul”) the Carmelite spiritual conception of spiritual growth and perfection. The aim of this chapter is to (1) to describe and explain the nature of the dark night of the soul, and then (2) compare and contrast this condition with depression. The purpose of Section 4.0 is to give a rationale for noche oscura’s inclusion in this larger dissertation. In the course of doing this, we must immediately introduce distinctions about different kinds of “dark nights”—especially

between the kind St. John of the Cross taught about and the kind that have become popular

fodder for spiritual writers of all stripes today.

Putting aside these latter kinds, I take Section 4.1 to describe and explain the

original Carmelite conception of “dark night of the soul” in the works of St. John of the

Cross, that of a path of sanctification to union with God, symbolized as the ascent and the

summit of Mt. Carmel, respectively. In Section 4.2, I extend the original account to

consider the question of whether someone might experience some further dark night even

upon reaching union with God, using St. Mother Teresa Calcutta’s autobiographical

1 Garrigou-Lagrange (1938: 662), translation mine.

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accounts of her own darkness as a test case. Finally, in 4.3 I conclude the chapter with an

examination of noche oscura compared to depression. As I have said with all the preceding

chapters in this dissertation, this is one of only five historical conditions I examine with

respect to its similarity to depression. I leave it to the final concluding Chapter Seven to

discuss the wider implications this study has for our understanding of depression.

4.0 - Rationale for Inclusion

We must at once distinguish between two very different notions of the “dark night

of the soul”: the popular or contemporary view, and St. John of the Cross’s own view. With

respect to the latter, “dark night” (or noche oscura) refers to a spiritually transformative

experience, in the contemplative Carmelite tradition, of becoming more perfect and of

reaching union with God, which may or may not itself be associated with phenomenal

feelings of darkness or even sadness; rather, it derives its name “night” from the way in

which the beginning, middle, and end of this spiritual transformation each, in its own

peculiar way, resembles a night (A1.2.1; 74-75).2 On the other hand, we have the present- day popular conception of “dark night”, which has been watered down to mean various things.

In this section, I discuss briefly some of the more recent, diluted notions of “dark night of the soul,” not only to distinguish them from St. John of the Cross’s view, but also

2 I elaborate more, just below, on these three reasons why it is called a “night,” according to St. John of the Cross. Cf. Kavanaugh & Rodriguez (1964/1973: 47). In the numbering of chapters and paragraphs, I follow Kavanaugh and Rodriguez (1964/1973: 37): “We use the following signs in referring to the major works: A=The Ascent of Mount Carmel; N=The Dark Night; C=The Spiritual Canticle; F=The Living Flame of Love. Following these identifying letters, we give the number of the book and chapter, or of the stanza, and then the number of the paragraph.” The only departure from this system is in using “.pro” after a book’s sign to refer to its prologue. Beyond this, for even greater clarity of reference, I have also included the pagination to their 1964 edition.

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to show how easily the Carmelite concept can be compared to (or mistaken for) some kind

of depression. According to one author, this once robust and specific notion has now

become

...an easy label for anything ranging from a few bad days in a row to the death of a loved one. People now say they are going through a dark night in circumstances that used to be described merely as miserable, and we are beginning to hear the chorus of reaction as well, as various experts weigh in and bemoan the cheapening of the term. Clearly, the danger of diluting a highly specific spiritual notion is real and present. Even in his own time John of the Cross himself was at great pains to distinguish the various nights of the soul from mere melancholia…As “the dark night” gains increasing currency, the words, like any much-used coin, are rubbed smooth by rough usage and come to mean many things to many people.3

What seems to hold these “many things” together, the common thread running through

them all, is that they involve a difficulty which can be made sense of in terms of its spiritual

significance. This is not much more helpful, however, for “spiritual” is another word that

has been “rubbed smooth by rough usage” to the point that it can mean various different

things. Indeed, Farrington (2009), although he displays some familiarity with St. John of

the Cross’s writings,4 himself recognizes that that sanjuanist “noche oscura,” properly

speaking, is something different than what he is talking about in his memoir, A Hell of

Mercy: A Meditation on Depression and the Dark Night of the Soul. Farrington simply

dispenses with the need for precise usage altogether,5 and thus can “get away with” a

3 Farrington (2009: 4-5).

4 On the one hand, Farrington is familiar with the fact that the standard scholarly version of St. John of the Cross’s works is the volume by Fathers Kavanaugh and Rodriguez. On the other hand, this familiarity shows itself to be limited to the surface, as when he takes the “nada” from the Sketch of Mount Carmel in a Hinduistic sense.

5 Farrington explicitly concedes, “I’m not writing this, in any case, for those looking to have their path precisely delineated…” (2009: 5).

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syncretistic smash-job of “the dark night of the soul” and Western Hinduism, with some

Rheinland mysticism, courtesy of Meister Eckhart, thrown in for good measure.

This pernicious and diluted popular notion of “dark night” pops up in various other

places, and some of it has seeped into explicitly Catholic Christian contexts. Psychologist

Fr. Raymond E. Runde’s (1991) Depression: The Dark Night of the Soul roughly equates

the two. After reading of Thérèse de Lisieux’s own experience of overwhelming darkness,6

Runde infers that Thérèse’s ailment must have been depression: “the words leaped out at me from the pages when I read about her depression. I had felt the same way she did. By then I had begun to formulate my theory of depression.”7 (It is sadly ironic that Runde did

not appear to grasp how Thérèse’s being a Carmelite nun would have shaped the way she

spoke about the “dark night,” viz., consistent with John of the Cross’s Carmelite tradition,

a purifying path to holiness and union with God.)

Psychologist Glòria Durà-Vilà’s (2017) Sadness, Depression, and the Dark Night

of the Soul: Transcending the Medicalisation of Sadness includes interviews of Catholic monks, nuns, seminary students, and devout laypersons in Spain, patria of San Juan de la

Cruz. One might expect that, of all places, of any demographic, this would be the ideal place for finding folks imminently familiar with John of the Cross’s noche oscura. But the truth is, how exactly these religious interviewees understand the “dark night” is unclear.8

6 In Thérèse de Lisieux (1912) The Story of a Soul [L'Histoire d'une Âme], Ch. 9.

7 Runde (1991: xii).

8 One can tell, for instance, by the excerpts from interviews (Durà-Vilà 2017: 154-55), that the monks, in making no explicit mention of sadness or sorrow (despite Durà-Vilà’s hasty inferences to the contrary), may have something quite different in mind that what Durà-Vilà does.

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(Perhaps it would be different if Durà-Vilà had interviewed Carmelites.9) On the other

hand, it is clear that Durà-Vilà is using “dark night of the soul” to mean “salutary, non-

pathological sadness within a religious conceptual framework.”10 And this is far from what

St. John of Cross was referring to.

According to Durà-Vilà, the “dark night of the soul” presents with both

psychological symptoms: “confusion, anxiety, poor concentration, self-doubt, guilt, fear of not overcoming it [i.e., the dark night], distress, disappointment, frustration, vulnerability”; and physical symptoms: “tearfulness, crying, poor appetite, tiredness, poor sleep.”11 These,

of course, match very closely with some symptoms of depression, as we have seen. For

Durà-Vilà, however, depression and the “dark night of the soul” are not the same, as one

is salutary and the other is pathological.

On Durà-Vilà’s view, framing one’s “normal sadness” in this salutary way,12 the

sufferer avoids the negative effects that arise when sadness is pathologized, which Durà-

Vilà thinks is damaging. This alternative framework, therefore, is considered primarily for

its therapeutic value—i.e., how it fares in promoting the mental health and well-being of

the sufferer who believes in it. Its value lies in its ability to attribute meaning to the

experience of psychological suffering.

9 “The monks of the Monastery of Saint Oriol belong to the Cistercian Order, and the nuns participating in the study, although coming from various monasteries, all form part of the Order of Saint Augustine” (Durà-Vilà, 2017: 77).

10 Cf. Durà-Vilà (2017: 43-48).

11 Durà-Vilà (2017: 157).

12 It appears that Durà-Vilà takes “normal sadness” to be a genus, a species of which is the Dark Night of the Soul (i.e., salutary religious depression). See Durà-Vilà (2017: 317-21). At one point, Durà-Vilà phrases things this way: “...as a way to set normal sadness, and the Dark Night of the Soul in particular, apart from depression” (2017: 321).

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Having taken notice of Durà-Vilà’s view of the “dark night” as “non-pathological religious sadness” in an earlier work (Durà-Vilà and Dein 2009), philosopher Anastasia

Scrutton (2015a) raises some concerns about applying this framework. First, Scrutton argues, this view seems to idealize or romanticize, and therefore ignore the reality of, psychological suffering. Second, it excludes sufferers who do not recognize, conform to, or conceptualize from within the Dark Night religious paradigm. For such persons, they simply do not have recourse to these therapeutic means.

While Scrutton’s paper (2015a) provides important insights into Christian theologies of depression,13 there are a couple elements in her account that raise red flags.

The most glaring is her apparently uncritical presumption that the psychological suffering

or acute mental distress self-reported by religious individuals is depression. She goes

further to interpret the religious suffering of Ste. Thérèse de Lisieux, St. Teresa of Calcutta,

and St. Paul of the Cross as simply depression. Perhaps it is; but this is not at all obvious.

(And, in any case, diagnosing any historical figure is fraught with difficulties.14) Such an

assumption is understandable, since the symptoms are similar, and it makes dialectical

sense given that Scrutton is interested in Christian theologies of depression in particular.

But Scrutton simply takes their having depression as a given. Moreover, by focusing

13 Scrutton observes that there are three major kinds of Christian theologies of depression (and of mental suffering in general, one can presume). “(i) Spiritual illness (SI), in which depression and other forms of mental illness are believed to be a kind of SI. This includes the ideas that depression is caused by sin or demons (or both); (ii) Spiritual health (SH), where depression is viewed as an indication of (and means to furthering) holiness or closeness to God; and (iii) Potentially transformative (PT), where depression (along with many other instances of suffering) is inherently bad and undesirable, but can become the occasion for the person’s spiritual growth (e.g., compassion, insight, appreciation of beauty)” (Scrutton, 2015a: 275).

14 Cf. Beveridge (2004), Muramoto (2014).

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myopically on the sufferer’s own experience of suffering, she hazards ignoring God’s

agency, His activity and interaction with the sufferer.

Now, some authors like Durà-Vilà (2017), Durà-Vilà and Dein (2009), and Font i

Rodon (1999) have attempted to contrast this novel, retrofitted, agreed-upon notion of

“Dark Night of the Soul” (qua “salutary religious depression”) with what they call

“pathological religious depression” (see Fig. 4.1). Even though they are mistaken in referring to this as the “dark night of the soul,” they are asking important questions about distinguishing between “salutary” and “pathological” religious depression, whatever religious depression exactly is.15

Here I make no attempt to weigh the merits of this distinction these authors are trying to

introduce; simply because I think they begin on the wrong foot, with identifying “salutary

religious depression” with the “dark night of the soul.” At the same time, I think such

15 I shall venture more on this question in Chapter Seven Conclusion.

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attempts are worthy of our interest, but they must begin with more precise and correct

categories.

To recap, there are many ways authors are imprecisely—and incorrectly—using the

term “dark night of the soul.”16 You have what may be termed the syncretistic usage, which

we saw in Farrington, who borrows from Carmelite tradition and mixes it with Western

Hinduism. Then we have a kind of synonymous usage, as we see in Runde, where “dark

night of the soul” is thought of virtually as interchangeable for “depression.” In response

to this usage, since “nowadays many Dark Nights are labelled as depression,”17 the final

camp below “calls for a different way of understanding and dealing with this experience,

one that deals with the very meaning of life, insisting that depression is a label and a

syndrome, whereas the Dark Night is a meaningful event.”18 This can be termed the therapeutic usage, since it is a label used primarily as a way to restructure one’s experience

of (what’s considered) normal sadness from negative to positive. (And as we just saw,

Durà-Vilà, along with Dein and Font i Rodon, even go so far as to try to delineate their

therapeutic usage from pathological religious depression—though the pathological kind

doesn’t get termed “dark night.”)

As we can see, using multiple meanings for the term “dark night of the soul,” so far

from the original meaning, can lead to much confusion. I therefore propose that we return

16 There are nearby phenomena in other Christian traditions, such as “spiritual desertion” that we find in the writings of Puritan Joseph Symonds (1642; cf. Wang 2011, 2013). It is possible that the Puritan spiritual desertion and the Carmelite dark night of the soul are two species of the same genus (e.g., of spiritual dryness). It is also possible that these are two names for the same phenomenon. Unfortunately space precludes giving a fuller account of these here.

17 Durà-Vilà (2017: 44).

18 Durà-Vilà (2017: 44).

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to the original sense of the term to determine what, if any, connection it may have to

depression.

4.1 - Noche Oscura in St. John of the Cross (1542-1591)

To understand noche oscura, we turn directly to the writings of St. John of the Cross

(1542-1591). As Kavanaugh and Rodriguez (1964/1973) are clear to point out, The Ascent

of Mount Carmel and The Dark Night are actually two parts of one work, often referring to

them simply as The Ascent-Dark Night.19 The purpose of this work is to show the individual believer how to reach the “high state of perfection” (1964/1973: 44), represented as the summit of Mount Carmel. “The aim of the spiritual life, as the Mystical Doctor envisioned it, is the state of perfect union with God through love” (1964/1973: 45), and The Ascent-

Dark Night is offered as the instructive means to reach this goal. For centuries saints have made independent attempts to lay out, in various ways, the path which ends in closer union with God, oftentimes chronicling a journey they themselves have taken: St. John Climacus

(579-649) in The Ladder of Divine Ascent, St. Bonaventure (1221-1271) in The Journey of the Mind to God, and St. Ignatius of Loyola (1491-1556) in Spiritual Exercises. What sets apart St. John of the Cross’s The Ascent-Dark Night, however, has to be the attention he gives to the phenomenal experience of God’s (apparent) absence.20

19 “He informs us that he will deal with the active night or purification of the sensory part in the first section of his work, with the active night of the spiritual part in the second and third, and with the passive night in the fourth part” (1964/1973: 48). Given that The Ascent is only three books long, The Dark Night is considered the fourth part.

20 As we shall see, while this phenomenal experience is associated with noche oscura, this is not itself noche oscura; properly speaking, noche oscura is the path to union with God along which one encounters this experience. (That is, the latter is a necessary condition for the former, and is the reason for the path’s name.)

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More than simply the originator of the phrase and the framework, if not the idea

itself,21 St. John of the Cross was named Doctor of the Church in 1926, a fact which reveals the importance and authority of his writings. At the time, Pope Pius XI had written:

“Although they treat of difficult and profound matters, The Ascent of Mount Carmel, The

Dark Night of the Soul, The Living Flame of Love, and several other shorter works and letters written by him, are nevertheless full of such sound spiritual doctrine and are so well suited to the reader’s understanding, that they are rightly looked upon as a code and guide for the faithful soul endeavoring to embrace a more perfect life.”22

A final word of introduction, especially as it relates to our inquiry regarding

depression, is St. John of the Cross’s own stated reasons for calling this phenomenon a

“dark night.” It turns out that his choice of terminology has little, if anything, to do with

sadness. Rather, the three reasons he explicitly gives at the outset of The Ascent involve:

(i) the point of departure (denial and privation of one’s senses), (ii) the means (the road of

faith), and (iii) the point of arrival (God and His communication with us) (A1.2.1; 74-75).23

4.1.0 - Union with God

Since “union with God” features so prominently as the goal of this entire journey,

it is worthwhile to examine what St. John of the Cross means exactly by this phrase, “for

21 The “ascent” motif, however, had appeared before, “in the 1535 Subida del Monte Sión (Ascent of Mount Zion) by the Franciscan friar Bernardino de Laredo” (Appelbaum 2007: xiii).

22 Kavanaugh & Rodriguez (1964/1973: 35). These written works of “sound spiritual doctrine” are limited, however, in their scope, covering things only of a mystical nature, such as that of embracing “a more perfect life” in supernatural union with God—rather than someone like the Doctor Angelicus St. Thomas Aquinas, whose written works cover a far wider range of theological topics. Hence the association of mysticism with St. John of the Cross, called the Mystical Doctor.

23 Cf. Kavanaugh & Rodriguez (1964/1973: 47).

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through an understanding of the goal, an explanation of the path reaching up to it is more

intelligible” (1964/1973: 45).24 First, this union is a supernatural union, as opposed to “the

natural or essential [or substantial] union by with God is always present in creatures

preserving them in being” (1964/1973: 45). Second, it is nothing less than a “total and

permanent union according to the substance of the soul and its faculties” (A2.5.2; 115,

cf.46). Third, it is a habitual union,25 “distinguishable from the more intense actual unions

which, though supernatural and total, are transient, incapable of being permanent here on

earth” (46).26 Finally, this habitual state of supernatural and total union can be called, in

short, a “union of likeness” produced by love (A2.5.3; 116, cf.46). This brings to mind a

similar distinction made by Thomas Aquinas between a “union of affection” (unionem

affectus) which is effected by love (amor), and a “real union” (unionem realem) which

persons have with those “who are connected with them and are similar to them” (ST II-

II.30.2.co). We do not know whether John was relying upon this distinction from Thomas;

we do know that he was very well educated,27 and at times he borrowed terminology from

24 For more explanation on the nature of union with God, with an illustration, see A2.5.

25 The word “habitual” here does not mean “periodic” or “occasional”; instead, it refers to habitus, or disposition to act. As John of the Cross says later, “The lack of conformity with God’s will can be not only in one’s acts, but in one’s habits as well. Not only must actual voluntary imperfections cease, but habitual imperfections must be annihilated too” (A2.5.4; 116).

26 John of the Cross explains, “And I shall be speaking of the obscure habit of union, for we will explain later, with God’s help, how a permanent actual union of the faculties in this life is impossible; such a union can only be transient” (A2.5.2; 115).

27 “It is uncertain whether or not John studied philosophy while he was at this college, but we can affirm that he left the Jesuit College ‘well trained in Latin and rhetoric,’ and that ‘he learned to read and write very well,’ and that ‘to these years [1559-63] must be assigned his first contact with the Latin and Spanish classics and the beginning of his love for humanism...on the basis of an abundance of exercises, reading, and composition” (Kavanaugh and Rodriguez, 1964/1973: 17).

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the Scholastics.28 In any case, Thomas’s distinction is helpful in this regard. We can think

of a union of affection with God as a necessary and first step to a union of likeness with

God.

On this schema,29 if union with God is the goal, then the path is, according to St.

John of the Cross, noche oscura. “The poetic figure ‘dark night’ provided St. John of the

Cross with a mysterious-sounding metaphor to designate the entire way leading to union

with God. The path, then, in the center of the mount of perfection, and which alone leads

to the summit, is a dark night.”30 It is well worth noting that, while the path is often

characterized negatively, in terms of purgation or purification, and given the isolation from

God one is likely to feel; its positive characterization cannot be forgotten, not only in terms

of the goal, but also in the motive for undertaking the path. “[F]or the effort to purify is an

effort of love; love’s very function calls for this purification by conforming the human will

to the divine will and directing all the soul’s activity toward God.”31

4.1.0.1 - A note on the writing/text. While his poetry is highly praised and holds prominence in Spanish literature,32 the prose of St. John of the Cross is, frankly, not as

28 Cf. Kavanaugh and Rodriguez (1964/1973: 36).

29 It is unclear whether St. John of the Cross really believes that the dark night of the soul schema is the only path one can take to union with God. Must everyone go down this mystical path? Perhaps he would admit that God could certainly draw people to himself in other ways. On the other hand, perhaps St. John means for this schema to be interpreted quite broadly, for there are many different kinds of individuals of varying progression along the path: “Not everyone undergoes this in the same way, neither are the temptations identical” (N2.14.5; 394).

30 Kavanaugh and Rodriguez (1964/1973: 47).

31 Kavanaugh and Rodriguez (1964/1973: 46).

32 “His poetry, too, was partly the fruit of his darkness” (Kavanaugh & Rodriguez 1964/1973: 15).

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good. “It is in the main didactic and often discursive…We find it is quite unpolished (he

himself complained of his style), cluttered with repetitions, redundancies, ambiguities, split

constructions that are often complicated and obscure, Latinisms, and so on.”33 Another translator adds, “Its style is sometimes dry and rugged, and its argumentation occasionally obscure.”34 This presents some difficulty in gathering clear meaning on ambiguous

passages. For instance, “St. John’s many-faceted use of the figure ‘night’”35 can lead one

to suspect he is equivocating at times. It is unfortunate, but this means that any close

reading of The Ascent-Dark Night will thus be necessarily interpolated with the reader’s

own best inferences as to what the saint means.36

We see this ambiguity in the way in which St. John of the Cross himself seems to

divide his work The Ascent-Dark Night. On the one hand, he divides the work into four

parts: the active night of the senses (A1.1-A1.15), the active night of the spirit (A2.1-

A3.45), the passive night of the senses (N1.1-N1.14), and the passive night of the spirit

(N2.1-N2.25). On the other hand, translators Kavanaugh and Rodriguez see another

division into three parts, based on the three reasons for calling the phenomenon a “dark

night”: the point of departure (denial and privation of one’s senses), the mean (the road of

faith), and the point of arrival (God and His communication with us). They base this on St.

John of the Cross’s remark at the end of Chapter 2 in Book 1 of The Ascent, “To provide

33 Kavanaugh and Rodriguez (1964/1973: 34-35).

34 Appelbaum (2007: xiii).

35 Kavanaugh and Rodriguez (1964/1973: 47).

36 It does not follow, however, that all of his prose is bad. “[T]here are not lacking prose passage in which the Mystical Doctor shows plainly his literary genius for expressing a thought in phrases of beauty, originality, and power” (Kavanaugh and Rodriguez 1964/1973: 35).

135 further enlightenment about this, we shall discuss each of these causes of night separately”

(A1.2.1; 74-75), after which he begins discussing the mortification of the senses in Chapter

3. I see no such threefold division of The Ascent-Dark Night (in the form we receive it37) if we take this remark, not as a statement of how he shall proceed, but to mean that he shall discuss each cause as the matters arise. That is, it is not a plotted path or outline but the introduction of an important general division of what he will address when the opportunity arises. This is likely his meaning, especially given that it was in the immediately preceding

Chapter 1 in Book 1 where he had given us his plotted path in four parts.38 (I revisit this discrepancy below in Sec. 4.2.2.)

4.1.0.2 - Sanjuanist terminology. As best we can tell, if we are to remain faithful to St. John of the Cross’s use of terminology, the “dark night of the soul” is a general category to which the more specific “dark night of the senses” and the “dark night of the spirit” belong.39 (Although the term “dark night of the soul” is often used in common parlance to refer to God’s felt absence,40the more appropriate term would be the more

37 I suggest here and argue below that, given that The Ascent-Dark Night is an unfinished work, we are largely missing the third night, which is the nature of God’s communication with us, once we have reached union with God at the Summit of Mount Carmel.

38 There he presents the fourfold division (and way of proceeding) this way. In the prologue preceding Chapter 1, he presents a poem “The Dark Night” (likely written at a prior time). Chapter 1 begins with a recitation of the first stanza followed by an explanation. “To understand this departure one should know that a soul much ordinarily pass through two principal kinds of night” (A1.1.1). “The first night, or purgation, which this stanza refers to, and which will be under discussion in the first part of this book, concerns the sensory part of man’s nature. The second stanza refers to the night of the spiritual part of man’s soul, with which we shall deal, insofar as the purgation is active, in the second and third parts of our book. In Book Four [The Dark Night] we shall discuss the passive purgation” (A1.1.2).

39 Here is one representative comment: when he says, in the prologue to The Ascent, that he’ll be discussing “the signs for the recognition of this purification of the soul (which we call the dark night), whether it is the purification of the sense or of the spirit…” (A.pro.6; 71-72, italics in original).

40 Cf. Durà-Vilà (2017), Moore (1940/1994), etc.

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specific “dark night of the spirit.”) This division reflects St. John of the Cross’s ontology

of the human person, a division of the soul into the “sensory part of the soul” and the

“spiritual part of the soul.” Kavanaugh and Rodriguez summarize the powers and faculties

of each part in the following way:

The sensory part, which has to do with sensible or corporal [sic] objects, possesses exterior sense faculties of sight, hearing, smell, taste, and touch; it also claims inner sense faculties, which he reduces to the phantasy and the imagination...The spiritual part of the soul, which is concerned with spiritual or incorporeal objects, numbers three faculties: intellect, memory, and will. The sensory faculties as well as the spiritual faculties of intellect and memory are cognitive; they involve the perception, or as the Saint terms it, apprehension and cognition of objects. The will on the other hand is an appetitive faculty. It inclines toward the good; to it, consequently, are related the appetites and the emotions or passions of joy, hope, fear, and sorrow.41

This shares some similarities with a Thomistic ontology of the human person, which

divides the soul into the intellect and the appetite, which itself is divided into the sensitive

appetite (to which the passions belong) and the intellective appetite (i.e., the will). The

sanjuanist use of “cognitive” is akin to Thomas’s sense of apprehension; Thomas tells us

that even for the passions, apprehension of an object must precede affect,42 and this appears to be the same for John of the Cross.

While the “dark night of the soul” as a general phenomenon is what most concerns

St. John of the Cross, he also acknowledges that there are more things that can be called a

“dark night” (noche oscura): “The darknesses and trials, spiritual and temporal, that fortunate souls ordinarily encounter on their way to the high state of perfection are so

41 Kavanaugh and Rodriguez (1964/1973: 47). For more on the sensory part of the soul, see A2.11.1; A2.12.1; A2.12.3; as well as C.28.4-5. For more on the spiritual part of the soul, see A2.6.1; A2.6.4-5; and A3.16.2.

42 An affect is partly constituted by an apprehension, or construal, of a sort. See Roberts (2003, 2007, 2013) who understands emotions as “concern-based construals.”

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numerous and profound that human science cannot understand them adequately; nor does

experience of them equip one to explain them. He who suffers them will know what this

experience is like, but he will find himself unable to describe it” (A.pro.1). He probably is

referring here to the tokens, rather than types, of darknesses and trials that are “so

numerous” along the path. (Elsewhere, he says there are “two principal kinds [i.e., types]

of night” (A1.1.1).) Nevertheless, this reveals another usage of “dark night” or “darkness”

we should accustom ourselves to seeing as we read St. John of the Cross, viz., as a token-

specifier. In general, when he uses the term “dark night” or the word “night” with no further predication, the context should make it clear whether it is referring to the general category of the “dark night of the soul” or to one of its two principal kinds.

One final thing to make clear is the actual referent of the term “noche oscura” or

“dark night” (of the soul). It of course connotes the phenomenal experience from which it

derives its name; however, properly speaking, the “dark night of the soul” refers to the

entire path upon which one traverses on the way to union with God.43 Since the notion of

a path, or a journey, is frustratingly metaphorical, we might say with more precision that

the “dark night of the soul” is the name given to the state an individual is in when he

journeys closer to union with God. We can say no less than this, because the being on this

path, where union with God is the goal, is a necessary condition of being in the dark night

of the soul. The mere feeling of God’s apparent absence, or any other or phenomenal

experiences associated with the dark night of the soul, is not sufficient for being in the dark

night of the soul.

43 It is the path upon which the “soul journeys toward that divine light of perfect union with God which is achieved, insofar as possible in this life, through love” (A.pro.1; 69).

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We shall proceed in the following fashion. First, I wish to explain the nature,

purpose, and phenomenal qualities of the dark night of the senses. Second, I must do the

same with the nature, purpose, and phenomenal qualities of the dark night of the spirit.

Since we cannot dispense with St. John of the Cross’s distinction of the active vs. the

passive night—i.e., what the individual must do vs. what God is doing—I shall split the treatment further into two. So we have ultimately four parts, in this order: the active dark night of the senses, the active dark night of the spirit, the passive dark night of the senses, and the passive dark night of the spirit.44

4.1.1 - Dark Night of the Senses — Active (A1.1—A1.15)

“The first night (i.e., the night of the sense) is the lot of beginners, at the time God

commences to introduce them into the state of contemplation; it is a night in which the spirit of man also participates, as we shall explain in due time” (A1.1.3; 73). Significant here is the inclusion of the spiritual part of the soul during this dark night of the senses. We saw above that the sensory part of the soul is largely comprised of the five empirical sense faculties and the inner sense faculties such as phantasy and imagination. Shutting these

“windows,” as John of the Cross calls them,45 to the outside world leaves the soul in a kind

of darkness; just as shutting out the light (to take one’s faculty of vision as the primary

44 This is John of the Cross’s own ordering, and I find it especially pedagogically useful.

45 Cf. A1.3.3; 77. In this respect John of the Cross sounds like an empiricist, since he says that without access to the world through these windows, we would have no knowledge. “The cause of this darkness is attributable to the fact that—as the scholastic philosophers say—the soul is like a tabula rasa (a clean slate) when God infuses it into the body, so that it would be ignorant without the knowledge it receives through its senses, because no knowledge is communicated to it from any other source” (A1.3.3; 76). But is that no knowledge of the outside world, or no knowledge full-stop? Presumably he cannot mean the latter, since he thinks a kind of muted knowledge of God is still possible for an individual under such circumstances, though it comes from within, where God had put it: “Nor did I look at anything, / With no other light or guide / Than the one that burned in my heart;” (Dark Night poem, Stanza 3).

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example) leaves one in literal darkness, unable to sense what is there, the mortification of

the appetites “is like living in darkness and in a void” (A1.3.1; 76). But the faculties of the

sensory part of the soul, in their usage, necessarily also involve the usage of the intellect

(in the spiritual part of the soul), such as in the apprehension of an object. This is why John of the Cross says that “it is a night in which the spirit of man also participates” (A1.1.3;

73).

The emphasis here is on the individual’s purgation or mortification of her own

senses, “to unburden [oneself] of all earthly things” (A1.pro; 68). In many ways this ascetic

practice of taming one’s desires and appetites, resembles the Stoic philosophy of subduing

one’s passions in service to one’s reason. But the primary—and definitive—difference

between these two is the end (telos) for which this mortification is done. For the Stoic, the

purpose of subduing one’s passions and desires is for the liberty of the intellect, which

would otherwise be burdened by these affects which are not amenable to good reasoning.46

For the dark night of the senses, it is a process borne essentially out of love for God; the

dark night of the senses gains its primary value not intrinsically, but instrumentally, as a means to the ultimate end of union with God.47

46 This is an unfortunately common and wrongheaded view of the relation between the passions and the intellect, since it does not consider the positive contributions that emotions can make to one’s reasoning.

47 We shall see this arise again in the dark night of the spirit; I share here a passage from The Ascent concerning the night of the spirit, but also quite pertinent to the night of the senses: “In each of these books the reader must keep in mind the intention we have in writing. Failure to do so will give rise to many doubts about what he read…Observing how we annihilate the faculties in their operations, it will perhaps seem that we are tearing down rather than building up the way of spiritual exercise. This would be true if our doctrine here were destined merely for beginners, who have to prepare themselves through these discursive apprehensions. But we are imparting instructions here for advancing in contemplation to union with God…As a result one has to follow this method of disencumbering, emptying, and depriving the faculties of their natural rights and operations to make room for the inflow and illumination of the supernatural” (A3.2.1-2; 214-15).

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Perhaps a happy coincidence, the experiences one undergoes in the dark night of

the senses strongly parallels with the qualities of acedia qua passion when it is properly

regulated by reason, which we saw in Thomas Aquinas’s thinking from Chapter Two

Tristitia. Recall that Bloomfield (1952) had characterized acedia as spiritual dryness.

Wenzel (1960b) actually takes issue with his teacher’s assessment, cautioning against

associating acedia with spiritual dryness in general or noche oscura in particular.

The notion of “spiritual dryness” as a synonym for the original meaning of acedia is rather misleading because it suggests connections with mysticism and the Dark Night of the Soul described by St. John of the Cross. To carry modern notions of mysticism which are based on the sixteenth-century Spanish mystics into medieval views on the contemplative life is a dangerous undertaking, for the “spirit of acedia” as it was experienced by the desert monks, and the notion of acedia as it was held by St. Bernard, Peraldus, and Thomas Aquinas, were clearly not the same as what is today understood by “spiritual dryness.”48

Wenzel’s concern notwithstanding, it is possible that what is happening in the first night,

the active dark night of the senses, is very much akin to the properly governed, moderate

acedia (qua passion) which I discussed in the previous chapter. (In his defense, Wenzel is

concerned primarily, perhaps only, with acedia qua capital Sin.) After all, the Mystical

Doctor is describing an experience in which the subject does what she can to deaden the

sensory appetites.

This dark night is a purgation not of things which satisfy the desires, but of the desires themselves. Commenting upon David’s Psalm 87:16 (“I am poor and in labors from my youth”), St. John of the Cross explains: “Even though he was manifestly rich, he says he was poor because his will was not fixed on riches; and he thereby lived as though really poor. On the other hand, had he been actually poor, without his will being so, there would

48 Wenzel (1960b: 164-65).

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have been no true poverty, because the appetite of his soul would have been rich and full”

(A1.3.4; 77). By analogy, St. John of the Cross teaches this fullness can only be filled by

God, and that this first dark night, in its active manner, or mode, is necessary for the

purpose of deadening one’s appetites for created things so that they can be rightly ordered

to God.

Importantly, this is the case whether or not a person has possessions or objects

which would satisfy these old desires. That is, one cannot accomplish this stage simply by

tossing out all of her possessions. “For we are not discussing the mere lack of things; this

lack will not divest the soul, if it craves for all these objects. We are dealing with the

denudation of the soul’s appetite’s and gratifications; this is what leaves it free and empty

of all things, even though it possesses them” (A1.3.4; 77) Such is the goal of the active

dark night of the senses.

4.1.2 - Dark Night of the Spirit — Active (A2.1—A3.45)

The second night, in the active mode, is the next subject of consideration.

Remember that although we can enumerate these as four different nights, they are really

only two nights, that of the senses and that of the spirit, and two modes for each one. Thus,

this active night of the spirit corresponds equally to the passive night of the spirit, albeit in

a different mode, or manner of proceeding, depending on whether one is talking about the

subject’s actions or about God’s actions. Here we are concerned with the subject’s actions.

This second (part of) night is the darkest; it is also called the “journey of faith”

(A2.3-4).49 It is the means between (i) the point of departure, the first night, the night of

49 As noted previously, St. John of the Cross applies the term “night” to various different uses. As Kavanaugh and Rodriguez (1964/1973: 47) acknowledge this saying that they are unable to “explore in this limited introduction St. John’s many-faceted use of the figure ‘night.’” Therefore, while this “second night” 142

the senses, and (ii) the point of arrival, the third night, of which God is the cause.50 St. John

compares faith, in the dark night of the spirit, to midnight, saying: “Faith, the means, is

comparable to midnight...The first part, pertinent to the senses, resembles twilight...The

third part, that period before the dawn, resembles the light of day” (A2.2.1; 109).

St. John of the Cross relies upon the three theological virtues—faith, hope, and

charity—for his schema in this second night. Whereas the night of the senses purifies the

appetites, the night of spirit cultivates the theological virtues. This also is done by means

of purification. The intellect is purified through faith (A2); the memory is purified through

hope (A3.1-15); and the will is purified through charity (A3.16-45). And just as the sensory

appetites were, in a way, darkened or mortified, so too are the faculties of the soul darkened

or emptied to achieve this purification.

The “theological virtues (faith, hope, and charity, related to these faculties as their proper supernatural objects [intellect, memory, and will], and through which the soul is united with God) cause the same emptiness and darkness in their respective faculties: faith in the intellect, hope in the memory, and charity in the will” (A2.6.1; 119, emphasis added).

Of the three, I shall henceforth focus only on charity, which is primarily love of and

friendship with God. If a person is to cultivate charity, it requires not merely the withdrawal

of affection from other things, but a purification and reorienting of whatever faculty or

faculties are responsible for directing one’s love and affection so that these may be turned

rightly upon God. That faculty is the will, since it can govern and indirectly steer one’s

can be considered one night of three, I will sometimes include the parenthetical reminder “(part of)”, since St. John of the Cross explains, “In actuality these three nights comprise only one night, a night divided into three parts” (A1.2.5; 75).

50 “Faith, the second part of this night, is our next subject for discussion. Faith is that admirable means of advancing to God, our goal. And God, as we said, is also for the soul a part, or the third cause, of this night” (A2.2.1; 109).

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affections from one object to another. In this process, a person may feel as if his will has

been emptied, as the saint writes, “Charity, too, causes a void in the will regarding all

things, since it obliges us to love God above everything. A man has to withdraw his

affection from all in order to center it wholly upon God” (A2.6.4; 120).

This may seem like a terrible and painful process—“a void in the will,” “emptiness

and darkness”—but it is both good and necessary for union with God. St. John of the Cross

moreover reminds us of all the harms that come along with having one’s will turned upon

created things: “Ink, paper, and time would be exhausted were we to describe the harm

which beleaguers the soul because it turns its affection to temporal goods” (A3.19.1; 242).

Such harms are the source of all worldly sorrows.

This is the root of all sorrow, which is worldly or inordinate, according to the saint:

the striving after different kinds of goods which pale in comparison to the joy of God.51 St.

John of the Cross discusses six such kinds of goods which one must turn his will away from in the dark night of the spirit: “temporal goods” (A3.18-20), “natural goods” (A3.21-

23); “sensory goods” (A3.24-26), “moral goods” (A3.27-29); “supernatural goods”

(A3.30-32), and “spiritual goods” (A3.33-45). At this point, the saint abruptly discontinues his treatise The Ascent, leaving this section unfinished. Based on what he had written and explicitly indicated up to this point, however, we can surmise that a completed treatise would include the following: the purification of all inordinate feelings or passions of hope, fear, and sorrow. This is based upon his enumeration of the four principal passions—joy,

hope, fear, and sorrow—in A3.16, upon his commencement with discussing joy in A3.17,

51 “Accordingly, if a man does not turn his joy to God in all things, it will always be false and illusory” (A3.21.2; 249).

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and, finally, upon the inference that the discussion of erstwhile goods in A3.18-45 is

situated properly under the header of joy in God as the norm (rather than under the topic of

sorrow, properly speaking). That is to say, in all of A3.16-45, he only gets around to directly addressing joy, and does directly address the other three principal passions, though it appears to have been his intention to do so. If this is right, we unfortunately miss out on

St. John of the Cross’s direct teaching on the disordering of sorrow, per se, though we are still able to infer some things about sorrow from his teachings on the disordering of joy.

St. John is aware that the soul’s turning its affection to temporal goods does not happen immediately, but there is a spectrum upon which one slides into idolatry and love of these goods. For the “natural goods,” for example, he notes four degrees of harm they bring upon an individual. From (i) “backsliding; a blunting of the mind in relation to God, darkening of God’s goods” (A3.19.3; 243), to (ii) the “dilation of the will in temporal things…[and neither] being afflicted about it, nor considering it to be so serious a matter”

(A3.19.5; 243) to (iii) becoming “so engrossed in the things, riches, and affairs of this world that they care nothing about…God’s law. Forgetful and sluggish about matters pertinent to their salvation, they become much more alive and astute in the things of the world” (A3.196; 244). In the fourth and final degree, the harms reminisce of depression.

Included here are

[A]ll those miserable souls who value earthly goods as their god, and are so enamored of them that they do not hesitate to sacrifice their lives when they observe that this god of theirs undergoes some temporal loss. They despair and commit suicide for wretched reasons...Since there is nothing to hope for from him, he gives despair and death. And anyone whom he does not pursue right up to death, the ultimate injury, dies from living in the affliction of anxieties and many other miseries (A3.19.10; 245-46).

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So, rather than seeing this an impossible, unbearable way to God, we see here St. John of

the Cross’s primary concern and reminder to us that God is the only good that truly and

fully satisfies.52

To summarize, what has been said here concerning charity, joy, and so on, applies

distinctly to the purification of the will. In the dark night of the spirit, there are three

faculties, corresponding to the three theological virtues, which must be purified. Though

there will naturally be some differences, we can apply what we have said about the will

(and charity) to these other two faculties, the intellect (and faith) and the memory (and

hope). The primary and most glaring difference is that the will is appetitive, while the

intellect and memory are cognitive (i.e., “they involve the perception, or as the Saint terms

it, apprehension and cognition of objects”).53 Yet even these faculties must be voided or

emptied, similar to the will. St. John of the Cross summarizes this common feature in this

way, “These virtues, as we said, void the faculties: Faith causes darkness and a void of

understanding in the intellect, hope begets an emptiness of possessions in the memory, and

charity produces the nakedness and emptiness of affection and joy in all that is not God”

(A2.6.2; 119).54

52 St. John of the Cross reminds us of this in his “Prayer of a Soul Taken with Love” (written probably in 1579): “So, my heart, why do you delay? Why do you procrastinate? From this moment on you can love your God!…What do you ask, what do you seek, my soul? Everything is for you and everything is yours! Do not think of yourself as little nor pay attention to the scraps that fall from the table of your Father. Rise…and take your glory in His! Hide yourself in it and be joyful; everything which your heart desires shall be yours” (Kavanaugh and Rodriguez 1964/1973: 669, cf.33).

53 Kavanaugh and Rodriguez (1964/1973: 47).

54 With respect to purifying/emptying the intellect, faith, though it “brings certitude to the intellect, does not produce clarity, but only darkness” (A2.6.2; 119). And with respect to purifying/emptying the memory, hope “also occasions emptiness, since it is concerned with unpossessed things and not with the possessed object” (A2.6.3; 120).

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4.1.3 - Dark Night of the Senses — Passive (N1.1—N1.14)

The passive dark night of the senses concerns what God is doing during this night.

Thus, what I have asserted above without subtlety should now be corrected. For the

believer is never alone in the dark night. The activity of the believer in this crucial process

cannot be fully understood without understanding God’s activity here.55 While the

resulting purification is impossible without personal effort,56 “human effort does little more than dispose one for the divine action.”57 All the while, human effort and divine action are

“parallel and simultaneous,” acting in cooperation, as opposed to successively. In this night of the senses, “God is likened to a loving mother who first nurses her child, carries and caresses it in her arms, but who then must wean it, teach it both to walk on its own and to put aside the ways of childhood.”58 But this metaphor is limited, for in the final analysis,

it is God’s divine intervention which is more clearly prevalent in the successive, final stages

of purification.

The similarities with depression are most apparent at the phenomenological level

of the believer in Dark Night. Although I had noted above a few painful aspects of this

night for the believer—in the purgation of one’s desires—the most painful is the purgation

55 I can only speculate as to St. John of the Cross’s nuanced philosophical views on human agency and its compatibility with theological Providence, but we can surmise a few key features of what such a view would look like, starting with the significant fact that he accounts for both the active and the passive as essential perspectives of the believer’s experience of growth in holiness.

56 “The purity implied is impossible without personal effort, but this effort, however intense, does not achieve the radical stripping demanded by the union. God's own intervention is necessary through a purifying communication that works passively, beyond the realm of what human effort can achieve” (Kavanaugh and Rodriguez 1964/1973: 355).

57 Kavanaugh and Rodriguez (1964/1973: 355).

58 Kavanaugh and Rodriguez (1964/1973: 355).

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of the desire of consolation from God. After all, “we are dealing with one who longs for

God with utmost love,” so to receive no consolation, “this feeling of being abandoned by

God, becomes the worst part of the suffering.”59

We cannot say for sure how long God will keep the believer in this “fast and

penance of the senses” (N1.14.5). It depends on “the greater or lesser amount of

imperfection that must be purged” and the experiences in this night are all “meted out

according to God’s will” (N1.14.5). Some go through quickly, and their experience is

intense; they “have more considerable capacity and strength for suffering” (N1.14.5).

Others “who are very weak he keeps in this night for a long time…They arrive at the purity

of perfection late in life” (N1.14.5). Some, however, “never reach it entirely”—a reminder

that, for many, the process of sanctification and growth in holiness extends beyond this life into the life to come (N1.14.5). Though this season seems dark to the believer going through it, God “does this to exercise them in his love, for without these withdrawals they would not learn to reach him” (N1.14.5). Nevertheless, as we know from experience, all souls who pass through this night “must usually remain in these aridities and temptations for a long while no matter how quickly God leads them” (N1.14.5, emphasis mine). At the

beginning of this night of the senses, the believer was only a beginner; henceforth, St. John calls him a proficient. There is yet more purgation to come.

59 Kavanaugh and Rodriguez (1964/1973: 356). “What the person undergoing the dark night experiences is a painful lack or privation: darkness in the intellect; aridity in the will regarding the exercise of love; emptiness of all possessions in the memory; and a general affliction and torment as a consequence. Such persons receive a vivid understanding of their own misery and think they will never escape from it. Their faculties seem powerless and bound; all outside help appear useless; they feel no hope for any breakthrough or remedy in the future. The effect of all this is the dread-filled experience of being abandoned by God” (Kavanaugh and Rodriguez 1964/1973: 356, emphasis mine)

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4.1.4 - Dark Night of the Spirit — Passive (N2.1—N2.25)

The passive dark night of the spirit concerns what God is doing during this night, also called the “journey of faith” (A2.3-4). It is concurrent with, and equal to, the active

dark night of the spirit, and the two are distinguishable only by their modes: the one active

and the other passive. Where the first night was likened to a loving mother who weans her

child, in this second night, “God's action is likened to fire working on and transforming a

log of wood.”60 The passive “emphasis is on allowing God to lead, on accepting the Lord's

work with all its consequences,”61 as opposed to the rule and spirit of asceticism that guided

throughout The Ascent.

John of the Cross explains, “If His Majesty intends to leads the soul on, he does not put it in this dark night of the spirit immediately after” the night of the senses (N2.1.1), but guides the (now) proficient believer along slowly, allowing him to exercise many years in this state of proficients. Here the soul “goes about the things of God with…more abundant interior delight than it did in the beginning before entering the night of sense” (N2.1.1).

Its [the soul’s] imagination and faculties are no longer bound to discursive meditation and spiritual solicitude, as was their custom. The soul readily finds in its spirit, without the work of meditation, a very serene, loving contemplation and spiritual delight. (N2.1.1)

But this is only a middle state before the next night.62

Nonetheless, the purgation of the soul is not complete. The purgation of the principal part, that of the spirit, is lacking, and without it the sensory purgation, however strong it may have been, is incomplete because of a communication

60 Kavanaugh and Rodriguez (1964/1973: 355).

61 Kavanaugh and Rodriguez (1964/1973: 355).

62 It is either a middle state or, if interpretation allows, a prolongment of the first night towards its end. The interpretive clue here is that the believer is now a proficient, which he would be in either of these cases.

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existing between the two parts of the soul that form only one suppositum. As a result, certain needs, aridities, darknesses, and conflicts are felt. These are sometimes far more intense than those of the past and are like omens or messengers of the coming night of the spirit.63 (N2.1.1)

When it comes to discernment, then, there may be no clear indication of the transition from

the first night to the second night because of the unity of the human person; the soul is

never actually divided into senses and spirit.

In this night, God in His mercy has deprived the soul “of all the natural affections

and apprehensions it perceived by means of its natural light” (N2.4.1; 345).64 Because of

this purging, the believer can feel abandoned by God, just as before, during the purgation

of the senses. Here the journey is dark, unillumined by reason, which is why it is also called

the “journey of faith.”65 Though the effects can feel devastating, the believer can be assured that God is actively participating: “Leaving the soul thus empty and dark, the ray purges and illumines it with divine spiritual light, while the soul thinks that it has no light and is in darkness” (N2.4.1; 345).” In fact, there’s good reason to think that St. John of the Cross greatly welcomed the experience: “Far from viewing it as a withdrawal of divine love, St.

John described the experience of the dark night as a ‘wounding by a strong divine love’ and ‘a certain feeling and foretaste of God’” (N2.11.1; 419).66

63 Here Kavanaugh and Rodriguez remind us, “The interchange between sense and spirit highlights the intrinsic unity of the human person” (1964/1973: 395). Though these two parts of the human person may be distinguishable by reason, it does not follow that they are separable, let alone that they operate separately.

64 Although this may sound like empirical sensation, it is better to think of it as illumination, by the inner light of reason.

65 It is unclear whether St. John of the Cross is a fideist. It cannot be determined from this alone, since even on non-fideist views, such as the Thomist’s, reason’s working cooperatively with faith does not preclude reason from sometimes being blinded at times along the way.

66 Wang (2011: 38).

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As noted before, St. John of the Cross leaves this work severely unfinished,67

leaving us to wonder what is missing. Notably what is missing is resolution. The emphasis

heretofore was always purgation, emptying, mortification… but what has been left out was

consolation, fulfillment, resolution. This is not a criticism of St. John or his work, but yet

another support for the notion that he had intended to fill out the missing parts with a fuller

account of the life of union with God at the summit.

Finally, it is significant to note that this entire process of the dark night of the soul, while all very mysterious and mystical, is not necessarily a process that happens in isolation from the external world. His editors write:

John's exposition of the night may seem to disengage that experience from the rest of life. But the night cannot occur apart from the external happenings of everyday, nor can we forget, while reading, the event of John's imprisonment in Toledo with all its social and material deprivations…John leaves to each reader and each age the task of making the suitable applications. What is essential is that the sufferings and privations bring about a growing response of faith, hope, and love.68

So it is not by any means reserved only for those in the monastic life, but is an experience

of growing in holiness that is available for all believers.

4.2 - The Problem of Saints in Darkness, & Whether There is a Further Night

In this section, I examine the issue of saints who experience darkness even after

making significant progress in the spiritual life, even union with God.69 This invites the

67 It ends abruptly with no more than a discussion of the first three stanzas of an eight-stanza poem (“The Dark Night”). In fact, after a summary explanation and detailed commentary on the first two stanzas (N2.1-14 and N2.15-24, respectively), the book leaves off with only a summary explanation of the third stanza (N2.25). “What is really at stake in the spiritual journey to union with God,” whether the night of senses or the night of spirit, “is an ongoing work of purification, a cleansing of all that is repugnant to God's holiness” (Kavanaugh & Rodriguez 1964/1973: 355).

68 Kavanaugh & Rodriguez (1964/1973: 356-7).

69 Of course some Christians might believe that genuine union with God, even of the kind St. John of the Cross has in mind, cannot be achieved in this temporal life at all, but only in eternity. If this is the case, 151

specific question of whether there is a further “dark night” beyond the “dark night of the

soul.” It is a real puzzle, because the “dark night of the soul,” according to St. John of the

Cross just is the path, so it would stand to reason that once one has reached the summit of

Mt. Carmel, being no longer on the path, one could expect not to experience a dark night

anymore. This is all the more to be expected, perhaps, because of what awaits us at the

summit, union with God! Why, indeed, would a soul experience a darkness once united

with God? On the other hand, the reported experiences of saints and heroes of the faith

contradict this and temper our optimism. Many saints, once attaining to a certain degree of

holiness or Christlikeness, nevertheless continued to (or thereafter began to) experience

darkness. So, assuming that this is a real spiritual darkness or aridity, we must determine

whether (i) there is some further night once reaching union with God, or whether (ii) such

saints are simply not quite at the summit and remain on the path. Below, I look at the story

of St. Mother Teresa of Calcutta in particular, then analyze it against the backdrop of St.

John of the Cross’s teaching on the dark night of the soul.

4.2.1 - St. Teresa of Calcutta (1910-1997) – Spiritual Darkness

Mother Teresa’s own spiritual darkness was virtually unknown to the general public

during her lifetime. The publication of her private writings and correspondence in 2007,

ten years after her death, “immediately caused sorrow and confusion in her admirers and a

glee that bordered on what the Germans call schadenfreude, taking pleasure in another’s

misfortune, in her detractors. Her letters revealed that, except for one short period, Teresa

then no one, including the Mother Teresas of the world, would be immune from experiencing some periods of darkness even after a significant attainment of holiness or Christlikeness.

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had been afflicted with a deep sense of God’s absence for the last half-century of her life.”70

Teresa was so deeply impacted by this spiritual darkness that she wrote, “If I ever become

a saint, I will surely be one of ‘darkness.’ I will continually be absent from Heaven—to

light the light of those in darkness on earth.”71 How could this saintly figure, this token

moral exemplar, have experienced such a deep, profound spiritual darkness and isolation

from God? Even more, if even she is not exempt from such spiritual darkness, then what

hope is there for us ‘normal’ people? It is worth trying, to the extent that we can, to analyze

what exactly Teresa’s spiritual darkness was: specifically, whether it was an instance of noche oscura or whether it was something different.

Teresa knew of and read the Mystical Doctor. In a letter to co-workers in England, she wrote, “...today your book of St. John of the Cross arrived.—I am just reading his works. How wonderfully He writes about God…”72 Although Teresa had admitted

previously that “she couldn’t profit from spiritual books, she was able to profit from the

works of St. John of the Cross.”73 Apparently, however, it was not specifically his characterization of noche oscura that caught her attention, but rather what (and the way in which) he wrote about God.

Curiously, Mother Teresa was unconvinced that her own spiritual darkness was the same thing that St. John of the Cross spoke of.

70 Walters (2016: 91).

71 Teresa-Kolodiejchuk (2007: 1). Taken from Mother Teresa’s letter to Father Joseph Neuner, March 6, 1962.

72 Teresa-Kolodiejchuk (2007: 217). Taken from a letter to co-workers, April 22, 1961.

73 Teresa-Kolodiejchuk (2007: 218).

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Though familiar with the Carmelite saint’s thought, she did not label her own suffering as a “dark night.” She had the intuition and now a confirmation from her spiritual director, that, though the sufferings were similar, their purpose was different.74

Although Teresa herself remained unconvinced, at least two others in whom she confided

thought that her darkness was the “dark night” that St. John of the Cross spoke of. In 1956

she wrote to Archbishop Périer about a deep and painful, seemingly unrequited, longing

for God.

The more I want Him—the less I am wanted.—I want to love Him as He has not been loved—and yet there is that separation—that terrible emptiness, that feeling of absence of God.75

The archbishop replied with, what compiler Kolodiejchuk considers, “a short summary of

the teaching of St. John of the Cross on the ‘dark night,’ without directly referring to it.”76

In what you reveal there is nothing which is not known in the mystical life. It is a grace God grants you, the longing to be His entirely without return on self or creatures, to live by Him and in Him but that longing which comes from God can never be satisfied in this world, simply because He is infinite and we finite.77

Many years later, in 1985, she confided her interior struggle in a priest, Jesuit Father Albert

Huart. He recounts the meeting in a later testimony:

Mother came...to speak about the excruciating night in her soul. It was not a passing phase but had gone on for years. What immediately struck me is what she added to the description of this painful and enduring night…: “Father, I do realize that when I open my mouth to speak to the sisters and to people about God and God’s work, it brings them light, joy and courage. But I get nothing of it. Inside it is all dark and

74 Teresa-Kolodiejchuk (2007: 218).

75 Teresa-Kolodiejchuk (2007: 164). Mother Teresa to Archbishop Périer, February 8, 1956.

76 Teresa-Kolodiejchuk (2007: 164).

77 Teresa-Kolodiejchuk (2007: 164). Archbishop Périer to Mother Teresa, February 9, 1956.

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feeling that I am totally cut off from God.” This sounded to me like pure John of the Cross.78

Clearly there are significant similarities, as Kolodiejchuk acknowledges, between the dark

night of the soul and Teresa’s own spiritual darkness, enough to suggest to Teresa’s

confidants that they were one in the same.

4.2.2 - Garrigou-Lagrange’s La Nuit Réparatrice: A Darkness Beyond Noche Oscura?

Beyond Teresa’s own insistence that her darkness was something different,

Kolodiejchuk’s grounds for thinking so seem to be based on teaching from Réginald

Garrigou-Lagrange, O.P., who makes a distinction between spiritual experiences that are

“chiefly purificatory” and those that are “chiefly reparatory.”

When the night of the spirit is chiefly purificatory, under the influence of the grace that is exercised mainly by the gift of the understanding, the theological virtues and humility are purified of all human alloy…The soul thus purified can pass beyond the formulas of mysteries and enter into “the deep things of God,” as St. Paul says (cf. 1 Cor. 2:10). Then, in spite of all temptations against faith and hope, the soul firmly believes by a direct act in a most pure and sublime manner which surmounts temptation; it believes for the sole and most pure motive supernaturally attained: the authority of God revealing. It also hopes for the sole reason that He is ever helpful, infinite Mercy. It loves Him in the most complete aridity, because He is infinitely better in Himself than all the gifts which He could grant us…When this trial is chiefly reparatory, when it has principally for its end to make the already purified soul work for the salvation of its neighbor, then it preserves the same lofty characteristics just described, but takes on an additional character more reminiscent of the intimate sufferings of Jesus and Mary, who did not need to be purified.79

78 Teresa-Kolodiejchuk (2007: 306). Testimony of Father Albert Huart, S.J., Calcutta, India, 15160, 15161, 15162, 15163.

79 Teresa-Kolodiejchuk (2007: 382), who cites Réginald Garrigou-Lagrange (1938/1989: 508-9). The original French passage is as follows: « Lorsque la nuit de l’esprit est surtout purificatrice, sous l’influence de la grâce qui s'exerce principalement par le don d’intelligence, les vertus théologales et l'humilité sont purifiées de tout alliage humain…L’âme ainsi purifiée peut dépasser les formules des mystères et entrer dans les profondeurs de Dieu, comme dit saint Paul (1 Cor., II, 10). Alors, malgré toutes les tentations contre la foi et l'espérance, l’âme croit fermement par un acte direct d’une façon très pure et très haute qui survole la tentation, elle croit pour ce seul et très pur motif surnaturellement atteint: l’autorité de Dieu révélateur; elle espère aussi uniquement parce qu’il est l'infinie Miséricorde toujours secourable; elle l’aime dans la plus complète aridité parce qu’il est infiniment meilleur en lui-même que tous les dons qu’il pourrait nous accorder…Lorsque cette épreuve est surtout réparatrice, lorsqu’elle a principalement pour but 155

As it turns out, Garrigou-Lagrange revisits this important distinction over and again in his

Les Trois Âges de la Vie Intérieure (1938).

The motivation for this distinction lies in the notion that noche oscura is meant to be a purifying experience. This means that for those who are already advanced spiritually and have already been purified, noche oscura may be a kind of one-and-done experience.

It seems that the night of the spirit is, for advanced souls, only a tunnel to go through before entering into transformative union, and then there is no longer any need to go through it again.80

Those who pass through this and reach the goal of transformative union with God should, then, be in a place beyond the path which is noche oscura. Yet that is not what experience teaches.

Some lives of great servants of God particularly dedicated to reparation, to immolation for the salvation of souls,81 or to the apostolate by inner suffering, however, remind us of a prolongation of the night of the spirit even after entry into this transformative union. But then this trial would no longer be mainly purifying, it would be mainly restorative [or reparatory, “réparatrice”].82

de faire travailler l’âme déjà purifiée au salut du prochain, alors elle conserve les mêmes caractères fort élevés que nous venons de dire, mais elle prend un autre caractère qui fait davantage penser aux souffrances intimes de Jésus et de Marie, qui eux, n’avaient pas besoin d’être purifiés » Garrigou-Lagrange (1938: 668-69, italics in original).

80 « On dirait que la nuit de l'esprit n'est pour les âmes avancées qu'un tunnel à traverser avant d'entrer dans l'union transformante et qu'il n'y a plus ensuite à le traverser de nouveau » (Garrigou-Lagrange 1938: 662).

81 Reminiscent of St. Paul’s exhortation to “present your bodies as a living sacrifice” (Rom. 12:1) St. John of the Cross says that every contemplative soul should be “an altar worthy of the presence of His Majesty” (AI.5.7). On the altar, the sacrifice is immolated.

82 « Certaines vies de grands serviteurs de Dieu particulièrement voués à la réparation, à l'immolation pour le salut des âmes ou à l'apostolat par la souffrance intérieure, font penser cependant à une prolongation de la nuit de l'esprit même après l'entrée dans l'union transformante. Mais alors cette épreuve ne serait plus surtout purificatrice, elle serait surtout réparatrice » (Garrigou-Lagrange 1938/1989: 662-63).

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Garrigou-Lagrange sees this as evidence for a further spiritual trial, la nuit de l’esprit

réparatrice (“the restorative night of the spirit”). It is not purgative, but reparative; it is not

for self, but for others.

4.2.3 - Evaluating La Nuit Réparatrice against St. John of the Cross’s Teaching

On the one hand, we might get flustered or exasperated by such a teaching. After all, if one has truly experienced union with God, why should there be more spiritual darknesses or trials after this union? On the other hand, Garrigou-Lagrange makes a strong case for la nuit réparatrice. In accordance with the teaching of St. John of the Cross, the path of noche oscura leads to the goal of union with God, so there is some reason to expect no more spiritual darkness once one has reached union with God. And yet we know from experience that there is. So Garrigou-Lagrange proposes this further, third night, la nuit réparatrice.

In contrast to this proposal, one could simply deny that Mother Teresa and other saints83 have reached union with God at all. This would of course explain why such

individuals are still in a dark night. They are still on the path which is the “dark night of

the soul,” not yet at the summit. This is actually a viable option given John of the Cross’s

own teaching, and I would like to consider it first.

Keep in mind what John of the Cross means by union with God: a habitual state of

supernatural and total union, which can be called, in short, a “union of likeness” produced

by love (A2.5.3; 116, cf.46). In contrast with “the natural or essential union” by which God

83 Since Teresa of Calcutta’s interior struggles and darkness were known publicly only recently, and since she was canonized long after his time, Garrigou-Lagrange instead names St. Paul of the Cross as a great example of someone who has experienced this third night.

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conserves all creatures in their being, this supernatural union is “when God’s will and the

soul’s are in conformity so that nothing is repugnant to the other” (A2.5.3; 116). The former

kind always exists, and without this kind of union, a created being “would immediately be

annihilated and cease to exist” (A2.5.3; 116). But the latter kind of union “is not always

existing, but we find it only where there is likeness of love” (A2.5.3; 116).

Now, importantly, this means that, since persons can have a likeness of love in greater or less degree, there can be great and lesser degrees of union with God. John of the

Cross teaches this:

He communicates supernatural being [as opposed to natural being, which sustains a creature’s existence] only through love and grace, which not all souls possess. And those who do, do not have it in the same degree. Some have attained higher degrees of love, others remain in lower degrees. God communicates Himself more to the soul more advanced in love, that is, more conformed to His will. A person who has reached complete conformity and likeness of will has attained total supernatural union and transformation in God. (A2.5.4; 116, italics mine)

Straightaway, this allows us to speak, albeit strangely, of partial union with God—since, after all, this is a union of likeness, becoming more Christlike. And it is possible that this was Mother Teresa’s situation. That is, her own spiritual aridity or darkness can be accounted for if we assume that she was still on the path to the summit. This would allow us to affirm that she was still in a strong, though incomplete, union of likeness with God, and it would also seem to dispense with the need for speculating any further dark nights at the summit.

As attractive as this option may seem, however, there is another one just as viable and consistent with John of the Cross’s own teaching: what Garrigou-Lagrange calls la nuit réparatrice. Recall that at the summit, we are speaking of a complete union as opposed to a partial union as was just discussed above. When a soul has indeed reached the summit, becoming advanced in love, it attains a total and “complete conformity and likeness of 158 will” with God (A2.5.4; 116). At this point, in some respects, it is difficult to distinguish supernaturally the qualitative differences between the individual’s soul and God. This is all very deep and mysterious, of course, and it is no wonder why St. John of the Cross is called the Mystical Doctor. In his own words, then:

When God grants this supernatural favor to the soul, so great a union is caused that all the things of both God and the soul become one in participant transformation, and the soul appears to be God more than a soul. Indeed, it is God by participation. Yet truly, its being (even though transformed) is naturally as distinct from God’s as it was before, just as the window, although illumined by the ray, has an existence distinct from the ray. (A2.5.7; 117-18, italics mine)

The comparative italicized above is key to understanding what he means. It is not as if the soul would ever be mistaken for God, since they are naturally distinct, but supernaturally it is more like God than the soul it was before, and this by participant transformation, by participating in God’s likeness and becoming transformed in it.

Now, nothing in this picture of union with God precludes feelings of spiritual aridity. It is possible that St. Teresa of Calcutta experienced both this total union of likeness with God and yet also a further spiritual dark night. Apart from the witness of saints, there are two major reasons, from St. John of the Cross’s teaching, for thinking that we cannot rule out and might even expect to experience some further dark night once reaching union with God.

First, recall that John of the Cross gives three reasons for calling this experience a

“night” (see Fig. 4.2). The third, the terminus ad quem, which takes place at the end, is

God’s communication to the soul. For God “communicates Himself so secretly and intimately that he becomes another night for the soul” (A1.2.4; 75). There are some textual difficulties here, I admit. In the following, John of the Cross claims that “in actuality these three nights comprise only one night, a night divided into three parts” (A1.2.5; 75), which

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might suggest that the third night belongs more properly to the path than to the summit.

Also, we are told that “when this third night (God’s communication to the spirit…) has

passed, a union with the Spouse, who is the Wisdom of God, then follows” (A1.2.4; 75).

This sounds as if union with God occurs after the third night, not before. But note that he

does not say “union with God”, but rather union with the “Spouse” who is the “Wisdom of

God” (“spouse” here is taken metaphorically or symbolically, since St. John of the Cross

is expounding upon a story of a newly wedded couple in the Book of Tobias [Tb. 6:18-

22]). It stands to reason that one can be united with God in a union of likeness first, and

only later attain a deeper wisdom from God as a result of this union: after all, since, as

noted above, the will is non-cognitive, a “complete conformity and likeness of will” with

God (A2.5.4; 116) does not entail a complete transformation of the cognitive part of man.

This schema resolves an earlier discrepancy in St. John of the Cross’s structuring of The Ascent-Dark Night (cf. Sec. 4.1). Addressing this now shall clarify the role of the third night. Kavanaugh and Rodriguez had pointed out that there was both a fourfold and a threefold division, which John of the Cross signals at the beginning of The Ascent, in

A1.1 and A1.2, respectively. This apparent contradiction resolves itself if we assume that

The Ascent-Dark Night was only ever meant to cover the first two nights (in both their

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active and passive modes). This accounts for the fourfold division. The third night cannot

be properly situated in this work, given that it is a manual on how to navigate the path

upwards to the summit (simply refer to the titles given: The Ascent of Mount Carmel; The

Dark Night, which is the path)—though he would be entirely remiss not to treat of the third

night in some small respect, as he does, given that it is the whole telos of the journey. And so John of the Cross is right to signal the threefold division at the outset of The Ascent,

even if he does not arrive to a full explanation of the third night in The Ascent-Dark Night.

That he left each of The Ascent and Dark Night unfinished supports this,84 and perhaps

suggests that a final part of a trilogy work (on the third night) was forthcoming yet never

carried out.85

Second, John of the Cross finishes his explanatory chapter on union with God with

this final note.

Although a person may have truly reached union, this union will be proportioned to his lesser or greater capacity, for not all souls attain an identical degree of union. (A2.5.10; 118)

If we glanced over this too quickly, we might just assume it is a restatement of what he has

already told us, namely, that souls can experience union with God to a greater or lesser

degree. But there he was talking about partial union with God; here he is explicitly referring

to those who have “truly reached union.” Before, he had attributed the disparity to a soul’s

84 This fact alone would be an argument from silence. But when taken in conjunction with the previous remarks, the uncompleted status of his works makes a stronger case that this was perhaps his intent. Add to this his early death at age 49, and the fact that he did not begin to write until age 36 (Kavanaugh and Rodriguez 1964/1973: 33).

85 Maybe the reason St. John never finished the work was that he could not. And maybe he could not because no one in this life can have the kind of union with God he thought could be had.

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greater or lesser advancement in love; here he attributes it to the difference in capacities

that different souls have. He continues:

[The degree of union] depends on what the Lord wishes to grant to each one. Here we have a resemblance to the saints’ vision of God in heaven: some see more, others less, but all see Him and are happy owing to the satisfaction of their capacity. (A2.5.10; 118)

In such a world, all those who see God, though some see more and others less, all see Him

to the fullness of their capacity—i.e., each is fully sated by his own portion. This provides

yet another reason to think that there still may be a dark night after union with God.

4.2.4 - La Nuit Réparatrice and Depression

What is the relation between depression and la nuit réparatrice? Already we can

see that the two concepts are not identical. To see this, consider how la nuit réparatrice

seems to require a stronger theodicy of suffering than does depression. Whether we assume

the contemporary concept of depression as presented in the DSM, that is, some set of

symptoms with etiology unknown, or we assume any of the various clinical theories on the

etiology of depression (e.g., biological, medical, social, psychological); depression is

something for which the sufferer is not directly responsible. Given this concept of

depression, there is no doubt that saints can experience depression. The notion of saints

and depression are not mutually exclusive, they do not contradict each other, since the latter

has nothing to do with one’s spiritual or moral advancement. A saint would be no more at

fault for acquiring depression than she would be for having green eyes.86 Depression surely warrants a theodicy of suffering, but it does not require a special response.

86 Or some physical illness. But here we must be careful to distinguish those kinds of physical illnesses for which we normally hold people accountable in greater (e.g., obesity) or lesser (e.g., type-2 diabetes) degrees and those we do not (e.g., cerebral palsy).

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By contrast, the concept of la nuit réparatrice poses a special problem for one’s theodicy of suffering. (One way to account for it, of course, would just be to deny that the purported saint has reached union with God, after all—i.e., simply reject that there is a nuit réparatrice. This rejection, of course, would have one make the corresponding dialectical move, denying that those in complete union with God can experience any darkness.) But assuming that a saint has reached a union with God and experiences la nuit réparatrice, a darkness which is not for her own purification and which she did not deserve, a darkness which arrives despite her own spiritual advancement and despite her closeness to God, it seems that God would be unjust in allowing her to wallow in this spiritual darkness and suffering. (I do not think this makes God unjust, and I think that standard recent theodicies of suffering can provide a partial adequate reply.87 I also think St. John of the Cross’s own

Catholic theological backdrop provides sufficient support for a viable theodicy, namely, its

theology of merit, which involves the more communal enterprise of becoming holy and

making others holy.) Whatever one’s theodicy of suffering, however, it is apparent that la

nuit réparatrice poses a more thorny problem, which makes it clear that the two concepts

are not identical.

It does appear to be possible, though not necessary, that an instance of depression

and an instance of la nuit réparatrice can happen concurrently. Consider Mother Teresa during her darkness, throughout which she loved from an endless font of self-giving kept replenished by God. She certainly did not consider her experience to be noche oscura (and thus purgative, and non-pathological), but that does not rule out the possibility of her

87 One such theodicy of suffering is Chaloux’s (2020), “The Grace Concealed in Suffering: Developing Virtue and Beatitude.”

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darkness being compounded with pathological sadness. This is not a judgment on her

actual condition, but only a concession that it is certainly possible the one could be

compounded by the other, just as St. John of the Cross tells us of noche oscura: “the dryness

may be furthered by melancholia…as it often is” (N1.9.3; 314, emphasis mine).

4.3 - Considered Judgment on Relation to Depression

I have distinguished St. John of the Cross’s dark night of the soul from other diluted,

popular notions of “dark night”: “non-pathological religious sadness” (Durà-Vilà and Dein

2009), and pathological depression within a religious context (Runde 1991). My concern

has been on describing the true Carmelite noche oscura and comparing it to depression.

We have already learned two elementary lessons concerning the relationship between noche oscura and depression. The first is that the two are obviously not identical. St. John of the Cross is fully aware of melancholy, striving to distinguish it from noche oscura.88

Not only does he preempt this comparison in the prologue of The Ascent-Dark Night

(A.pro.4-6; 71-72), he goes so far in Dark Night to offer grounds upon which to distinguish the two (N1.9; 313-16).89 The second lesson is that the two may, however, both be manifest

at once. While they are distinct conditions, they can coincide, often with the spiritual aridity

produced by noche oscura being compounded by melancholy; as he says, “the dryness may

be furthered by melancholia…as it often is” (N1.9.3; 314, emphasis mine). But

88 Here I presume that the melancholy (“melancolía”, cf. Appelbaum (2007: 98)) to which St. John of the Cross refers is on a par with our contemporary understanding of depression. By the next chapter, Chapter Five on Melancholia, I will of course place this very presumption under scrutiny.

89 In that chapter, N1.9, he actually distinguishes the spiritual aridity brought on by noche oscura from a total of three other things. “[T]he origin of these aridities may not be the sensory night and purgation, but sin and imperfection, or weakness and lukewarmness, or some bad humor or bodily condition” (N1.9.1).

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importantly, this is not an essential, let alone intended, feature of the dark night of the

senses. It comes about per accidens, albeit very often, because of our sinful human nature.

The strong associations of noche oscura with depression have mainly to do with

the feeling of abandonment by God, which constitutes the most painful suffering in this

season. This association is only surface-level, however, since this feeling of abandonment by God springs from the believer’s desiring God yet failing to receive any consolation from

God. This season itself cannot even begin unless and until the beginner, with God’s invitation and assistance, exerts humanly effort to purge himself of all that is abhorrent to

God, thereby growing in holiness towards union with God. Thus, this season—the dark

night—is not a sad time, all things considered, but a reason for immense joy. Painful is the

“wounding by a strong divine love” (N2.11.1; 419).

So crucial is the believer’s participation, for God never forces this season upon him:

“He cannot ravish. He can only woo.”90 If the aridity is too painful, God comes to his aid

at times with consolation:

Although they do not advance, God exercises them for short periods and on certain days in those temptations and aridities to preserve them in humility and self- knowledge; and at other times and seasons he comes to their aid with consolation, lest through loss of courage they return to their search for worldly consolation. (N1.14.5)

So even in the necessarily painful experience of growing in holiness, the God who suffers

is merciful and leads the believer along gently.

90 Lewis (1942/2001: 24-25).

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CHAPTER FIVE

Melancholia

“The Tower of Babel never yielded such confusion of tongues as this Chaos of Melancholy doth variety of symptoms.” — Robert Burton, (1621) The Anatomy of Melancholy1

“For as the Soul is not cured by natural Causes, so the Body is not cured by Spiritual Remedies.” — Joseph Symonds (1642), The Case and Cure of a Deserted Soul2

Today, the antiquated notion of melancholy remains closely associated with depression, oftentimes thought of as a conceptual predecessor to depression. In this chapter,

I focus specifically on religious melancholy, in keeping with my overall thesis to mine the depths of these historical conditions which have a purported spiritual etiology. In order to hone in on religious melancholy in particular, I must spend a few moments, in Section 5.0, clarifying and then setting aside the various senses in which “melancholy” has been used.

As Angus Gowland (2006a) writes, “Such generalizations are precarious,” yet they must be made; so long as we pay careful attention to specific contexts which warrant it, these generalizations should be more helpful than harmful.3

1 Burton (1621/1847: 240).

2 Symonds (1642: 275), cf. Robe (1749: xxiv).

3 Gowland (2006a: 105). Gowland, for instance, is writing specifically on “the religious significance of melancholy,” which is becoming “increasingly evident in medical as well as moral-psychological writings in post-Reformation Europe” in both Protestant and Catholic writings.

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Since the term “melancholy” can be used to denote either a syndrome (medical or

not) or a symptom or affect, I reserve the higher level for melancholy qua syndrome and assign the symptoms to a lower level. There is the sense of melancholy as black bile (5.0.1); below this level the reader will find the two major melancholic symptoms: anger- melancholy (5.0.1.1) and sorrow-melancholy (5.0.1.2). (There is no need to repeat these symptoms under each subsequent heading, especially since the first quickly becomes obsolete.) Next is the change from the 17th to 19th century concerning melancholy qua

medical syndrome yet without its former humoural etiology (5.0.2). Rounding out this

group are 16th-century Elizabethan and 19th-century Romanticism’s prestigious melancholic genius (5.0.3), the change from the 19th to 20th century concerning melancholy

as a psychiatric conceptual precursor to depression (5.0.4), and, finally, a look back at 17th-

and 18th-century religious melancholy (5.0.5). While perhaps at first overwhelming, the

reader will find that this preliminary discussion is necessary for targeting our primary

object of interest. In any case, I have severely limited the preliminaries to only a very broad

survey, consisting of a few short sections, as any full and clear account would be closer to

the length of an entire book or two.

Beginning with 5.0.5 and leading into 5.1, I discuss religious melancholy in

particular. The short Section 5.0.5 is meant to introduce and then contrast religious

melancholy with other senses of melancholy in Sections 5.0.1 through 5.0.4. I take Robert

Burton’s seminal account of religious melancholy in his (1621) The Anatomy of

Melancholy and use it as a model for understanding later accounts of religious melancholy

from 17th- and 18th-century divines. We observe that Burton places religious melancholy

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as a species of love-melancholy, and that religious melancholy fundamentally divides into

two, with respect to whether one approaches (5.1.1.1) or withdraws from God (5.1.1.2).

Following this groundwork, I then examine the causal predicament preceding

religious melancholy, particularly the non-pathological causal contributors which have

been proposed or entertained by our authors, such as: God (5.1.2.1), the Devil (5.1.2.1),

Religion (5.1.2.3), and a person’s own moral impulse or weakness of faith (5.1.2.4). I

furthermore discuss God’s role in a final section on religious melancholy as nostalgia and

return to God (5.1.2.5). Among these, the reader will find a brief aside on the attitudes

towards using “physick” (5.1.2.2), or medicine, which must be addressed in light of what

we say about whether the devil or some other supernatural cause is to blame for the onset

of an instance of religious melancholy. As is customary, I conclude this chapter with a final considered judgment on the relationship between religious melancholy and depression

(5.2). There I also examine what links religious melancholy might have to a couple of conditions we have already looked at: acedia (5.2.1) and noche oscura (5.2.2).

5.0 - Rationale for Inclusion

In many contexts, melancholy is virtually synonymous with depression, but a look

at its conceptual history will reveal that the matter is much more complex, and that the term

“melancholy” has been used in a wide variety of different senses. The word “melancholy,”

itself a very early English word—its earliest recorded incidence prior to AD 1375 makes it

“one of the earliest 7% of entries recorded in OED”4—is originally Greek (μελαγχολία),

4 “Quotation evidence from a1375 (first cited in William of Palerne)…[that earliest 7% of entries in] OED includes about 1200 entries first evidenced in the decade 1370—1379 (words such as pigeon, remit, secret).” See OED entry “melancholy, n.1” (2020).

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transmitted through classical Latin (melancholia),5 and now known to all Romance

languages as well as several Germanic languages.6 As to what the word actually means or

refers to, however, that has not been so static. Add to this the fact that even the concept of

melancholy, where that word specifically denotes a persistent sorrowful affect or

syndrome, has itself undergone a massive transformation in its history—even within the

last 400 years. Here in this introductory section, I parse apart the snarl of several meanings

of the term “melancholy” that history has left to us, in order to focus our inquiry specifically

on religious melancholy.

Below I briefly outline the six or so senses in which “melancholy” has been used, in order to set them aside to discuss religious melancholy in particular. First, there is its original, historical usage as a medical malady, a condition of too much black bile in the body. Second, there are the two classic symptoms which are called melancholy: one, the familiar sad affect, and the other, the now obsolete ill temper or anger. Third, there is the sense in which it is a medical malady, but without the medieval physiology, which lost favor around the 17th century. Fourth, there is the sense of prestigious melancholy which

gained prominence in the Elizabethan period (ca.1558-1603) and continued thereafter,

notably reemerging as a characteristic feature of the Romanticism era (ca.1770-1850).

Fifth, there is the psychiatric sense of melancholy, an arm of medicine which began with

5 “Etymology: < Anglo-Norman malencolie, malancolie, melancolie, melencolie and Middle French melancolie (c1180 in Old French; French mélancolie) < post-classical Latin melancholia (5th cent.; already in classical Latin as a Greek loanword) < ancient Greek μελαγχολία condition of having black bile < μελαν (see MELANO- comb. form) + χολή bile (compare CHOLER n.) + ία -IA suffix1.” See OED entry “melancholy, n.1” (2020).

6 “Compare Old Occitan melancolia, melanconia (13th cent.), Spanish melancolía (1490; 1251 as malenconía ), Italian malinconia (late 13th cent.; c1243 as mellenconia), Middle High German melancolia, melancoli, melancolei (14th cent.; German Melancholie), Middle Dutch melancolie, merancolie, mirancolie (Dutch melancholie), Swedish melankoli (1557).” See OED entry “melancholy, n.1” (2020).

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18th-century nosologies (taxonomies of disease) and continued until the mid-20th century

with the growing coinage of depression. Sixth and finally, there is the notion of religious

melancholy, which is my primary object of interest.

5.0.1 - Black Bile - pre-17th-c.: Hippocrates, Galen, & the Humours

Melancholy has its conceptual historical roots in Hippocrates (460-377 BC) and in

Galen (AD 130-210), perhaps the two most prominent physicians in antiquity. Both

physicians affirmed a humoural view of melancholy, on which melancholy was due to an

excessive production of black bile (μέλαινα melaina, χολή chole). Despite its being

outdated by today’s standards, the humoural theory, with its emphasis on explanation in

biological terms, was in some respects an improvement upon the presumably superstitious

approach the Greeks had been used to.7 This humoral physiological view remained largely

unchanged from antiquity on through the medieval ages.8 Nevertheless, by the time of the

17th century, with improved medical knowledge, the humoural theory was eventually

superseded.9 It was said that, of the four humours, two of them were not even observable!

7 For example, prior to Hippocrates, in the ancient Greek world the condition of epilepsy was known popularly as the “sacred disease” (Hippocrates 1923: 139-45). Dutch philosopher Marlies ter Borg writes that the same transition occurs with popular views about melancholy around the time of Aristotle, as he argues that melancholy, like epilepsy, should be viewed in more natural terms. Cf. ter Borg (2014: 65n.3, cf.4). Highly important for my purposes (which I can only note for the time being, since there is not sufficient space here to present a full defense): the supernatural or spiritual perspective which I have been discussing is not a superstitious perspective.

8 See especially Chapter 1, “Melancholy in the Physiological Literature of the Ancients,” and Chapter 2, “Melancholy in Medieval Medicine Science and Philosophy,” in Part I (“The Notion of Melancholy and Its Historical Development”) of Klibansky, et al. (1964/1979).

9 “From the 17th cent. onwards the word was used in its later sense without aetiological implications.” See OED entry “melancholy, n.1” (2020), sense 2b.

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This should not be so surprising if we realize that Galen “had never dissected a human being.”10

Although the term “melancholy” eventually came to be associated specifically with only two main symptoms, as we see just below, this was not always the case. Even by the

16th century, there was still plenty of ambiguity surrounding the term “melancholy,” despite general agreement as to its atrabilious (āter, “dark, black”; bīlis, “bile”) pathophysiology.

We see authors like André du Laurens11 and Timothie Bright12 apparently thinking of melancholy and madness, which itself carried a wide variety of connotations, as interchangeable notions.13 Even so, not all in the 16th century was pathologized, as du

Laurens distinguishes between a pathological melancholy and a melancholy simply of natural temperament: “All such as we call melancholike men, are not infected with this miserable passion which wee call melancholie: there are melancholy constitutions, which keep within the bounds and limits of health, which if we credit ancient writers, are very

10 Arikha (2013).

11 André du Laurens (1560-1609). French professor of medicine and physician to King Henry IV and Marie de Médicis. Notable work: Discourse of…melancholike diseases (1597/1599).

12 Timothie Bright (1551-1615). M.D. Cantab., physician to St. Bartholomew’s Hospital London, 1585-91; subsequently Anglican priest; inventor of modern shorthand. Notable work: Treatise of melancholie (1586).

13 Bright writes of the “mad man” in his (1586) Treatise of melancholie (cf. Hunter and MacAlpine 1963: 38), and du Laurens in his (1597/1599) Discourse of…melancholike diseases describes the “sillie melancholike man” as having strange imaginations and foolish delusions, like one who refused to urinate: “a Gentleman who had resolved with himselfe not to pisse, but to dye rather, and that because he imagined, that when he first pissed, all his towne would be drowned.” This story has a happy ending: “In the end they seeing his obstinacie, and in what danger he put his life, found a pleasant invention. They caused the next house to be set on fire, & all the bells in the town to ring, they perswaded diverse servants to crie, to the fire, to the fire,…Then this sillie melancholike man which abstained from pissing for feare of loosing his towne, taking it for graunted, that it was now in great hazard, pissed and emptied his bladder of all that was in it, and was himselfe by that means preserved” (Hunter and MacAlpine 1963: 52).

171 large and wide.”14 By the beginning of the 1700s, the symptoms of pathological melancholy began to standardize somewhat,15 as certain authors took “melancholy” to mean only a sad affect.16

In acknowledging melancholy’s black bile physiology, we should not be too quick or simplistic to assume that all users of this very traditional medical model thought of melancholy only in (early) biomedical terms. Indeed, physician and Christian mystic St.

Hildegard von Bingen17 sought to harmonize melancholia as a physiological problem, on the one hand, with melancholia as a product of sin, on the other. Hildegard’s solution is to grant the medical reality of a disordered body and mind as a proximal material cause of melancholy, while also affirming the theological doctrine of original sin, specifically the sinful actions of Adam, as a distal (and, in this case, original) efficient cause of melancholy.

She writes in Causæ et curæ that the moment Adam disobeyed God, his humours coagulated and thus the black humour was created.18 This sentiment would later be echoed

14 Hunter and MacAlpine (1963: 51). He continues: “We must therefore for the orderly handling of this matter, set downe all the sorts and differences of melancholike persons, to the end that the likeness of names may not trouble us in the sequele of this discourse.”

15 Only temporarily, however, as 18th-century men of science would soon lend their ingenuity to carving up diseases and afflictions in various idiosyncratic ways according to their proposed nosology. See Sections 5.0.2 through 5.0.5 below.

16 “It should be noted that Blackmore [1654-1749] no longer used ‘Melancholy’ in the old sense of madness but described it as always accompanied by ‘Sadness, Dejection, and Fear’, the sense in which depression is used today” (Hunter and MacAlpine 1963: 319).

17 St. Hildegard von Bingen (1098-1179). Also called “Sybil of the Rhine,” Christian mystic, first recorded female physician in history; well known also for her musical compositions and the invention of a language.

18 “Cum enim Adam divinum praeceptum praevaricatus est, in ipso momento melancolia in sanguine eius coagulata est, ut splendor recedit, cum lumen extinguitur, et ut stuppa ardens et fumigans foetendo remanet. Et sic factum est in Adam, quia cum splendor in eo extinctus est, melancolia in sanguine eius coagulata est, de qua tristitia et desperatio in eo surrexerunt, quoniam diabolus in casu Adae melancoliam in ipso conflavit, quae hominem aliquando dubium et incredulum parat.” (Hildegard von Bingen (ed. Kaiser), 172

by 17th-century Dutch theologian Wilhelmus à Brakel19 who writes, “It is also certain that

Eve in her holy state was neither subject to illness, melancholy, vain imaginations, nor to

any other sinful condition.”20 We shall return to the important topic and task of

harmonizing pathological melancholy with Christian doctrine when we discuss religious

melancholy below.

Both senses of “melancholy” that follow should be understood as symptoms of

melancholy, though these symptoms themselves will often be called “melancholy” in some

adjectival or other attributive form of the word, not to be confused with other senses of the

word which typically pick out a syndrome or state. To stave off such confusion, I

distinguish them as “anger-melancholy” and “sorrow-melancholy.”

5.0.1.1 - Symptom #1 - anger-melancholy. This first sense of melancholy qua

symptom is now obsolete: an “ill temper, sullenness, brooding, anger.”21 We are told that

“the sense ‘anger’ is attested in Middle French from the beginning of the 14th cent.”22 And

we see just such an occurrence in the 16th-century English translation of Jean Froissart’s

14th-century Chroniques, “And the kynge beyng in his malencoly, assone as he sawe hym

he sayd in great yre [ire]...”23 In medieval physiology, this anger-melancholy arises as a

1903: 14327-36). Cf. Walker (2008: 34), “Hildegard of Bingen, a prominent writer and theologian, even went so far as to claim that Adam had melancholy coagulate in his blood the moment he disobeyed God’s will.”

19 Wilhelmus à Brakel (1635-1711) was a Reformed minister at Rotterdam and an influential actor in the Dutch Further Reformation. Notable work: The Christian’s Reasonable Service (1700/1992).

20 Brakel (1700/1992, Vol. I: 299).

21 See OED entry “melancholy, n.1” (2020), sense 1.

22 See OED entry “melancholy, n.1” (2020), etymology.

23 Froissart’s Cronycles (1525/1902: 1385).

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result of too much black bile in the body. It is uncertain when this usage became obsolete,

but it is perhaps an interesting coincidence to note that the APA’s DSM lists irritability as

one among a constellation of symptoms at home in depressive disorders.

5.0.1.2 - Symptom #2 - sorrow-melancholy. The second sense of melancholy qua

symptom is of course more well-known: a “sadness, dejection, esp. of a pensive nature;

gloominess; pensiveness or introspection.”24 Similarly, in medieval physiology, sorrow- melancholy was a product of too much black bile in the body. By the 17th century, however,

sadness-melancholy would persist as the dominant symptom of melancholy but without its

humoural theoretic underpinnings. It is curious to note that, originally, even this sorrow-

melancholy was not pathological, according to extant records: “Old French melancolie is

attested first in the sense ‘profound sadness’ (c.1180), and only subsequently in the medical

sense (c.1256).”25

5.0.2 - Melancholy in Medicine (17th c. - 19th c.) without Aetiology

From the 17th century onward, “melancholy” qua syndrome began to divest itself

of associations with humoural theory.26 In medical and psychological contexts, more and

more, the term was used without presuming this humoural etiology. As one writer points

out, even by the time of Burton’s classic work (1621) The Anatomy of Melancholy,

humoural theory was already on its way out:

By the time Burton was writing, though, humoural theory, such as it had developed in the West, was in jeopardy: his book pre-dates by just seven years the publication

24 See OED entry “melancholy, n.1” (2020), sense 3a.

25 See OED entry “melancholy, n.1” (2020), etymology.

26 See OED entry “melancholy, n.1” (2020), sense 2b.

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in 1628 of William Harvey’s An Anatomical Essay Concerning the Movement of the Heart and the Blood in Animals, the Royalist physician’s revolutionary account of blood circulation, based on lectures he gave in 1616 to the College of Physicians.27

However, it is also true that this change did not happen suddenly, let alone in the minds of

every author who is writing in this period. The reader of these historical texts must be

careful not to assume that every author was informed on the latest medical theories. Some

used the humoural theory, some did not. And even in cases where the author was informed,

he may nevertheless have chosen to employ the humours in a non-literal sense, since his

contemporary lay-readers would understand his meaning. This fact becomes significant

when we peruse the theological writings on religious melancholy.

5.0.3 - Elizabethan & Romanticism’s 19th-c. Poetic Melancholic Genius

This sense of melancholy, a reflective sadness that is the subject of poetry, is still

recent enough to be familiar, yet it needs some contextual explanation. It was most

prominent “in the Elizabethan period [ca.1558-1603], and for some centuries thereafter,”

this idea that “the affectation of melancholy was a fashionable mark of intellectual or

aesthetic refinement.”28 It is the melancholy of Drummond29 and Milton,30 Coleridge31 and

27 Arikha (2013).

28 See OED entry “melancholy, n.1” (2020), sense 3a.

29 William Drummond (1614?/1856: 35). “A sweet Melancholie my Senses keepes.” From Mad.: When as Shee smiles.

30 John Milton (1637/1851: 83). “I…began Wrapt in a pleasing fit of melancholy To meditate my rural minstrelsie.” From Comus/Masks 19.

31 Samuel Taylor Coleridge (1796/1864: 33). “Their mild and manliest melancholy lent A mingled charm, which oft the pang consigned To slumber.” From Sonnet to Bowles [2nd vers.].

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Austen.32 Rather than something to be cured of, it was something to be welcomed—Milton

calls it “pleasing,” Austen “delightful.” Kierkegaard calls it “prestigious,”33 while the poet

William Hamilton Reid calls it “poetic”:

NOT her, of moping look, and haggard face, That loves at home with Silence to abide, Mute as the tomb—but one of heav’nly race, Is the sweet nymph to Poesy ally'd. Child of serenity and sober sense.34

While Reid tries to drive a distinction between the two, in many cases, this sense of poetic

melancholy implied the presence of melancholy qua somatic and mental ailment—

whatever physiological model was used—so that melancholic experience was just part and parcel with the intellectual or aesthetic benefits of melancholy. Later evaluators would go to understand it rather as employing different frameworks, either negative or positive, to interpret the same experience.35

Although this is where we typically situate this sense of melancholy

chronologically, this sense has been present in some form or another almost from the

beginning. Klibansky, et al. argue that Aristotle’s notion of melancholy—which welcomes

an appropriate amount of melancholy humour which can improve one’s character and

32 Jane Austen (1818/1880: 144). “The shock however being less real than the relief, offered it no injury; and she began to talk with easy gaiety of the delightful melancholy which such a grove inspired.” From Northanger Abbey.

33 Kierkegaard’s character Judge Wilhelm in Either/Or, to be precise: “In our day, it has become somewhat prestigious to be melancholy [tungsindig]” (1839/1987, II: 185). See also Kierkegaard’s 1839 journal entry which directly touches upon this passage (1839/1987, II: 381).

34 Reid (1791). “Thus the title of a sonnet [“Poetic Melancholy”] by W. Hamilton Reid in The Gentleman’s Magazine, June 1791, p. 567,” as we are told in Klibansky, et al. (1964/1979: 217).

35 Cf. Palitsky, et al (2019), Radden and Varga (2013), Scrutton (2015).

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intellect36—was distinct from “that of the psychopathologists, for whom it was nothing but

a mental illness.”37 Medieval French theologian and Aristotelian Guillaume d’Auvergne

(1190-1249) had apparently written a hymn in praise of melancholy.38 “Other theologians

had also dealt with the question of melancholy from this point of view,” seeing it as a

condition “which overtook the pious and unworldly, not in spite of their piety and

unworldliness, but because of it.”39 Nevertheless, it remains true that this sense of

melancholy was particularly widespread and prominent in Elizabethan England and later

in the Romantic period.

This notion of melancholic genius, however, did not come without its flaws. There

is evidence to suggest that it was a subtle support for sexism and racism, as it enabled

distinctions between superior and inferior persons. It was not until the modern period that

melancholy became strongly associated with genius,40 so that those who were melancholy

(of a certain kind) were thought to be quite fortunate or gifted—a convenient rationale for

the growing inequities in society that afforded more opportunity for contemplation to the

leisured than to the working class.41 Unfortunately, however, it was usually men who were

36 “The amount of melancholy humour must be great enough to raise the character above the average, but not so great as to generate a melancholy ‘all too deep’…Then and only then is the melancholic not a freak but a genius” (Klibansky, et al. 1964/1979: 32).

37 Klibansky, et al. (1964/1979: 75). See especially their account of this sense of melancholy found in Part II (“‘Poetic Melancholy’ and ‘Melancholia Generosa’”) of Klibansky, et al. (1964/1979).

38 Klibansky, et al. (1964/1979: 75).

39 Klibansky, et al. (1964/1979: 75). I am skeptical, without the authors having named these theologians or their works, whether they were dealing with the question of melancholy, as such, or something else.

40 Klibansky, et al. (1964/1979: 241).

41 “By the 1850s and 1860s, for a variety of reasons, melancholia was sharply devalued as a sign of male cultural authority. Rather than signalling the creative power of the rarefied genius, it seemed to have 177

gifted with genius melancholy, whereas women were afflicted with a deleterious

melancholy,42 that is, when they were not overcome with hysteria (i.e., in one famous

description, “a picture of women in the words of men…a caricature of femininity”).43

Writes one author of this lopsided gender diagnosis, “Instead of saying that women

naturally fall into the category of depression, we might say that the category of depression

has been constructed in such a way as to fit women better than men.”44 He of course is

course discussing recent diagnostic trends, but there is ample evidence to suggest that

diagnostic categories are, and have been, gender-biased for some time.45

If that were not problem enough, it was thought that only those who were more evolved, living in advanced civilizations, were capable of having melancholy, let alone genius melancholy. In the Romantic period and thereafter, it was a “common argument that depression did not yet occur in non-Europeans for its essential Western characteristic of self-blame (a consequence of mature selfhood) was not observed. The absence of depression was sometimes directly attributed to a less evolved brain where the ‘primitive

become widespread, mundane and déclasseé–a conventional attribute of middle-class commercial, leisured and professional men. In the course of this demographic diffusion, male melancholia became associated with inaction, indecisiveness, inhibition and other forms of emotional debility traditionally reserved for depressed women” (Kucich 2006: 126-27).

42 “In some sources male and female melancholia appear to be qualitatively different from one another” (Bell 2014: 80). And Richard Baxter says, “it is much more frequently the Disease of Women than of Men” (Baxter 1682/1707, Vol. IV: 844).

43 Chodoff and Lyons (1958: 739).

44 Bell (2014: 77).

45 “In fact, the issue of gender bias in mental health is much wider than this. Different mental illnesses have different gender biases. Women are more likely to suffer from panic disorders and eating disorders. Men seem to suffer higher rates of autism, attention-deficit/hyperactivity disorder, and alcoholism…It may just be that the way we have chopped up mental disorders into kinds has led to a whole slew of unobvious gender biases. So the gender bias in the prevalence of melancholia is one of the strongest challenges to…psychiatric realism” (Bell 2014: 78, emphasis mine).

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layers’ predominated.”46 Again, this problem unfortunately spreads much wider than one diagnosis,47 and it reveals the larger ethical problem concerning how social context and

perceived normativity plays a large role in shaping how we understand mental disorders.

5.0.4 - Melancholy as a Psychiatric Conceptual Precursor to Depression

In this sense, melancholy begins to gain a more biomedical currency as the

humoural model becomes outdated. With the establishment of the Royal College of

Psychiatrists in 1841 and the American Psychiatric Association in 1844, psychiatry moves

from a fringe pseudoscience to a growing body of respected medical men optimistic about

curing the mind of its ills.48

It is no secret that psychiatric language and concepts are continually changing and

evolving, and this reality makes our predicament uncertain—at least initially. Thomas A.

Ban (2013) samples a few of these changes:

During the past 200 years the language of psychiatry has been continuously changing reflecting the changes in the conceptualization of insanity. The term “psychic reflex”, introduced by Griesinger in 1843 was replaced by the term “conditioned reflex” by Pavlov (1906) in the early years of the 20th century; the term “neurosis”, introduced by Cullen in 1777 was dismissed with the publication of DSM-III in 1980; the use of the term, “psychosis,” adopted by Feuchtersleben in 1845 was narrowed by Kurt Schneider (1950) in the middle of the 20th century by

46 Littlewood (2002: 11-12).

47 “Before the Civil War, psychiatrists discussed whether drapetomania, slaves running away from their masters, was a mental disease…During the suffragette campaigns of the late nineteenth century psychiatrists discussed whether the discontent of women was a form of ‘nervousness’ that might be remedied by a ‘rest cure.’…During the Vietnam war, psychiatrists discussed how to cure the ‘inappropriate’ reluctance of soldiers to go into battle…And during recent revisions in the standard diagnostic manual, the DSM-III psychiatrists have classified smoking as an illness and no longer refer to homosexuality as an illness” (Evison 2012: 828). “In the UK in the 1970s, there was an ‘illness’ known as ‘state benefit neurosis’, which involved the disorder of refusing to take a lowly paid job when more money was available through the benefits of the state” (Walker 2008: 166).

48 For a history of the APA, see McGovern (1985) and Barton (1987); for a history of the RCP, see Bewley (2008).

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restricting its use to “psychiatric disease” distinct from personality anomalies; and the term, “psychiatry,” coined by Reil in 1908, with its implicit separation of the mind (“psyche”) from the “body,” became anachronistic with the birth of neuropsychopharmacology in the 1950s.49

Add to this the evolution of the term “hypochondriasis,” which now refers to the imagining

of illness in oneself, but prior to the 18th century referred generally to a rumbling or

uneasiness in the gut below the rib cage.50 And finally, to our concern, the word

“depression” did not appear to gain traction until Adolf Meyer’s insistence on the usage of

the term to replace “melancholy,” what Meyer called “a depression of mental energies, of

an as yet unspecified nature”51 Prior to that, the word “depression” had enjoyed some loose

association with melancholy since Heinroth (1818) conceived of melancholia as a

“depression of emotion,” without depression of the other faculties.52 An even earlier “use

is attested from 1816 in French denoting mental illness characterized by depression.”53

5.0.5 - Religious Melancholy in 17th- and 18th-century Clergymen

Now that I have whittled away at distinguishing the different senses of melancholy,

I turn to my main topic of interest—religious melancholy. Here I will focus mainly on the notion of religious melancholy as understood by religious authors, theologians, and clergymen from the 17th and 18th centuries, such as: Robert Burton, Jeremy Taylor, Richard

49 Ban (2013: 31).

50 As its etymology will prove: the conjunction ὑποχόνδριος hypokhondrios (“of the soft parts between the ribs and navel”), from ὑπό hypo- (“under”) and χόνδρος khondros (“the cartilage [of the sternum]”).

51 According to Healy (1997: 38). Cf. Ban (2014: 17).

52 Ban (2014: 11).

53 See OED entry “melancholy, n.1” (2020), etymology.

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Baxter, Timothy Rogers, John Moore, Sir Richard Blackmore, James Robe, and Benjamin

Fawcett.54

It appears that Fawcett’s work (1780) was the last of its kind, a clergyman writing substantively on religious melancholy.55 Leading up to and after his work, more medical men were giving attention to melancholy, and, if one knows anything about 18th- and 19th- century nosologies, they made quite a mess of things!—religious melancholy gets construed as everything from scrupulosity and resultant sorrowful affect (closer to its original meanings) to mania,56 madness,57 insanity,58 paranoia,59 neurosis,60

54 Robert Burton (1577-1640) — Vicar of St Thomas's Church in Oxford; later, simultaneously also rector of Seagrave in Leicestershire (cf. Ryan, 1948: 35). Notable work: The Anatomy of Melancholy (1621/1847). Jeremy Taylor (1613-1667) — M.A. Cantab., D.D. Oxon, Bishop of Down and Connor. Notable work: Ductor dubitantium, or the rule of conscience (1660/1671). Richard Baxter (1615-1691) — Nonconformist divine and author. Notable works: A Christian Directory: Or, a Summary of Practical Theologie, and Cases of Conscience (1673/1707, Vol. I); and The Cure of Melancholy and Overmuch Sorrow by Faith and Physick (1682/1707, Vol. IV). Timothy Rogers (1658-1728) — M.A. Glasgow, nonconformist minister of London and Wantage, Berkshire. Notable work: A Discourse concerning trouble of mind, and the disease of melancholly…By Timothy Rogers who was long afflicted with both (1691/1706). John Moore — (1646-1714). Chaplain to William and Mary, Bishop successively of Norwich and Ely. Notable work: Of Religious Melancholy (1692). Sir Richard Blackmore (1654-1749) — Theologian, physician, and poet. Notable work: Treatise of The Spleen And Vapours Or, Hypocondriacal and Hysterical Affections. With Three Discourses On the Nature and Cure of the Cholick, Melancholy, and Palsies (1726). James Robe (1688-1753) — Minister at Kilsyth, Scotland. Notable work: Counsels and comforts to troubled Christians, with an essay shewing that true religion is neither the cause nor the effect of vapours and melancholy (1749). See especially “The Preface to the Reader,” pp. i-xxii. Benjamin Fawcett (1715-1780) — Minister of Paul's Meeting, Taunton, and subsequently of Kidderminster. Notable work: Observations on the nature, causes and cure of melancholy, especially of that which is commonly called religious melancholy (1780).

55 Hunter and MacAlpine (1963: 253).

56 mania: de Sauvages (1768/1772: 342), Crichton (cf. Hosack 1821: 314-15), Young (cf. Hosack 1821: 314-15), and Rush (cf. Hosack 1821: 314-15).

57 madness: Cullen (1769-1784), de Sauvages (1768/1772: 342), Haslam (1809: 307).

58 insanity: de Sauvages (1768/1772: 342), Linnaeus (1759/1763; cf. Cullen 1769-1784: 101), Vogel (1764; cf. Cullen 1769-1784: 199), Cullen (1769-1784), Sagar (cf. Cullen 1769-1784: 348), Pinel (1809).

59 paranoia: Vogel (cf. Cullen 1769-1784: 199).

60 neurosis: Cullen (1769-1784).

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hypochondriasis,61 and even nostalgia.62 This was largely due to the recent successes in

taxonomizing plants and animals in the natural world, coupled with the mistaken

assumption that this success could be replicated in classifying illnesses and diseases of the

human body and mind. “Although Cullen’s nosology moved toward a more modern

classification system, it was evident by the early 19th century that the formal rules of

biological classification were not suited for disease nosologies because diseases are by their

nature inconsistent and idiosyncratic.”63 Writing in the early 19th century, leading physician David Hosack bemoans:

[I]t will readily be admitted, that the writers upon methodical nosology have, in general, been more desirous of displaying their ingenuity and learning, in subtle subdivisions of their subject, and in devising a new nomenclature, than they have been in directing their labours to the great and useful purpose for which nosological arrangement was originally designed…Indeed, it is justly admitted by two of the latest and most learned critics upon this subject, that the same precision is not to be expected in the science of medicine that has been attained in the various branches of natural history.64

Thus, given the wide variety of classification systems, and the disagreement this produced about what religious melancholy was, I shall set aside these 18th- and 19th-century

nosologies in order to focus only on religious melancholy as discussed by religious writers

of the 17th and 18th centuries.

61 hypochondriasis: Hosack names several, including Fracassinus, Wilson, and Mandeville (cf. Hosack 1821: 314-15). This association is retained as late as Karl Leonhard (1957), who named “hypochondriacal” as one of five distinct forms of pure depressions (cf. Ban 2014: 16).

62 nostalgia: Vogel (cf. Cullen 1769-1784: 199; Hosack 1821: 44, 314-15). See also Hofer (1688), an obscure medical dissertation on nostalgia, or philopatridomania, as a mental disorder. Anspach’s (1934) is the first English translation of Hofer’s dissertation.

63 Munsche and Whitaker (2012: 238).

64 Hosack (1821: ix-x).

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The result is a distinct, identifiable kind of “melancholy,” a kind of religious sorrow

that seems connected with a hyper-awareness of one’s own sinfulness, fear of God’s

retribution, and despair at the perceived slim prospect of God’s love for and redemption of

this one specific sinner, oneself. No doubt that this same affliction has befallen people

before and after this specific time period. Yet this time period is of special interest to us,

because, historically, these religious authors fall in between the twilight of humoural

theory’s outdated notion of black bile and the advent of psychiatry with its more biomedical

models of melancholy and depression. Its spirit pierces deeper than did the old medieval

physiology, while leaving an indelible mark on what was to come.65

5.1 - Our Interest, Religious Melancholy in Particular

We turn now to religious melancholy in the works of religious authors, theologians,

and clergymen from the 17th and 18th centuries. This should not be confused with any of

the various kinds of so-called religious melancholy we have just seen in 18th-century and

19th-century medical nosologies, such as de Sauvages’s manic melancholy,66 or such as

Pinel’s religious insanity (extreme exaltation of religious opinions) which tends peculiarly

to despair and suicide.67 Rather, it is a melancholy that is characterized mainly by its affective component, on the one hand, and by its cognitive component, on the other hand.

Religious melancholy’s affective characteristics are a static and abiding or overwhelmingly

65 For instance, in the way early 19th-century English lunacy reforms were to become more humane. “In the early 19th century, evangelicalism played a major part in English lunacy reform, and in changes towards a more rational and humane legislation concerning people with mental illness” (Bewley 2008: 1).

66 « Les mélancoliques, ou plutôt les maniaques… » (de Sauvages 1768/1772: 342).

67 Pinel (1809: 265, 44-46ff). Cf. Lecky (1869: 56n), Huneman (2017).

183 oppressive sullenness, sorrow, and even fear, which is often resultant upon some recognition of oneself (its cognitive component), for example, of one’s own sinfulness, unworthiness, or sense of failure before God.68

It is noteworthy that during this era, it was not uncommon for bishops and medical men to rub shoulders with one another, as the secular-sacred distinction, particularly in medicine, was not as deeply chasmed as it is today.69 This is significant because, as we shall see, this milieu allowed for the emergence and flourishing of minds like Timothie

Bright, who was a medical doctor and subsequently an Anglican priest, and Sir Richard

Blackmore, who was well known as a poet and physician but who also wrote dense theological material.70 Many such authors we will encounter had both proper theological training and the latest medical education,71 which uniquely positions them to speak with authority on religious melancholy.

68 As we shall soon see, this does not exhaust the cognitive component. There are at least two major categories, as Burton (1621/1847: 421ff) outlines them. Those people who “In excess” of love of God “do that which is not required” (e.g., fretting over scruples, superstition) and those who “In defect” are either “Secure, void of grace and fears” (e.g., “atheists”) or are “Distrustful, or too timorous, as desperate [or] in despair.” See below Sections 5.1.1.1 and 5.1.1.2 for a further explanation of these categories.

69 “[O]n July 15, 1662, the King conferred an official charter upon the ‘Royal Society of London for Improving Natural Knowledge.’ The ninety-eight ‘original fellows’ included not only scientists like Boyle and Hooke, but poets like Dryden and Waller, Wren the architect, Evelyn, fourteen peers, and several bishops. Between 1663 and 1686 some three hundred additional fellows were enrolled. No class distinctions divided them; dukes and commoners rubbed elbows in the enterprise; and poor members were exempt from dues. In 1673 Leibniz, admitted to membership, declared the Royal Society the most respected intellectual authority in Europe” (Durant 1963: 496-97).

70 Such as his Modern Arians Unmask’d (1721), Just Prejudices against the Arian Hypothesis (1721), and Natural Theology, or, Moral Duties Consider'd apart from Positive (1728).

71 We could include psychological education here as well, but it is a bit anachronistic. In any case, writers like Timothy Rogers and Richard Baxter, who doled out advice to those in melancholic suffering, had deep, piercing psychological insights.

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I begin first by delving into Burton’s Anatomy of Melancholy, as his analysis of

religious melancholy, in virtue of being the first of its kind,72 serves as a useful guide for

understanding later accounts. We uncover therein two kinds of religious melancholy, one

marked by excess, the other by defect. Next, I turn to examining the causes—both

pathological and non-pathological—surrounding religious melancholy, looking not only to

Burton but to several different authors.

5.1.1 - Robert Burton’s Analysis of Religious Melancholy in The Anatomy of Melancholy (1621), Which is a Model for Understanding Later Accounts

In discerning the characteristics of and circumstances surrounding the onset of

religious melancholy in this era, one can do no better than by turning to Robert Burton’s

Anatomy of Melancholy. It is easy to underestimate Burton’s immense scholarly

contribution, “one of the most fantastic works, not only of 17th-century English literature

but of all literature.”73 The product of a learned and erudite mind, Anatomy is modeled after

Scholastic syntheses and is a veritable gauntlet of “countless quotations…from almost

1000 different authors.”74 The work is all but forgotten today—known to a few esoteric

literature enthusiasts, perhaps, yet virtually unknown to mental health professionals.75

Burton’s esteem, however, is preserved in Christ Church at Oxford, where he served as

72 “I have no pattern to follow as in some of the rest [i.e., with other kinds of melancholy], no man to imitate. No physician hath as yet distinctly written of it as of the other” (Burton 1621/1847: 593).

73 Ryan (1948: 35).

74 Ryan (1948: 37).

75 If known, it certainly lacks influence. There are of course some exceptions, such as Kendler’s (2019) recent article examining the historical search for causes of psychiatric illnesses, beginning with Burton.

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vicar (at St. Thomas’s Church) and as College Librarian.76 In the Cathedral’s northeast

corner, in the Lady-Chapel, there is a wall monument, against the pier opposite the shrine

of St. Frideswide, which features Burton’s bust above an inscription that reads, Paucis

notus, paucioribus ignotus, hic jacet Democritus Junior cui vitam dedit et mortem

melancholia.77 In the Christ Church Hall, in the far right corner beyond the noble portraits crowding the walls, is tucked away the inconspicuous stained-glass north window,

displaying four eminent figures: Robert Burton, John Locke, and two College deans

Aldrich and Fell.78 Burton’s own portrait, the 17th-century original, is but a five-minute

walk to Brasenose College.

Opening the Anatomy, one can see that Burton is fully aware of the immense task before him, and aware of the cutting-room floor that he has inherited, wittily remarking,

“The Tower of Babel never yielded such confusion of tongues as this Chaos of Melancholy doth variety of symptoms.”79 Not only does he understand that “melancholy” is

synonymous with all kinds of foolishness, madness, delirium, and disease, but he thinks—

as anyone might, with a net cast this wide—just about every person has some kind or degree

76 “In 1616 Burton was appointed vicar of St Thomas’s Church, Becket Street, Oxford (a Christ Church living) and his coat of arms appears on the south porch there. From 1624 until his death he also served as College Librarian at Christ Church (this was before the present Library was built, so Burton worked in the ‘Old Library’ in the cloister – today student accommodation). It was this library and the Bodleian Library that he chiefly drew from when compiling his exhaustively researched Anatomy. On his death his own personal library, of at least 1700 titles, was split between the Bodleian and Christ Church” (Godfrey 2019). The author here, Jim Godfrey, is one of the Cathedral Vergers and has worked at Christ Church since 1987.

77 “Known to few, unknown to fewer, here lies Democritus Junior who gave his life and death to melancholy.” On the location of this wall monument, see King (1862: 3-24). “Democritus Junior” is the pseudonym under which Burton originally published the Anatomy in 1621.

78 Haverfield (1907: 4).

79 Burton (1621/1847: 240).

186 of it.80 Thus, Burton’s aim in Anatomy was to compile and categorize all the different varieties of melancholy.

In the book-length preamble, Democritus Junior to the Reader, we receive a satirical and candid, though at times self-deprecating, presentation of the author. One gets the sense he is playing a delicate game of enticement with the reader: “Thou thyself art the subject of my discourse.”81 His elegant prose is then punctuated with moments of irony and self-awareness that he, too, is but a fellow melancholic sufferer in need of understanding and a cure.82 All the while, in the background seems to be some admonition as to the real value of analyzing these matters using only the intellect [“wisdom”]. He warns the reader:

So that take melancholy in what sense you will, properly or improperly, in disposition or habit, for pleasure or for pain, dotage, discontent, fear, sorrow, madness, for part, or all, truly, or metaphorically, ’tis all one. Laughter itself is madness according to Solomon, and as St. Paul hath it, “Worldly sorrow brings death.”…“In the multitude of wisdom is much grief, and he that increaseth wisdom, increaseth sorrow,” [Eccl.] ii. 17.83

80 “For indeed who is not a fool, melancholy, mad?—Qui nil molitur inepte, who is not brain-sick? Folly, melancholy, madness, are but one disease, Delirium is a common name to all. Alexander, Gordonius, Jason Pratensis, Savanarola, Guianerius, Montaltus, confound them as differing secundum magis et minus [in degree];…and ’twas an old Stoical paradox, omnes stultos insanire, all fools are mad, though some madder than others…‘Tis the same which Tully maintains in the second of his Tusculans, omnium insipientum animi in morbo sunt, et perturbatorum, fools are sick, and all that are troubled in mind: for what is sickness, but as Gregory Tholosanus defines it, ‘A dissolution or perturbation of the bodily league, which health combines:’ and who is not sick, or ill-disposed? in whom doth not passion, anger, envy, discontent, fear, and sorrow reign? Who labours not of this disease? Give me but a little leave, and you shall see by what testimonies, confessions, arguments, I will evince it, that most men are mad…” (Burton 1621/1847: 28-29).

81 Burton (1621/1847: 15).

82 “I write of melancholy, by being busy to avoid melancholy. There is no greater cause of melancholy than idleness, ‘no better cure than business’” (Burton 1621/1847: 18).

83 Burton (1621/1847: 29).

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Of the Anatomy, and of the curious preamble in particular, one author writes, “The book is

a catalogue of passions as well as a compendium of quotes and stories–not so much a

medical treatise, even though there are, and must be, pages on anatomy and physiology.”84

After the preamble, Burton proceeds to analyze and divide up melancholy, employing an

elaborate order “modeled upon that of the Summa Theologica and other great scholastic

syntheses.”85

We locate our interest towards the end of the Anatomy, in the Third Partition:

Burton’s discussion of religious melancholy in particular. Since he is treading new territory

here—i.e., giving an analysis of melancholy of a religious kind into its various divisions—

Burton writes, “I have no pattern to follow as in some of the rest [i.e., with other kinds of melancholy], no man to imitate. No physician hath as yet distinctly written of it as of the other; all acknowledge it a most notable symptom, some a cause, but few a species or kind.”86 And indeed, Burton’s analysis becomes a foil for virtually all later analyses of religious melancholy. He places religious melancholy under the genus of love melancholy,

the importance of which will become evident as we proceed.

First and foremost, Burton presumes the truth of the Christian faith, and begins his

discourse on religious melancholy by describing God’s love and beauty and the story of

84 Arikha (2013).

85 Ryan (1948: 37). “Thus Burton divides his work into three partitions; each partition is subdivided into sections; the sections into members, and the members into subsections. Before each partition stands an analytical scheme showing its complete subject-matter in outline. These outlines are useful and even necessary” (Ryan 1948: 37). See Paul Jordan-Smith’s Bibliographia Burtoniana (1931: 31, 35, 60), where he discusses Burton’s usage of the Angelic Doctor.

86 Burton (1621/1847: 593).

188 salvation. The rationale for beginning here is that it provides the backdrop for explaining the ultimate telos of human beings—and how pursuing that telos often goes awry.

As Melancthon discourseth…‘And him our will would have loved and sought alone as our summum bonum, or principal good, and all other good things for God’s sake: and nature, as she proceeded from it, would have sought this fountain; but in this infirmity of human nature this order is disturbed, our love is corrupt’…we are carried away headlong with the torrent of our affections: the world, and that infinite variety of pleasing objects in it, do so allure and enamour us, that we cannot so much as look towards God, seek him, or think on him as we should.87

Burton begins by noting, via Melanchton, the telos of man, to love and seek after God as summum bonum. Similarly, for nature, by which Melanchton may mean nature in general or more specifically human nature; because man’s Postlapsarian nature is infirm, marked by original sin, the natural good order of our affections becomes disturbed and disarrayed, and “we are carried away headlong with the torrent of our affections.” Instead of loving

God properly as we ought, we are prone to fail in one of two ways: either excess or defect

(a schema reminiscent of the Aristotelian Doctrine of the Golden Mean). This twofold division reflects two different kinds of religious melancholy, according to Burton. He writes: “For method’s sake I will reduce them to a two-fold division, according to those two extremes of excess and defect, impiety and superstition, idolatry and atheism.”88 Erring on the side of defect in loving God is easy enough to see, but what is this about loving God in excess? Burton explains,

Not that there is any excess of divine worship or love of God; that cannot be, we cannot love God too much, or do our duty as we ought, as Papists hold, or have any perfection in this life, much less supererogate: when we have all done, we are unprofitable servants. But because we do aliud agere [inattentively, indifferently], zealous without knowledge, and too solicitous about that which is not necessary,

87 Burton (1621/1847: 595-96).

88 Burton (1621/1847: 597).

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busying ourselves about impertinent, needless, idle, and vain ceremonies, populo ut placerent [desirous to please people].89

So, then, it is not actually a loving God in excess, which is impossible. (In this, Burton agrees with Aquinas: ST II-II.24.7.co.) Rather, it is much in the same way as other virtues and vices; for instance, foolhardiness is not an excess of the virtue courage, since it is incorrect to say that a vice is the result of too much virtue, but it is a disordering of (in a sense that can be called excess) those internal affections, estimations, and so on, that, were they to be in moderation, would properly be called courage. So it is with this vice of excess where the virtuous mean is proper love of God.

Simply put, by this category of “excess” I understand Burton to mean a disordered approach towards God, where the mode is love of God; and by “defect” a disordered withdrawal, or retreat, away from God, where the mode is love of God.90 With respect to

both, the mode is love—approaching God in love, or withdrawing from God in lack of

love—as opposed to fear, or hatred, or some other affect under which we could evaluate

the same movements. Of course this is not to say that these other passions are irrelevant;

the complex desires of a human person are such that love of God and (certain kinds of) fear

of God are likely inversely related: a withdrawal from God in lack of love may necessarily

be accompanied by a withdrawal from God in fear, and vice versa.91

89 Burton (1621/1847: 597).

90 As will become apparent later, this provides the grounds for saying how even nonreligious persons can have religious melancholy. They need not have in mind any religious object. What others call general melancholy might actually be a case of religious melancholy—fueled by Sehnsucht, that inarticulable, inchoate longing after the Creator, living as wayfarers in a foreign land—even if the subject is unaware of it.

91 As I say, only some species of fear, such as shame (verecundia) and embarrassment (erubescentia). It may be true that love of God is positively correlated with other species of fear, such as wonder (admiratio) and awe (stupor). See Thomas Aquinas’s treatment of the species of fear in ST I- II.41.4.co.

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In the next couple of sections, we will see just how Burton unpacks these vices of excess and deficiency, with respect to loving God, both of which he sees fit to term

“religious melancholy”. The affective component will differ in some cases, more dramatically in others, whereas the cognitive component will differ on these accounts of excess and defect. For both of these kinds of religious melancholy, Burton summarizes the exterior and interior causes and the symptoms, with which I begin. In the section following these, in 5.1.2, I shall then undertake in more depth the issue of causes preceding religious melancholy with an eye towards evaluating whether one can be at fault for having religious melancholy.

5.1.1.1 - Religious melancholy as characterized by excess: disordered approach towards God where the mode is love of God. The exterior causes of this kind of religious melancholy are, according to Burton, “the devil’s allurements, false miracles, priests for their gain. Politicians to keep men in obedience, bad instructors, blind guides.”92 Its interior causes are “simplicity, fear, ignorance, solitariness, melancholy, curiosity, pride, vainglory, decayed image of God.”93 And its symptoms are “zeal without knowledge, obstinacy, superstition, strange devotion, stupidity, confidence, stiff defence of their tenets, mutual love and hate of other sects, belief of incredibilities, impossibilities.”94 Notice immediately that among the interior causes of religious melancholy he includes

92 Burton (1621/1847: 421).

93 Burton (1621/1847: 421).

94 Burton (1621/1847: 421).

191 melancholy. This is a surprising inclusion that makes little sense at the moment, and we shall return to it at the end of Section 5.1.1.2.

This sense of religious melancholy is excess in the sense that it results from ignorant overzeal or, as some authors put it, disordered passions, moral impulses, or religious feelings.95 It is a disordered approach towards God, a disordered inclination towards loving

God: while the end is good and right, the means or the mode is misguided. Patrick Blair writes of a person stricken with religious madness, “It was at first a fiery zeal for Religion, or rather a mistaken notion of it too much encourag’d by a certain set of people that disordered his senses and at last made him furiously mad”96 Notably, this kind, characterized by excess, appears to approximate religious madness or religious insanity, but with the key difference being that religious melancholy by excess is invariably accompanied by sorrow, namely, when the offerings and posturings of those who “do that which is not required” are not received as they would expect.

Sometimes this comes about, as we have seen, because of simplicity or ignorance, other times because of fear. We call such persons scrupulous—in a certain sense. Scruples and fear will also feature prominently in the next section on religious melancholy by defect, so for now we would do well to observe Bishop John Moore’s distinctions between different cases of scruples. (1) “The first case is of those who are apt to think that the reformation of their lives hath not proceeded from a sincere love of God…; but from a meer dread of those punishments which he hath threatned.”97 (2) “The Second Case relates

95 cf. Knight (1827: 32-36), Pinel (1809: 44-46).

96 Blair in Hunter and MacAlpine (1963: 326)

97 Moore (1692: 4).

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to them who find a flatness in their Minds, and want of Zeal when they apply themselves

to any Religious Duty; which makes them fear, that what they do, is so defective and unfit

to be presented unto God, that he will not accept it.”98 Between these two, of course, the

latter fits more squarely into the next kind of religious melancholy, which is characterized

by defect, since it arises from a pusillanimous and disordered view of oneself and of one’s

own offerings to God. But the first kind, as we can see, is at least consistent with the kind

of person who, in overzeal and ignorance, due to a fearful misunderstanding of their status

before God, offers up “that which is not required,” hoping beyond all hope to please God

more and receive more of His love.

5.1.1.2 - Religious melancholy as characterized by defect: disordered withdrawal

away from God where the mode is love of God. Burton does not as cleanly distinguish

between exterior and interior causes for this latter kind of religious melancholy. Instead,

he begins by noting a few causes, some of which we recognize from before.99 He begins,

“the devil and his allurements, rigid preachers, that wound their consciences, melancholy,

contemplation, solitariness.”100 Burton then finds it necessary to interpose at this point a

discussion on “How melancholy and despair differ,” after which he enumerates a few more

causes of this kind of religious melancholy, “Distrust, weakness of faith, guilty conscience

98 Moore (1692: 4).

99 The causes we see repeated here, which before belonged to the exterior, are: “the devil’s allurements” and clergy who abuse positions of authority and influence. The causes we see repeated here, which before belonged to the interior, are: “melancholy”, “solitariness”, and some mistaken image of God and his loving mercies. In the following, I will assume that these same categorizations into exterior and interior causees hold for this latter kind of religious melancholy (by defect), just as they did for the the former kind (excess).

100 Burton (1621/1847: 421).

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for offence committed [i.e., scruples], misunderstanding Scr[ipture].”101 Finally, its

symptoms are “fear, sorrow, anguish of mind, extreme tortures and horror of conscience,

fearful dreams, conceits, visions, &c.”102 This kind of religious melancholy is characterized by lack or deficiency in the sense that it is a disordered withdrawal away from loving God, rather than a disordered inclination towards loving God, as we saw above. Since withdrawal from a love relationship can take many different forms, this kind of religious melancholy will look different for different individuals; but the key feature they have in common is a movement away from God, whether out of fear or allurement or weakness, which resolves in a characteristic sorrow or sullenness for which this melancholy is named.

As I indicated in the preceding section, one common avenue of withdrawal leading

to this kind of religious melancholy by defect is scrupulosity. One author, speaking of

Puritan John Owen’s tumble into “an indignant melancholy” which coincided with the

twilight of Puritanism and a fear of growing secular reactionism, uses the following

metaphor which recalls how King “James VI once spoke of 'this salmond-like instinct of ours' which prompts a man to revisit his early haunts.”103 For many these haunts take the

form of scrupulosity, overanalyzing one’s own faults, living in fear of God’s retribution

and in unrelenting awareness of one’s own unworthiness. Bishop Jeremy Taylor succinctly

101 Burton (1621/1847: 421).

102 Burton (1621/1847: 421).

103 Moffatt (1904: 65-66). The original context of King James VI of Scotland and I of England’s remark is with respect to visiting his old homeland, as he writes in December 1616 of his intent to return to Scotland for the first time since 1603: “First, wee ar not ashamed to confesse that wee have had these ma[nie] yeiris a greate and naturall longing to see our native Soyle and of our birth and breeding. And this salmonlyke instinct of our [mind] restleslie, both when wee wer awake, and manie tymes in our [sleep], so stirred up our thoghtis and bended our desiris to make ane [jorney] thither that wee can never rest satisfied till it sall pleas [God] wee may accomplish it. And this wee do upoun our hon[our say] to be the maine and principall motive of our intended jorney” (Burton, et al. (RPC), 1891: 685). Cf. MacDonald (2005: 893).

194 remarks of the dual-edged nature of scrupulosity: “Scruple is a little stone in the foot, if you set it upon the ground it hurts you, if you hold it up you cannot go forward; it is a trouble where the trouble is over, a doubt when doubts are resolved.”104 The context of

Taylor’s remark lies within a larger theological discussion on right conscience which guides the believer in righteousness under the New Covenant;105 however, Hunter and

MacAlpine’s anthology unapologetically gives to Taylor’s piece the anachronistic, clinical label, “obsessional neurosis.”106 A prominent Puritan author Richard Baxter similarly addresses scrupulosity in the larger context of his treatise on Christian ethics, this specific portion of which is devoted to staying one’s thoughts. Baxter writes of those who are prone to melancholic thoughts, “Their Thoughts are most upon themselves, like the Mill-stones that grind on themselves when they have no grist; so one Thought begets another. Their

Thoughts are taken up about their Thoughts…Their Thoughts are all perplexed…They are endless in their Scruples.”107

* * *

104 Taylor (1660/1671: 158).

105 Concerning the New Covenant, or New Law of Christ, being written on tablets of human hearts as opposed to tablets of stone, the relevant passages of Scripture are: 2 Cor. 3:3, Jer. 31:33, Heb. 8:10, and Heb. 10:16. As to replacing a heart of stone with a heart of flesh which walks in the statutes of God, see: Ezek. 11:19-20 and Ezek. 36:25-27.

106 It is not entirely inaccurate; but neither is it entirely genuine (i.e., authentic to the period). To their credit, however, they are careful with some of their phrasing: “A scruple as Taylor defined it is in psychiatric terminology today called an irrational fear or obsessional phobia” (Hunter and MacAlpine 1963: 163, italics mine).

107 Baxter (1673/1707, Vol. I: 249), which contains his opus The Christian Directory, in which this excerpt appears: specifically in Part I, “Christian Ethicks”; Chap. VI, “Directions for the Government of the Thoughts”; Tit. 5, “Directions to the Melancholy about their Thoughts, Signs of Melancholy, The Causes, Directions for cure, Special truths to be known for preventing causes, troubles, &c.” Cf. Hunter and MacAlpine (1963: 241).

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There are two important takeaways to note from what has been discussed up to

now. First, both of these authors, Taylor and Baxter, had included the problem of

scrupulosity under ethics and right Christian living. In that respect, to be scrupulous was

seen as a problem of wrongful thinking, for which one could be held culpable, and not

necessarily as an illness of the mind. It may spring up without notice. “Very often it

[scrupulosity] hath no reason at all for its inducement, but proceeds from indisposition of

body, pusillanimity, melancholly,” or from a host of other potential causes.108 While it may

arise involuntarily, to allow it to linger was considered properly a human action, if not done

directly then indirectly, if not a positive act then a negative act, as when a person lets his

thoughts drift without attempting to restrain or divert them. Paradoxically, scrupulosity can

be seen as a perverse form of self-love, or self-preference, as the scrupulous man does not

think to judge others as harshly as he judges himself.109 It may manifest as disgust or hatred

for self, but oftentimes involuntary emotional reactions are the product of (in this case, an incorrect) apprehension,110 or construal,111 of the situation.

Second, both Taylor and Baxter, as well as Rogers and Burton, all retained a view

which regarded melancholy, in some form or another, as a disease. As I had mentioned

108 Taylor (1660/1671: 158-59).

109 From Aquinas (ST II-II.27) to Kierkegaard (WL: 54; cf. Lippitt, 2013: Ch. 3), Christ’s mandate to love others (Mk. 12:30-31) is grounded in proper love of self, which, in turn, is grounded in proper love of God. In scrutinizing ourselves with such severity, we are failing, as Kierkegaard would put it, to live up to that passage of Scripture (1 Pet. 4:8) which teaches that “‘Love hides a multitude of sins’; what it cannot avoid seeing or hearing, it hides by silence, by a mitigating explanation, by forgiveness” (WL: 289, cf. 289- 94).

110 For Thomas Aquinas, following Aristotle, a passion of the sensitive appetite is always preceded by an apprehension: “Appetite follows apprehension” (ST I.78.1.ad2; I.79.2ad2; I.80.1.ad3; I.81.2). Cf. Miner (2009: 15, 66).

111 For emotions as “concern-based construals,” see Roberts (2003).

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above, Burton names melancholy itself as a potential interior cause of religious melancholy

(of either kind, excess or defect). This makes sense (and escapes the charge of circular

reasoning) if we understand this “melancholy” in the sense of a physical indisposition112

(i.e., black bile) which causes in someone the manifestation of an instance of religious

melancholy. Importantly, then, it would follow, on Burton’s account, that a person’s state

of religious melancholy may or may not be due to a physical disease. (He uses the sense of

“melancholy” when it is predicated as “religious melancholy” more broadly or loosely than when “melancholy” is used in a standalone context, in which case its specific meaning is physical ailment or disease.) This accords well with Taylor’s account. As we discussed earlier, scruples is one potential cause of religious melancholy; and we have just seen that

Taylor names “melancholly” and “indisposition of body” as potential causes of scruples,113

a claim that makes much clearer sense if he means melancholy as a disease. At one point,

Taylor appears to advance a distinction between the “melancholy man” and the “scrupulous

man.”

The scrupulous man is timorous, and sad, and uneasy, and he knows not why. As the melancholy man muses long, and to no purpose, he thinks much, but thinks of nothing; so the scrupulous man fears exceedingly, but he know not what nor why. It is a Religious melancholy, and when it appears to be a disease and a temptation, there needs no more argument against its entertainment.114

But then his last remark above indicates that he thinks these categories are not mutually

exclusive. “It is a Religious melancholy,” he says, “when it appears to be a disease and a

112 Recall that now-entrenched medical terms like “disease” originally connoted nothing more than a bodily un-easiness, and “disorder” indicated some dis-ordering of a normatively ordered bodily constitution.

113 Taylor (1660/1671: 158-59).

114 Taylor (1660/1671: 164).

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temptation.”115 That is, when these categories of scrupulosity (a temptation) and

melancholy (a disease) overlap, the product is religious melancholy.

Rogers is more forthright, saying simply, “It is a real disease.” Within context,

however, we can see he is a bit more nuanced:

It is a foolish course which some take with their melancholy friends, to answer all their complaints and moans with this, that it’s nothing but fancy; nothing but imagination and whimsey. It is a real disease, a real misery that they are tormented with: and if it be fancy, yet a diseased fancy is as great a disease as any other; it fill them with anguish and tribulation.116

It is a disease, says Rogers; and if it’s not, then the person’s own perception is, in a sense,

diseased. The afflicted person’s phenomenological experience, affectively and cognitively,

is tainted. “The Distemper of the Body causeth Distemper of Soul,” Symonds says, “for

the Soul follows its Temper. This Disease worketh strange Passions, and strange

Imaginations” as a result.117 Baxter picks up on this same theme, saying, “the thinking

Faculty is diseased, and becomes like an inflamed Eye, or a Foot, that is sprained or out of joint, disabled, for its proper Work.”118 The mind’s proper work is to think, hence the

advice: “Trust not to your judgment, in your melancholy state,” critical matters such as

“the condition of your souls, or the choice and conduct of your Thoughts or ways,” but rely

115 Taylor (1660/1671: 164).

116 Rogers (1691/1706: xi-xii).

117 Symonds (1642: 274).

118 Baxter (1682/1707, Vol. IV: 845). Indeed, Luther recounts how the believer can duped into believing that it is Christ who “vexes and torments them”: “`Tis a fearful thing when Satan torments the sorrowful conscience with melancholy; then the wicked villain, masterlike, disguises himself in the person of Christ, so that it is impossible for a poor creature, whose conscience is troubled, to discover the knavery. Hence many of those, that neither know nor understand the same, run headlong into despair, and make away with themselves; for they are blinded and deceived so powerfully by him, that they are fully persuaded it is not the devil, but Christ himself, that thus vexes and torments them” (Luther, 1566/1872: 262).

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on others, such as “the judgment and direction of some experienced faithful guide.”119

Since it is a disease, Baxter also directs his readers to “neglect not Physick,” or medicine:

And do not as most melancholy persons do, that will not believe that Physick will do them good, but that it is only their soul that is afflicted: For it is the spirits, imagination and passions that are diseased, and so the soul is like an eye that looketh through a coloured glass, and thinks all things are of the same colour as the glass is.120

In fact, Baxter plainly states, as if in the form of a maxim, “till the body be cured, the mind

will hardly ever be cured.”121 Though some will protest that “that Physick cannot Cure

Souls,” Baxter understands that the “Soul and Body are wonderful Copartners in their

Diseases and Cure,” and that if there is medicine available for the body, then “we have

Reason to use such means.”122 This understanding of melancholy as a disease, which is

sometimes a contributing cause to religious melancholy, is important to keep in mind when

trying to discern whether a person, or some other non-pathological cause, is responsible

for having religious melancholy, the focus of our next topic.

5.1.2 - The Non-Pathological Causal Predicament Preceding Religious Melancholy: Or, Who’s to Blame?

We have just seen that, on Burton’s account, a person’s condition of religious melancholy may or may not be due to a physical disease. This has tremendous implications for what we say “religious melancholy” is. For now we can think of a religious melancholy

119 Baxter (1673/1707, Vol. I: 254).

120 Baxter (1673/1707, Vol. I: 254).

121 Baxter (1673/1707, Vol. I: 254).

122 Baxter (1682/1707, Vol. IV: 844-45). Cf. Baxter (1749: 253), Hunter and MacAlpine (1963: 241- 43).

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that is pathologically caused (i.e., by a disease, viz., melancholy), as well as a religious

melancholy that is not. A competing view to this can be found in the words of Blackmore

that religious melancholy “chiefly, if not only, happens when the patient, seized with these

disorders, was accustomed to divine thoughts and spiritual ideas before.”123 That is, there

is nothing particularly special or separate about religious melancholy; it is just melancholic

illness with a religious tinge to it. Fawcett seems to agree: In a section titled “Why

Melancholy is sometimes called religious,” he answers “It appears…that this disease first

affects the body, and afterwards the mind, by filling the thoughts with continual gloom,

and sometimes horror.”124 But Fawcett then offers that religious melancholy is a distinct

species because it is differentiated by its object of attention [a person’s “subject of

uneasiness”].125

If their subject of uneasiness be any thing relating only to the present life and world, it is called in general, melancholy. But if religion, the soul, and eternity be the subjects of uneasiness, it is called, religious melancholy.126

Fawcett’s view seems to entail, contra Burton, that there are no cases where religious

melancholy is non-pathologically caused.

In this section, I want to examine Burton’s contention further. I turn my focus onto

the cases of religious melancholy that are ostensibly caused non-pathologically. If it is not

pathologically caused, other causal contributors that our authors have proposed are:

123 Blackmore (1726: 158-59).

124 Fawcett (1780: 20).

125 Thomas Aquinas often distinguishes species of passions, for instance, in virtue of them having different objects.

126 Fawcett (1780: 20).

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Religion, God, the devil, or a person’s own moral impulses or weakness of faith. I first

discuss God and the devil in 5.1.2.1. Then, after a brief inquiry into “physick” or medicine

in 5.1.2.2, I take up the possible non-pathological causal contributors of Religion in 5.1.2.3

and a person’s own moral impulses or weakness of faith in 5.1.2.4.

5.1.2.1 - God and the devil. There are obvious reasons to want to absolve God from

direct responsibility for something bad. To my knowledge, none of our authors attribute

religious melancholy to God’s direct activity. As Rogers points out, even in Job’s case,

who was covered “all over with tormenting sores, which brought the poor man into a very

great melancholy,” it was the devil who afflicted him, “and by God’s permission, no

doubt,” because of “the envy and rage that he is filled with, [which] prompts him to disturb

the health and peace of men.”127 Puritan minister Cotton Mather writes of a man who “fell

in that balneum diaboli, ‘a black melancholy,’” primarily because “Satan who had been

after an extraordinary manner irritated by the evangelic labors of this holy man, obtained

the liberty to sift him.”128 Melancholy was known, since medieval times,129 as “the devil’s

bath” (balneum diaboli), and various recent authors have pointed to this label as historical

evidence for a strong association with the devil.130 Burton writes plainly, “The principal

127 Rogers (1691/1706: xiv-xv).

128 Quoted in Adams (1892, Vol. 2: 601).

129 Schleiner (1985: 164) tells us that Luther gets this adage from the medievals. Földényi (2016: 74-75) and Burton (1621/1847: 259) more specifically point to Avicenna, according to whom Földényi says, “the bile is painted black by the devil, which is why black bile was proverbially said to be the devil’s bath (balneum diaboli).”

130 Brann (2002: 5-7), Földényi (2016: 74-75), Gowland (2006b: 86), Jimenez (1986: 29), Lawlor (2012: 39-40, 126), Podmore (2013: 112), Radden (2002: 165; 2017: 55), Schleiner (1985: 164), Schmidt (2007: 49), Vacek (2015: 20).

201 agent and procurer of this mischief [despair] is the devil.”131 Nevertheless, many of our authors, in a move which may be surprising, are quick to turn attention away from devilish causes. Rogers advises,

[D]o not attribute the effects of meer disease to the devil; though I deny not that the devil has an hand in the causing of several diseases…But notwithstanding all this, it is a very overwhelming thing to attribute every action almost of a melancholy man to the devil, when there are some unavoidable expressions of sorrow, which are purely natural and which he cannot help, no more than any other sick man can forbear to groan and sigh. Many persons will say to such, why do you so pore and muse, and gratify the devil? Whereas it is the very nature of the disease to cause such fixed musings.132

Indeed, it is the very nature of melancholy qua disease to complicate the mind with turmoil, just as it is the nature of “tormenting sores” to be itchy or painful. So the melancholic sufferer who bemoans, pores, and fixedly muses should be no more to blame for these actions than Job should be blamed for flinching at his sores. These actions themselves are a response to the disease—and an expected response, at that—they are not actions of the devil. We may attribute cause of the disease to the devil, where it is appropriate, but not the effects, where these effects are more properly a man’s own actions or response to the discomfort he is in. Says Rogers, in a vein reminiscent of Ockham’s razor, “I would not have you to bring a railing accusation against the devil, so as to attribute to him a thousand things, wherein he has no hand at all; neither must you falsly accuse your friends, by saying, that they gratify him, when they do not so.”133

131 Burton (1621/1847: 640).

132 Rogers (1691/1706: xiv).

133 Rogers (1691/1706: xvi-xvii).

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Concerning “balneum diaboli”, while it is true that many religious authors used this

phrase (or something near it) in connection with melancholy,134 it is important to

understand exactly what they were meaning by it. We find that balneum diaboli was not

uniquely a supernatural affliction, such as a demonic or other-worldly attack, but rather

manifested primarily, if not entirely, simply as the natural (i.e., bodily and mental)

affliction of melancholy. Burton writes, “and besides, the humour itself is Balneum

Diaboli, the devil’s bath.”135 Elsewhere he gives a rationale: “Besides, as I have said, this

humour is balneum diaboli, the devil’s bath, by reason of the distemper of humours, and

infirm organs in us.”136 And finally: “His ordinary engine by which he produceth this

effect, is the melancholy humour itself, which is balneum diaboli, the devil’s bath.”137 To

summarize, it is melancholy itself which is “devil’s bath,” used in a poetically descriptive

sense because the experience is burdensome and also in a more literal or theological sense

to account for the badness of the experience. In it, the devil makes use of a man’s faculties

against him; his means are the human being’s own bodily and mental constitution. This

assessment accords well with a remark by 17th-century Jesuit priest Cornelius à Lapide:

“This is no more than a melancholic humor (viz., an opportunity for the adversary to vex

134 Including, but not limited to: Cotton Mather (1702/1820: 396; cf. Radden 2002: 165; Vacek 2015: 20), Robert Burton (1621/1847: 126, 259, 640, 653, 659), and Martin Luther (1566/1872: 270; cf. Schleiner 1985: 165). And, as we are told by second-hand: St. Caterina of Genoa (cf. Lawlor 2012: 40, 126), St. Teresa of Ávila (cf. Földényi 2016: 75), Philip Melanchthon (cf. Watson 1686/1833: 279), Galgerandus of Mantua (cf. Burton 1621/1847: 126; cf. Földényi 2016: 74-75), Serapio (cf. Burton 1621/1847: 653), as well as “the Arabian Rhasis,...Michael Psellos, Gordonius, Paracelsus,” and many others (Földényi 2016: 75).

135 Burton (1621/1847: 259).

136 Burton (1621/1847: 659).

137 Burton (1621/1847: 640).

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men.) [This is] why the devil, who deals with natural causes, mainly uses a melancholy

humor.”138 It is perhaps not surprising if we consider that the devil may use only what material is available to him; so he is constrained by, or rather takes advantage of, one’s faculties, humours, and indispositions. Baxter explains:

And withall, the malice of the Devil plainly here Interposeth, and taketh advantage by this disease, to tempt and trouble them, and the shew his hatred to God, and Christ, and Scripture and to them. For as he can much easier tempt a cholerick person to anger, than another; and a flegmatick fleshly person to sloth, and a sanguine or hot tempered person to lust and wantonness; so also a melancholy person to thoughts of blasphemy, infidelity and despair.139

Of course the question remains whether the devil is necessary for the causing of

melancholy. Is the devil responsible for all cases of melancholy, or only some? One could

object here that invoking the devil is explanatorily superfluous, since the physical story is

the same whether or not we include the supernatural explanation. But this objection seems

to presuppose, first, a causal closure view of the physical world, at least methodologically

speaking, and, relatedly, that the physical explanation given is an entirely sufficient and satisfactory explanation. For we cannot judge that invoking the supernatural is explanatorily superfluous unless we are willing to argue that the physical cause story amounts to a fully satisfactory explanation. It may not be.140 In addition, perhaps it is true

138 Klibansky, et al. (1964/1979: 77n). “In the sixteenth century this notion still—or again—appears, treated now from the angle of humoral pathology rather than of moral psychology. Cornelius A Lapide (Cornelii a Lapide...commentarii in scripturam sacram, Lyons-Paris 1865, says (on I Reg. 16.23): ‘Nullus enim humor magis quam hic melancholicus (sc. opportunus est diabolo, ut homines vexet.) Quare daemon, qui agit per causas naturales, maxime utitur humore melancholico.’”

139 Baxter (1673/1707, Vol. I: 250).

140 There is the old retort, “Almost doesn’t count—except in horseshoes and hand grenades!” Sometimes “close enough” is satisfactory. It all depends upon what one’s goals are, as well as the level of insight of the audience. In medicine, for example, the physician will offer one explanation to the patient or layperson which will satisfy them, but which the technician or professional will find frustratingly insufficient. To this latter group, the physician must present a different explanation, albeit of the same, in order for it to be a satisfying explanation. At the level we are operating in this inquiry, the level of ontology, we seek a satisfying and true explanation of what a thing is and how it comes about, regardless of whether that 204 that the devil is responsible for all cases of melancholy: after all, such a being’s activities are epistemically opaque to us. If so, then there are no cases where the physical cause and the supernatural cause are not both present, though we might be unaware of the latter.141

Many other authors, before and after these, have weighed in on this complex subject.142 If my preceding remarks regarding satisfying explanations and causation is right, then this lays the groundwork for a better understanding of how other ostensibly non- pathological causes of religious melancholy, such as Religion and one’s own moral impulses or weakness of faith, may be consistent with pathological causes or explanations of the same. Before turning to those, however, we must first take a moment to investigate the attitudes of our religious authors towards the use of medicine, or “physick”, by persons who were afflicted with religious melancholy. That is, if many hold to a view that religious melancholy was in part supernaturally caused, what did they say about taking medication for melancholy?

5.1.2.2 - Physick for ostensibly non-pathologically caused religious melancholy.

We are perhaps accustomed to assuming that the previous age was feverishly religiously

explanation is physical or nonphysical, natural or supernatural. If we have reason to consider melancholy under the aspect of the supernatural—and there are such good theological/theodical reasons, in addition to the precedent we find in the religious authors we’ve been looking at—then we are well within rights to find an entirely (merely) physical explanation unsatisfying.

141 This is similar to how we can give a physical explanation and then an accompanying explanation at the molecular level. This latter domain, of course, would be epistemically difficult to penetrate for most of us, but our lack of awareness of this molecular activity would not make it the case that it does not exist. This molecular explanation, undiscovered and unarticulated, would be at the ready even if no one was aware.

142 St. Teresa of Ávila, for instance, writes in the 16th century, how a confessor may be led into error. “He at once ascribes everything to the devil or melancholy. As to the latter, I am not surprised; there is so much of it in the world and the evil one works such harm in this way that confessors have the strongest reasons for anxiety and watchfulness about it” (1577/1905: 160).

205 superstitious. In some ways, this is true. For instance, the Salem witch trials took place in the 1690s, about midway through the two centuries in which our authors were writing. And it was not uncommon for prayer and spiritual disciplines to be looked upon as medicine, in some sense of the word. As Martin Luther had taught, “God’s Word and prayer is physic against spiritual tribulations.”143 Sometimes, however, such feverish superstition led to a suspicion and avoidance of all things medicine. If, after all, melancholy was balneum diaboli, an attack by the devil, then it stood to reason that prayer and other spiritual disciplines need be the only remedies applied.

In a wry tone, one 19th-century writer describes religious remedies of insanity in the 1600s (“There were then no insane asylums,”144 he reminds us). “[A] grim and pitiful gleam is thrown on the treatment for insanity in vogue during the seventeenth century in lines which tell us

‘By his bed-side an Hebrew sword there lay, With which at last he drove the devil away.’”145

While this suspicion and avoidance of medicine was certainly present and far-spread, not all of our writers took this tone. Some, like Baxter, directly denounce it.

[N]eglect not Physick; and tho’ they will be averse to it, as believing that the Disease is only in the Mind, and that Physick cannot Cure Souls, yet they must be perswaded or forced to it. The Soul and Body are wonderful Copartners in their Diseases and Cure…we have Reason to use such means.146

143 Luther (1566/1872: 260).

144 Adams (1892, Vol. 2: 600).

145 Adams (1892, Vol. 2: 602).

146 Baxter (1682/1707, Vol. IV: 844-45, emphasis mine). Cf. Hunter and MacAlpine (1963: 241- 43).

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Many others called for a holistic treatment of body and mind, encouraging their readers to

make use of medicine if necessary.

Even in cases where we might assign some blame to the devil, the use of medicine

is still appropriate.147 Directly after calling melancholy balneum diaboli, Burton writes,

“There be those that prescribe physic in such cases, ‘tis God’s instrument and not unfit.

The devil works by mediation of humours, and mixed diseases must have mixed

remedies.”148 Baxter ventures to reason that medicine might actually do some work in expelling the devil:

If it were as some of them fancy, a Possession of the Devil, it’s possible Physick might cast him out: For if you Cure the Melancholy his Bed is taken away, and the Advantage gone by which he worketh: Cure the Choler, and the Cholerick Operations of the Devil cease.149

In this way, the use of medicine to heal the body robbed the devil of a place to harbor away

and do damage.

Critically, however, we also see that medicine was not always sufficient. In fact,

there was much that a melancholic could do prior to (or alongside) taking medication.

While Baxter, for instance, was quite affirming in his directions to use medication, he

actually only mentions this last. Whether he is saving the best for last, or whether he is

being rhetorically cautious in speaking to the persuasion of his audience who “will be

averse to it,” Baxter first gives no less than seven pieces of advice, and only afterwards

147 Though he is discussing possession and how it was perceived, Schmidt puts it succinctly: “The notion of melancholy as the balneum diaboli entailed that medicine itself was an important part of the battery of dispossession and the cure of the demonic affliction of conscience in some English Protestant circles” (Schmidt 2007: 49).

148 Burton (1621/1847: 659).

149 Baxter (1682/1707, Vol. IV: 845).

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states, “If other means will not do, neglect not Physick.”150 In another work, his advice to

“commit your self to the care of your Physician, and obey him,” is preceded first by no less

than 20 directions to the melancholic.151 Symonds similarly ends a long discourse with advice on medicine.

But I leave such with this Advice, When they find their Temper to be naturally or accidentally melancholick, to use all such Ways as God hath prepared in a natural Way: For as the Soul is not Cured by natural Causes, so the Body is not cured by spiritual Remedies.152

I return to the topic of such spiritual advice and non-medicinal remedies in Section 5.1.2.4

below.

What shall we say of divines who give such medical advice? How did they envision

their role? Burton was acutely aware of this tension, anticipating the criticism that “I being

a Divine, have medled with Physicke.”153 Lund (2010) observes that “Initially [Burton]

distinguishes between the ‘by-streame’ of melancholy and ‘the maine channell of my

studies,’ divinity. However, he soon abandons this distinction, arguing instead for the close

relationship between the two.”154 Burton reasons that the plague of melancholy is so common an infirmity that involves both “Body and Soule,” that it “hath as much need of

150 Baxter (1682/1707, Vol. IV: 845, cf. 844).

151 Baxter (1673/1707, Vol. I: 254, cf. 250-253).

152 Symonds (1642: 275).

153 Burton (1621/1847: 25).

154 Lund (2010: 114-15).

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Spirituall as a Corporall cure.”155 And thus a spiritual author writing practical works156

should, to the best of his ability, also be a physician.157

A good Divine either is or ought to be a good Physitian, a Spirituall Physitian at least, as our Saviour calls himselfe, and was indeed, Mat. 4. 23. Luke 5. 18. Luke 7. & 8. They differ but in object, the one of the Body, the other of the Soule, and use divers medicines to cure: one amends animam per corpus, the other corpus per animam,…One helpes the vices and passions of the Soule, Anger, Lust, Desperation, Pride, Presumption, &c. by applying that Spirituall Physicke; as the other use proper remedies in bodily diseases.158

If he cannot be a physician to the body, then he must be a spiritual physician, just as Christ

was. Burton links “melancholy and divinity not theoretically but in terms of medical

treatment and its equivalent, pastoral care. Burton envisages himself as a kind of ‘whole

Physitian’ by combining his ministerial vocation with his interest in medicine.”159 The medicine Burton has to offer?—“Spirituall Physicke” which goes towards healing the soul from its vices and disordered passions. We witness the same approach by Baxter, who does not think it unfit to give both spiritual and bodily advice:

Medicinal Remedies and Theological Use not to be given together by the same Hand; but in this Case of perfect Complication of the Maladies of Mind and Body

155 Burton (1621/1847: 27).

156 Lund explains: “English religious writing of this period was often characterised as ‘practical’ in its emphasis” (Lund 2010: 115n).

157 “David Irish makes an unacknowledged borrowing from Burton to explain the responsibilities of the medical profession: ‘the Divine heals Corpus per Animam; the Physician, Animam per Corpus,’ and hence ‘every Divine is a Spiritual Physician, and every Physician ought to be a Spiritual Divine,’ Levamen Infirmi (London, 1700), p. 7.” Quote from Lund (2010: 114n).

158 Burton (1621/1847: 27). Burton continues: “Now this [melancholy] being a common infirmitie of Body and Soule, and such a one that hath as much need of Spirituall as a Corporall cure, I could not find a fitter taske to busie my selfe about, a more apposite Theame, so necessary, so commodious, and generally concerning all sorts of men, that should so equally participate of both, and require a whole Physitian. A divine in this compound mixt Malady, can doe little alone, a Physitian in some kindes of Melancholy much lesse, both make an absolute cure…and ’tis proper to them both, and I hope not unbeseeming me, who am by my profession a Divine, and by mine inclination a Physitian.”

159 Lund (2010: 115).

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I think it not unfit, if I do it not unskillfully: My Advice is, that they that can have an Ancient, Skilful, Experienced, Honest, Careful, Cautelous Physician, neglect not to use him.160

Baxter likewise also thinks that the case of religious melancholy is so perfectly complex,

that it so completely involves both the soul and body, that a proper care must be attentive

to both. Burton agrees: “A divine in this compound mixt Malady, can doe little alone, a

Physitian in some kindes of Melancholy much lesse, both make an absolute cure.”161

But to what end, or telos? The character “the physician” in Alasdair MacIntyre’s

After Virtue removes illness and pain, yet he does so without taking into account any telos

of the human person.162 By contrast, the physician and the divine, according to our authors,

are committed to making well with respect to a certain objectively-given telos. Richard

Greenham, whom Burton had clearly read,163 is worth quoting at length on this subject.

If a man troubled in Conscience come to a Minister, it may be he will looke all to the soule and nothing to the bodie: if hee come to a Phisition, hee onely considereth of the bodie, and neglecteth the soule. For my part, I would never have the Phisitions cousell severed, nor the Ministers laboure neglected; because the soule and bodie dwelling together, it is convenient, that as the soule should be cured by the word, by prayer, by fasting, by threatening, or by comforting; so the bodie also should be brought into some temperature, by Physicke, by purging, by dyet, by restoring, by musicke, and by such like means, providing alwaies that it bee done so in the feare of God, and wisdome of his spirite, as we thinke not by these

160 Baxter (1682/1707, Vol. IV: 845).

161 Burton (1621/1847: 27).

162 MacIntyre (1981) Ch. 3. See Smith (2019) for a concrete example of this. Writing on the American Psychological Association’s newly launched “Non-Monogamy Task Force,” Smith comments: “Remember when psychologists’ goal was to help people live balanced and ordered lives? Now, it seems, the profession’s highest purpose is to empower and validate people’s deepest desires and sexual urges without having to suffer ‘stigma’ or any adverse judgments from themselves or society.”

163 “Although he does not quote directly from Richard Greenham here, there are strong resonances of the teaching of that founding proponent of the art of spiritual physic…In his copy of Greenham’s Works, Burton has put a cross mark in the margin next to this sentence along with the (cropped) note ‘both’” (Lund, 2010: 115). In a footnote, Lund then provides, what I presume is, where to see this cross mark with one’s own eyes: “Bodleian Library shelfmark G.5.6 Th (for full bibliographic information see Nicolas K. Kiessling, The Library of Robert Burton (Oxford: Oxford Bibliographical Society, 1988), item 707).”

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ordinarie meanes to smoother or smoke out our troubles; but as purposing to use them as preparatives, whereby both our soules and bodies may be made more capable of the spirituall meanes to follow after.164

As Greenham says, this is not merely in order to smother or smoke out our troubles, not

simply as an end in themselves, but as a means to an end, that of serving God with both

soul and body.

5.1.2.3 - Religion. Some authors like Blackmore, Robe, and Fawcett seem

particularly averse to laying the responsibility at the feet of Religion—itself, its practices

or beliefs—as being the cause of a person’s religious melancholy, and their reasons are

well worth considering. First of all, this would unjustly place a special fault upon Religion

for causing melancholy. Fawcett puts it simply:

Were we to charge religion itself as gloomy in its nature and tendency, and therefore to give it the name of melancholy, this would be a most unjust reproach. “A melancholy temper and disposition is not from religion, but from our nature and constitution; and therefore religion ought not to be charged with it.”165

Blackmore suspects that who propose such a thing actually have malevolent motives:

“when the Imaginations of religious Persons receive a melancholy Turn,”166 this critics…

foolishly call superstitious madness; and then offering violence to reason, indulging a petulant, flagitious humour, they reproach religion as the cause of this effect, treating the persons that profess and practise it, in raillery and ridicule: hence all pious and devout men are by such accounted only hypocondriacal enthusiasts, or whimsical visionaries.167

164 Greenham (1598: 44-45).

165 Fawcett (1780: 22). He quotes here “Archb. Tillotſon, fol. vol. I. p. 109.” John Tillotson was Anglican Archbishop of Canterbury from 1691 to 1694, upon his death.

166 Blackmore (1726: 158).

167 Blackmore (1726: 158-59).

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And on that account, these insane religious melancholics are then written off as ill and their

Religion as fraudulent. Blackmore replies in very strong terms that such critics are rather surreptitiously “contemners of heaven, who are fond of all occasions of bringing dishonour and contempt upon religion.”168 For it is true—and this is the second reason—that Religion

is neither a necessary nor sufficient condition for being melancholic.169

We have seen the following remark of Blackmore’s before, in Section 5.1.2, but

only as it pertained to whether religious melancholy was a distinct kind of pathological

melancholy. Blackmore’s view seems to be that it is not. Here, however, we can see in a

wider context that Blackmore is replying to those who hold Religion to be at fault for

melancholy. A bout of so-called “religious melancholy”

chiefly, if not only, happens when the patient, seized with these disorders, was accustomed to divine thoughts and spiritual ideas before; and then it is but natural that a disturbed imagination should chiefly entertain such images, as were before well known, and had been long familiar to the mind.170

Blackmore’s main concern is answering to those who “reproach religion as the cause of

this effect.” His reply indicates that such a charge is silly, since he holds religious

melancholy simply to be always an instance of pathological melancholy—that is, that it is

168 Blackmore (1726: 159).

169 “[M]any men express zeal for piety and vertue, who however are entirely delivered from the symptoms of this disease, and have not in their constitutions the lead infusion of spleen and vapours [~suff.]; so in multitudes that fall under the dominion of melancholy, the distemper does not always operate in this manner, nor turn their thoughts and anxious cares to religious objects [~nec.]” (Blackmore 1726: 159). To this Robe adds that religious melancholics, those who have the “disease of Melancholy, Vapours, &c. as they accompany trouble of mind, or a distressing anxiety about spiritual and eternal concerns…are far from being the only, or even the greatest number of those who have been broken in their hearts, grieved in their minds, rationally sorrowful for their sins, sensible in their misery, and solicitous about their recovery and salvation. Innumerable have been such to a great degree; and yet have had both the soundest mind, and healthiest body” (Robe 1749: ii, emphasis mine).

170 Blackmore (1726: 159).

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always caused somatically. Interestingly, however, Blackmore does yield a bit to other,

non-somatic causes, at least in the way they can amplify religious melancholy, saying that

the natural temperament of melancholy goes into overdrive once Patients “discover Marks

of a Design upon their own Lives.”171 It is at such time that “their Distemper exceeds its

proper Nature and Extent, and has contracted a Degree of Lunacy.”172

If Religion is not a cause of melancholy, then its defenders are to be sure that neither

is it an effect of melancholy; that is, scrupulous sorrow for perceived sin and trouble of

mind, which characteristically pains the religious melancholic, is not attributable or

reducible merely to the effects of vapours or other medical indisposition. There are some

persons, Robe says, who “discourse as if trouble of mind was nothing but the disorder of

the body; and ridicule legal sorrows for sin, and terrors of conscience, as only the fumes of the spleen.”173 But to go this route is equally as troubling and mistaken. For this cheapens and detracts from both the reality of Religion and proper religious feelings. As for the first,

Robe says defensively, “Even Kings have employed their pens on the Christian

religion.”174 As to the second, the sinner ought, sometimes and in appropriate degrees, to

171 Blackmore (1726: 163). Cf. Hunter and MacAlpine (1963: 322).

172 Blackmore (1726: 163). We do not know exactly what cases Blackmore had in mind. Indeed he admits “that it is not easy to distinguish” cases between “the highest Hypocondriack and Hysterick Disorders, and Melancholy, Lunacy, and Phrenzy…and set the boundaries where one ends, and the other begins” (163- 64). However, he does offer some diagnostic criteria for identifying melancholy proper: “continual Thoughtfulness upon the same set of objects always returning to the Mind, accompanied with the Passions of Sadness, Dejection, and Fear, seems to be the genuine and discriminating Idea of proper Melancholy” (164).

173 Robe (1749: ii, italics mine). Robe quotes here the words of an unnamed author, whom he describes only as “the author of Rem. Pass. in the life of a private gentleman, 2d Ed p. 249” (Robe 1749: ii).

174 Robe (1749: v).

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feel these pains and sorrows, for to dismiss them is to invite self-condemnation. Just as we saw with Blackmore, the target of Robe’s disapprobation are certain

pretended philosophic Divines who have gone dreadful lengths in ridiculing the faith the Gospel requireth, terrors of conscience, and spiritual comfort from divine impressions as the effects of a heated imagination, and melancholie constitution. There are further sad instances of these who have made use of the fashionable term Hyppo, to conceal the horrours of their conscience; and have pretended to look upon and complain of them, as fits of the spleen, which they must disregard as fancy, or drown in a bottle.175

Says Robe plainly and to the point, “If religion was the natural cause of vapours or

Melancholy; or upon the other hand their effect; it would be so in all religious Persons.”176

5.1.2.4 - Moral impulse and weakness of faith. Writing in what could be called the

twilight of this two-century period we have been examining, Paul Slade Knight writes,

“Insanity, like some other diseases, may have for its origin a moral, or a physical cause;

either an affection of the mind, or a disorder of the body.”177 Indeed, so-called “moral treatment,” an approach to treating insanity from the 18th to the 19th century developed not

by medical men but by laypersons, was an attempt to cultivate virtue and right living,

typically in line with Christian devotion.

It was not without controversy, however; its introduction represented, according to

one author, “a rather damning attack on the medical profession's capacity to deal with

175 Robe (1749: iii, italics mine).

176 Robe (1749: iv). Robe says further, “Many in all ages have been eminently religious to the conviction of both friends and foes, who were never known to be tainted in the least with these maladies: They must bid defyance to common sense, and the experience of all times and places, who can venture to call this fact into question” (1749: iv).

177 Knight (1827: 36). Cf. Hunter and MacAlpine (1963: 774).

214 mental illness.”178 This program of moral treatment “was, implicitly, a challenge to the somatic etiology preferred by physicians,” and it “called into question the value of standard medical interventions.”179 Moral treatment for insanity eventually fell out of use, primarily due to the abuses it invited, such as unlawful confinement, physical threats, and purposeful inculcation of fear.180 In my view, I believe the unchecked and authoritative paternalism by asylum workers and medical caregivers of this era to be more at fault for the rampant abuses than the program of moral values itself. (There are indeed additional reasons why moral approaches, as well as psychological approaches,181 to mental disorder were rejected or superseded in favor of somatic approaches,182 but a fuller account of this is unfortunately beyond scope of the present chapter.183)

178 Bynum (1981: 43). Bynum is specifically speaking of Tuke’s Description. “Samuel Tuke was not a physician,” and his work “was hardly polemical in tone,” yet it was perceived as a hostile takeover attempt by non-professionals.

179 Scull (1981: 8).

180 “Physical threats were a last resort. Moral fear, however, was constructive, and creating appropriate terror in a patient could be salutary for securing the calm obedience necessary for effective treatment” (Porter 1987: 216).

181 “[T]he lack of receptivity to psychological approaches was rooted in the ‘deep structures’ of Victorian psychiatric theory. The hostility was all the more notable since, as was sometimes acknowledged at the time, somatic-pathological approaches to insanity in apparently critical areas embodied a double failure. On the one hand, they yielded little in the way of increased scientific understanding of the etiology and pathology of insanity; and on the other hand, they possessed no clear-cut or decisive therapeutic advantages over ‘moral treatment’ or other more purely empirical nonmedical methods when it came to curing the insane” (Scull 1981: 20, italics in original).

182 “I have suggested that the success of that medical response rested in part upon a careful reworking of the claim that insanity was a somatic disorder, and that the response was essentially a political and social process, culminating in claims that both moral and medical treatment were essential for the adequate treatment of lunatics” (Scull 1981: 8).

183 “Doctors opposed the psychological theories of mental disorder because they thought such theories would give encouragement to a veritable ‘swarm of religious psycho-therapeutists’” (Scull 1981: 28n). For more, see Clark (1981) and Scull (1975).

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What laymen were able to introduce in 18th-century psychiatric settings, our 17th-

and 18th-century authors took for granted. As I have already discussed, many of our authors

considered themselves physicians in a sense, spiritual physicians, who offered spiritual

remedies which treated both the soul and the body. And as we have seen, while many times

religious melancholy had only a pathological cause, at other times, it was accompanied by

a non-pathological cause. We have already discussed a few of these non-pathological

causes, but none which were necessarily personal flaws in the melancholic person, none

which a program of moral treatment and right living might be intended to fix. We discuss

some of these now.

There are some indications in our 17th- and 18th-century authors that religious

melancholy could, in some fashion, be brought on by one’s own doings. Baxter writes, “It

is so easie and ordinary a thing for some weak-headed persons, to cast themselves into

Melancholy by over-straining their Thoughts or their Affections.”184 In fact, Baxter points

out, in suspicion of the humoural theory, “Such a Black Distinct Humour called

Melancholy, which hath of old been accused, is rarely, if ever, found in any.”185 But he

does not go so far as to dispense with a medical paradigm altogether. He admits that we

can speak of “the Blood itself” being, in a sense, “called Melancholy Blood,” but this

happens “when it hath contracted that Distemper and Privity by Feculency, Sluggishness

or Adustion, which disposeth it to the Melancholy Effects.”186 That is, these somatic

184 Baxter (1673/1707, Vol I: 248). Italics in original.

185 Baxter (1682/1707, Vol. IV: 845).

186 Baxter (1682/1707, Vol. IV: 845).

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changes occur because of the behavioral changes in a person, or rather, because of a

person’s actions: sluggishness, feculency (or filthiness), and adustion (or aridity).187

We should also remember that scrupulosity is a major cause of religious

melancholy. And scrupulosity, our authors were in consensus, was something for which

one could be held culpable. Among other causes of scrupulosity, Taylor mentions

“ignorance, or unseasoned imprudent notices of things, indigested learning, strong fancy

and weak judgment.”188 While a man is often not aware of his own ignorance, it is

nevertheless true that sometimes he is culpable for it (indirectly, or to a mitigated degree).

This notion of culpability is consistent with the notion that it is an attack from the devil. For the devil uses a man’s own faculties and passions against him, and in all other actions for which we are held culpable, the devil merely tempts and seduces. So it is here with melancholy and the weaknesses of body and mind. Says one author, “Admittedly,

‘melancholy sadness’ made the devil’s victory easier, in fact it could be said that he overcame men by their own ἀθυμία [atonia].”189 It might also be that the devil tempts a person by his own pride and vainglory, so that he imagines that he knows the Scriptures well enough, or does not need to study or meditate upon them, when in fact this may not be the case. For as Baxter lists as his first direction to the melancholic: “See that no error in Religion be the cause of your distress: especially understand well the Covenant of Grace,

187 Here, Baxter uses “adustion” most likely in a metaphorical sense of “dryness” or “aridity,” though it does have a nearby medical meaning similar to “cauterization.”

188 Taylor (1660/1671: 158-59).

189 Klibansky, et al. (1964/1979: 77).

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and the Riches of mercy manifested in Christ.”190 Why these doctrines as reassurances?

Because characteristically the scrupulous “are continual self-accusers…They are still

thinking that the day of Grace is past, and that it is now too later to repent or find mercy.”191

They keep their thoughts “not much on God (unless on his wrath).”192 Thus:

They dare not hope, and therefore dare not pray: And usually they dare not receive the Lords Supper; here they are fearfullest of all: And if they do receive it, they are cast down with terrours, fearing that they have taken their own damnation, by receiving it unworthily. Hence they grow to a great averseness to all holy duty: Fear and despair make them go to prayer, hearing, reading, as a Bear to the stake: And then they think they are haters of God and Godliness, imputing the effects of their disease to their souls.193

As is clear from the above, all of this wrongful thinking being a causal contributor to the

onset or amplification of one’s religious melancholy is consistent with melancholy itself

being a disease: since, recall, it is a disease of the mind which disorders a person’s thinking

and affections. It stands to reason, then, that to the extent that he is able, a person should

resist and directly confront this wrongful thinking.

Now, I say to the extent one is able. One may not be able. It is quite telling that

Baxter, sensitive to this reality, prefaces all of his advice directly to the melancholic with

the following disclaimer:

When this disease is gone very far, Directions to the persons themselves are vain, because they have not Reason and free-will to practice them, but it is their friends

190 Baxter (1673/1707, Vol. I: 250).

191 Baxter (1673/1707, Vol. I: 248).

192 Baxter (1673/1707, Vol. I: 249).

193 Baxter (1673/1707, Vol. I: 249).

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about them that must have the Directions. But because with the most of them, and at first, there is some Power of Reason left, I give Directions for the use of such.194

In the beginning, he says, or when it is at its mildest or moderate stages, the melancholic may still have some agential control enough to implement these directions. When severe, however, they cannot, and it is their friends and surrounding community which must take these directions and help to implement them.

Now, this notion of culpability for one’s own religious melancholy is not universally affirmed or accepted. Paul Slade Knight, writing in the 19th century, claims that, of the nearly 700 cases he had investigated, “the malady of only one was ascertained to be undoubtedly the effect of a moral cause,”195 leading him to conclude that “The moral impulses, however, very rarely produce insanity, and this is also the case with regard to religious feelings.”196 Rather “an over zeal for religion, or a violent excitement of some one of the passions, is frequently the inevitable result of the corporeal affections, by which affections the mind is constantly influenced.”197 That is, this overzeal for religion is a manifestation of, rather than a cause of, insanity.198 However, Knight’s claim that moral impulses and religious feelings rarely produce insanity very likely relies on treating

“insanity” as a physical illness and taking “produce” to apply only to the moment of onset.

Thus, his claim seems really to be that moral impulses and religious feelings cannot be the

194 Baxter (1673/1707, Vol. I: 250).

195 Knight (1827: 35; 32).

196 Knight (1827: 32-33).

197 Knight (1827: 36).

198 Hunter and MacAlpine (1963: 774).

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sole cause of the onset of physical disease. Perhaps this is correct; it does, however, leave

open a lot of room for these to be contributing causes at the onset and to be conditions

which amplify, or make worse, one’s physical illness. Knight seems later to admit just this,

saying that it is “the incipient insanity,” or somatic illness which “has caused the fickleness

in devotion, together, probably, with an unusual fervour,…urged on by an erroneous

zeal.”199 In such cases, according to Knight himself, this unusual fervour and erroneous

religious zeal can complicate one’s “incipient insanity,” such that it aggravates the somatic

preconditions for melancholy and supplies the resultant religious melancholy (or “religious

insanity”) with its characteristic flavor.200

All this said, what we have discussed here concerns religious melancholy only

when it is not merely naturally caused. Perhaps this includes all cases of religious

melancholy: as we saw with Taylor, he seemed to think that religious melancholy was the

product of both temptation (scruples) and disease (melancholy). This also is consistent with

Burton’s account, which lists multiple pathological and non-pathological causes of

religious melancholy; his account does not require that any pathological cause (or any set

of pathological causes) is sufficient to produce religious melancholy. Still, simply because

we are acknowledging that non-pathological causes (e.g., behavior, spiritual,

characterological defects) can be to blame, it does not follow that arighting these defects

will necessarily fix one’s religious melancholy. Francis J. Braceland, M.D., former APA

199 Knight (1827: 32-33).

200 Adds Knight…“whether that be of the usual gloomy cast,” the ‘religious melancholy’ we are used to, “or whether it be of a lively and amorous character, as I have sometimes seen it…this latter is rather a rare species of what is termed religious insanity” (Knight 1827: 33). This reinforces the relation of religious melancholy as a kind of love melancholy, as in Burton’s schema. That is, if it is of a lively and amorous character, one has as “excess” disordered zeal or passion for God.

220

President, reminds the Christian believer that living a righteous life does not preclude

suffering—including mental suffering.

The fact that I am in a state of grace does not save me from bankruptcy if I am imprudent in business, or from being killed in a motor accident, or from becoming ill, from letting my mental equilibrium be affected by an unfortunate heredity, or drink, or sorrow, or overwork. This needed to be said authoritatively to help those people who steadfastly maintain that if one ‘attends to one’s duties,’ one will not become emotionally or mentally ill.201

Righteous living does not guarantee a life free of suffering, any more than eating well and exercising guarantees a life free of illness. They are certainly good standards to adopt, and they make the desired outcome probable, but it’s still possible that one could suffer a bout of cancer despite eating well and exercising.

5.1.2.5 - Nostalgia and return to God. In the beginning of Section 5.1.2.1, I

immediately dispensed with the notion that God has any part in producing religious

melancholy. Here I want to introduce a bit of nuance in a fuller reply to that suggestion.

Namely, I want to examine briefly the association between melancholy and nostalgia, then

venture to tie this into religious melancholy in particular, which can be viewed as a longing

for a return to God.

Nostalgia [νόστος (nóstos, “returning home”) + ἄλγος (álgos, “suffering” or

“grief”)] was coined by Johannes Hofer in his 1688 medical dissertation on melancholy at

University of Basel, Switzerland—hence nostalgia would come to be known as “the Swiss

201 Braceland (1964: viii).

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malady.”202 Interestingly, this makes nostalgia, along with melancholy, “one of the earliest recognized mental disorders.”203 Hofer was not particular about the name of this ailment:

If nosomanias or the name philopatridomania is more pleasing to anyone, in truth denoting a spirit perturbed against holding fast to their native land from any cause whatsoever (denoting) return, it will be entirely approved by me.204

Today, we use the work “homesickness,” since “nostalgia” now means something quite

different. Hofer would likely also welcome this term, as his title likewise suggests the

German “Heimwehe” (a longing for “going home”). By the 18th century, writers were were including nostalgia in their methodical nosologies, often alongside melancholy or a sad affect.

To Cullen, nostalgia was, for “people absent from their native country, a vehement desire of revisiting it.” de Sauvages called nostalgia an oddity that made people away from their homeland greatly desire to return; if they could not, they would fall into grief accompanied by insomnia, anorexia, and “other untoward symptoms.”205

Linnaeus describes the malady as “a longing for your homeland and relations when you are away from them.”206 Although Linnaeus places nostalgia and melancholia in different

orders, Vogel considers nostalgia to be a species, or subtype, of melancholia.207

202 Pulteney (1805: 148) called it the “Swiss malady,” saying further that “it is not easy to apply a remedy…both the Swedes and the Swiss find the greatest relief (next to their return home) from strong exercise” (413). Cf. Munsche and Whitaker (2012: 237).

203 Munsche and Whitaker (2012: 237).

204 Anspach (1934: 381, italics mine). Carolyn Kiser Anspach gives us the first English translation of Hofer’s 1688: Dissertatio medica de nostalgia, oder Heimwehe. I will henceforth quote Hofer from her spectacular translation work.

205 Munsche and Whitaker (2012: 237).

206 Linnaeus (1759/1763: 14). Cf. Munsche and Whitaker (2012: 237).

207 Vogel thus says of melancholia “Insania longa cum moestitia ac timore, Nostalgia eius species est” (Vogel 1764: 20). Cf. Munsche & Whitaker (2012: 237).

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We can trace this association between nostalgia and melancholia or sadness all the way back to Hofer, who acknowledges that the two could mix together. “Nor shall I quarrel much if anyone contends that this [nostalgia], admixed of a melancholy delirium, is something immovable,” as a man’s mind is “occupied much for a long time around the arousing of one idea” that he becomes “either wearied or exhausted on that score.”208

Despite its regional moniker, it was a universal malady: “Because it concerns the impaired part, it is clear that anyone can have this.”209 In presenting this medical dissertation on nostalgia, Hofer was essentially introducing this malady to the medical community. He thus goes on to list its symptoms: “What signs, moreover, proclaim the disease to be already present, are varied; especially continued sadness, meditation only of the Fatherland, disturbed sleep,” among others.210 Among its remedies: “hope of returning to the

Fatherland must be given as soon as the strength seems somewhat equal to bearing the annoyances of a return journey; frequent company must be brought, by whom the imagination of the patient is distracted from that persistent idea.”211

Now, whether we call this condition “nostalgia” or “homesickness,” it is clear that in Christian teaching and tradition there is a parallel condition of longing for a homeland, meanwhile living as wayfarers and pilgrims in a foreign land. The Apostle Paul teaches that “our citizenship is in heaven” (Phil. 3:20), and that “you are no longer strangers and aliens, but you are fellow citizens with the saints, and are of God's household” (Eph.

208 Anspach (1934: 381).

209 Anspach (1934: 384).

210 Anspach (1934: 386).

211 Anspach (1934: 389).

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2:19).212 Peter Kreeft, following Tolkien and C.S. Lewis, calls this desire “Sehnsucht,”

which he fashions into his argument from desire for God’s existence. This inarticulable,

inchoate longing for “something we-know-not-what, something beyond this world,” is actually a desire for God. Similarly, Kierkegaard talks in terms of being wayfarers, and

Marcel similarly riffs on this essential foreigner element, saying that a man “no longer on a road to anywhere would be a man no more.”213

It is not absurd to think that a case of religious melancholy—or general malaise, as

I am now stretching the category beyond Burton’s original framework, yet in a way that is

consistent with later usage—could actually point to a deep desire to connect to the divine.

We shall revisit this topic more in the next chapter when we examine Kierkegaard’s varied

notions of despair.

5.2 - Considered Judgment on Relation to Depression

It is significant that many spiritual writers knew of melancholy, some even

identifying it by name, and yet distinguished it from their own topic of focus: St. Teresa of

Ávila from spiritual turmoil and growth,214 St. John of the Cross from noche oscura,215

212 Note also simply Heb. 11:14-16, “For those who say such things make it clear that they are seeking a country of their own. And indeed if they had been thinking of that country from which they went out, they would have had opportunity to return. But as it is, they desire a better country, that is, a heavenly one. Therefore God is not ashamed to be called their God; for He has prepared a city for them.”

213 Marcel (1960, Vol. II: 142). Cf. Luschei (1971: 33, 61).

214 St. Teresa of Ávila (1577/1905: 94, 175, 215). It is incumbent on the reader to know when St. Teresa is using “melancholy” in the sense of sorrowful affect or malady, or when she uses “melancholy” to mean “hysteria” (Cf. 215n).

215 St. John of the Cross (A.pro.4-6; 71-72; N1.9; 313-16).

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Joseph Symonds from spiritual desertion,216 and St. Mother Teresa of Calcutta from

spiritual darkness.217 This does not include much earlier thinkers who wrote on acedia and

tristitia; who, though they may not have mentioned “melancholia” by name,218 construe

their topics more along spiritual lines than somatic. This is probably what has led many

authors to attempt to bridge the link between these spiritual maladies and somatic-mental

illnesses.219

I bring this up because I think what we have with religious melancholy in particular

is a condition so varied in its instances, if not also in its theoretical presentations, that it

necessitates dividing up. Thus, some kinds of religious melancholy may be better classified

alongside one of these other spiritual maladies, while other kinds might be better

understood in terms of somatic-mental illness. I will begin with two spiritual conditions we

have already seen, before turning the question back to depression.

5.2.1 - Is this Dame Acedia?

The answer to this question, and the next, will ultimately depend upon which dame

comes to court, that is, which kind of religious melancholy we investigate. Recall that

216 Symonds (1642: 274-75). “There are two Sorts of Men…In the First, the Cause is natural, in the Second spiritual. As for the First Who are oppressed with Melancholy, that dark and dusky Humor, which disturbs both Soul and Body Their Cure belongs rather to the Physician, than to the Divine, and Galen is more proper for them, than a minister of the Gospel” (274).

217 As we saw in the previous chapter, St. Teresa of Calcutta distinguished her condition even from noche oscura. Cf. Teresa-Kolodiejchuk (2007: 218).

218 I cannot locate a usage of the word in any of the previously cited works by Evagrius, Cassian, or Gregory. Thomas Aquinas mentions melancholy as a possible outcome of extreme sadness which destroys reason (ST I-II.37.4.ad3).

219 See, for example, McAllister (2020), which gives a brief account of the (often unsuccessful) recent attempts in psychology, theology, and philosophy to make sense of the relation between acedia and depression.

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acedia is a pernicious sin, which subtly gains control, and for which one can be held

culpable to varying degrees. This would seem to rule out those cases of religious

melancholy which are solely somatic. But it might still include cases of religious

melancholy which are yet in a great degree, or primarily, somatic, if there is at least some

contributing cause for which one can be held culpable. We have already seen how a person

can be tempted by the devil, who operates using the body’s own faculties and humours,

and yet be held responsible to some extent for the resulting actions. It primarily depends

upon, as Baxter put it, what free-will and reason is preserved in the melancholic, and whether the case is severe.

That aside, there are the much more obvious cases of religious melancholy which align more closely with acedia, for instance, those that have no pathological origin or cause. Whether or not such cases are actual, any author who called this religious melancholy would have found a better word in acedia. Burton used “sloth” only in a symptomatic sense,220 as does Taylor.221 Baxter does use “sloth” in the sense of a vice, or

deadly sin,222 but he does not seem to discuss it directly in connection with religious melancholy. And yet this is what they describe. As we saw on Taylor’s view, religious

melancholy seemed to be the product of both temptation (scruples) and disease

(melancholy). In acedia, it begins with a temptation. Our writers on acedia are silent as to

220 Burton (1621/1847: 52, 58, 70, 83, 168, 242); there are also a few instances where “sloth” might be taken as a character flaw (34, 154, 168, 650). Though he relies on Gregory (cf. 292, 555, 624) and Aquinas for authority, he does not appear to mention either Evagrius or Cassian. See also Jordan-Smith (1931).

221 Taylor (1660/1671: 22).

222 Baxter (1673/1707, Vol. I: xx, xxv, xxvi, 89, 229-30, 322, etc.) and (1682/1707, Vol. IV: 10, 60, 203, 238, etc.). Yet on one occasion does he mention it, in passing, in his discourse on melancholy (1673/1707, Vol. I : 250; 1682/1707, Vol. IV: 836).

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whether acedia is, or arises from or leads to, a disease—this simply was not their concern.

I have argued elsewhere that it is possible for an instance of acedia to also be an instance

of depression, if it reaches the level of clinical pathology (i.e., if it also satisfies the

conditions set out by the DSM).223 Similarly, it is possible for an instance of acedia to also

be an instance of religious melancholy, provided that it is a kind of religious melancholy

for which one can be held culpable.

5.2.2 - Is this Dame Noche Oscura?

As noted above, St. John of the Cross made a point to distinguish noche oscura

from melancholy. By “melancholia, depression, or temperament” (A.pro.4), he clearly

means some “deficiency of sense or spirit” (A.pro.6). Noche oscura, on the other hand, is

a purgating experience, yet it is ultimately a time of growth. In noche oscura, it is not that

“God has forsaken them” (A.pro.4); in fact, it is a clear sign that God is drawing them

closer, as “God is the author of this enlightenment in the night of contemplation” (A.pro.5).

Rather than it being a time of confession—for the trials are not the individual’s fault—it is

a “period for leaving these persons alone in the purgation God is working in them, a time

to give comfort and encouragement” (A.pro.5).224

223 Cf. McAllister (2020).

224 In St. John of the Cross’s own words: “It will happen that the soul's greatest suffering will be caused by the knowledge of its own miseries. That it is full of evil and sin is as clear as day to it, and even clearer, for, as we shall say further on, God is the author of this enlightenment in the night of contemplation. And when this soul finds someone who agrees with what it feels (that these trials are all its own fault), its suffering and distress grow without bounds. And this suffering usually becomes worse than death. Such a confessor is not satisfied with this but, in judging these trials to be the result of sin, he urges souls who endure them to go over their past and make many general confessions which is another crucifixion. The director does not understand that now perhaps is not the time for such activity. Indeed, it is a period for leaving these persons alone in the purgation God is working in them, a time to give comfort and encouragement that they may desire to endure this suffering as long as God wills, for until then no remedy—whatever the soul does, or the confessor says—is adequate” (A.pro.5).

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Now, this schema holds insofar as we understand the “melancholy” in “religious

melancholy” to be either (i) a physical illness, or (ii) the consequences of culpable sin. In

either case, it is most certainly not an instance of noche oscura. The latter case would be a

candidate for an instance of acedia, but of course circumspect discernment is necessary for

each individual situation we encounter. If a case of religious melancholy, to use the term

“melancholy” in its looser sense, is neither of (i) nor (ii), but instead indicates a time of

spiritual purgation or growth brought on by God, then it may indeed qualify also as a case

of noche oscura. It is true, however, that such cases of noche oscura or other types of

spiritual trial are rarely, if ever, called “religious melancholy,” and that many authors

sought to distinguish it from religious melancholy. Sometimes, the best way to keep a sharp

distinction between two similar things is by giving one of them a different name. But a

nominal difference does not entail a real difference.

5.2.3 - A Final Word on Religious Melancholy’s Relation to Depression

Since many accounts have already been given of the relation between melancholy

and depression,225 I address here only the nature of the relation between depression and the more particular religious melancholy. Again, it depends upon which kind of religious melancholy is under scrutiny. Less obviously, it also depends upon which kind of depression is under scrutiny. If we recall the diagnostic criteria for depression as laid out in the DSM, these criteria do not necessarily require that depression be caused solely, or even primarily, by somatic conditions. (There will certainly be somatic symptoms in any

225 Examples abound: Ban (2014), Bell (2014), Berrios (1985, 1988), Buie (2010), Davison (2009), Földényi (2016), Glas (2003), Horwitz and Wakefield (2007), Horwitz, et al. (2016), Houston (2000), Jackson (1986, 2008), Jansson (2011, 2013), Lawlor (2012), Porter (1987, 2003), Radden (2002, 2003, 2007, 2009), Rubin (2008), Scull (2015), Taylor and Fink (2006), Varga (2013), and Wilhelm (2006).

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case of religious melancholy or depression, for as Jutel notes “For us to be able to classify

a disease, it must first be visible to medicine.”226 But the symptoms also need not be

entirely somatic.) Neither do these criteria rule out the possibility that depression might

have non-natural causal contributors. This should not be seen as some plea from

ignorance—“after all, we cannot know that there aren’t other causes”—but instead it

should be seen as in keeping with the general acknowledgement that even the most paradigmatic illnesses in medicine have multicausal etiologies.227

I can see, then, depending on how we carve up depression and religious melancholy

each, that there will be multiple points of contact. Kinds of religious melancholy that are

(i) the result of somatic or mental preconditions, or physical illness, will align up with kinds of depression that are the result of the same. (This is the easiest and most obvious matchup, as depression is often construed in biological terms, and even the most staunch naturalist

can agree with this.) Kinds of religious melancholy that are (ii) the consequences of

culpable sin will align up with kinds of depression that are the result of the same—such

cases may be also called acedia.228 Kinds of religious melancholy that, failing both (i) and

(ii), are (iii) a time of spiritual purgation or growth brought on by God will align up with

kinds of depression that are the result of the same—such cases may be also (or perhaps

226 Jutel (2011: 16).

227 Kendler (2019) describes three stages in the history of classifying causes of illness, from (1) multicausal, to (2) monocausal, back to (3) multicausal. “[I]n the mid-20th century, the third phase began. With decreasing deaths from infectious diseases, epidemiology and clinical medicine shifted to a chronic disease model in which paradigmatic disorders, such as cancer and cardiovascular disease, were shown to be highly multicausal.” Psychiatry should have followed suit. Instead: “Paradoxically, at this time, biological psychiatry, then rising to dominance in American psychiatry, vigorously pursued monocausal theories…Despite ample evidence to the contrary, monocausal thinking continues to influence our field.”

228 See especially McAllister (2020), where I argue that, in some cases, an instance of acedia can also be an instance of depression.

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best) called noche oscura, or some other spiritual trial.229 These observations provide the

basis for including a spiritual etiology among the real etiologies on a pluralistic account of

depression.

However, I must repeat the same caveat as before. Our authors on religious

melancholy understood the malady to be not uniquely physical. So any account or model

of depression which denies or neglects the spiritual will not have full access to the rich

wisdom of these spiritual texts if they try to squash religious melancholy into that physical

model. This is reductionistic. Rather, our authors understood religious melancholy within

the greater context of the human’s proper relationship with God and proper self-ordering.

Insofar as psychiatry and psychology remained entrenched in naturalism and reject this

greater context, then, properly speaking, the religious melancholy our authors spoke of is

just not the same as depression.

229 For example, spiritual desertion (Symonds), spiritual darkness (St. Teresa of Calcutta), spiritual aridity (Wang 2010, 2011), spiritual turmoil (St. Teresa of Ávila), or la nuit réparatrice (Garrigou-Lagrange).

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CHAPTER SIX

Tungsindighed

“My depression [Tungsind] is the most faithful mistress I have known—no wonder, then, that I return the love.” — Kierkegaard as A, (1843) Either-Or1

“I must now remain quiet, by no means work too strenuously—indeed, hardly strenuously at all—not begin any new book, but try to come to myself and truly think the idea of my melancholia [Tungsind] together with God, right here and now.” — Søren Kierkegaard, (1847) Journal Entry2

“Tungsindighed” is a Danish word which literally means “heavy-mindedness.” It often gets translated into English as “melancholy” and sometimes as “depression”, but these terms obscure or taint the original meaning, especially as the word was employed by

Søren Kierkegaard. In this chapter, I examine Tungsindighed and related concepts in

Kierkegaard’s writings, in keeping with my overall thesis to mine the depths of these historical conditions which have a purported spiritual etiology, in order to bring historical wisdom to our contemporary predicament regarding depression. After a customary rationale for inclusion in Section 6.0, in Section 6.1 I explore Tungsindighed in

Kierkegaard’s Journals, Notebooks, and Papers and in Either-Or (1843). In Section 6.2, I

stay within Either-Or to examine Kjedsommelighed (“boredom”), followed by an

evaluation in Section 6.3 of Fortvivlelse (“despair”) in both The Sickness Unto Death

1 Kierkegaard (EO I:20).

2 Kierkegaard (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194)).

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(1849) and in Works of Love (1847). I then conclude with an appraisal as to how these

Kierkegaardian concepts relate to depression.

6.0 - Rationale for Inclusion

Writing in the 1830s-1850s, Søren Aabye Kierkegaard was certainly aware of the

humoural view of melancholy,3 though it had by his time become rather outdated, yielding

to a view of melancholy with more medical purchase, as we saw in the previous chapter.

In “A Literary Review,” he uses the fashionable term “Millionair-Spleen-Heroism,” which makes reference to the black bile of melancholy, to describe asceticism.4 As we shall see,

Kierkegaard was also familiar with the popular notion of melancholy as poetic genius,

which he acknowledges carries some prestige.5 But for the purpose of expressing the self’s

melancholic situation and experience, close interaction with the humours doesn’t seem to

interest Kierkegaard as much as the existential concept of despair and the more

phenomenally expressive term Tungsindighed (“heavy-mindedness”). Although there are

many other expressive synonyms in the Danish lexicon at this time, Kierkegaard seemed

to favor “Tungsindighed” and its variants–which appear 216 times in the Skrifter–over other options like Nedtrykthed (1 instance), Melankoli (14 instances), Krise (12), Krisetid

3 See Ferrall and Repp (1843: 197), for a Danish-English dictionary from Kierkegaard’s time period. Kierkegaard certainly knew the word “Melancholi”, as evidenced by a cursory search on , the Søren Kierkegaards Skrifter (SKS), the comprehensive and searchable online collected writings of Kierkegaard in Danish.

4 See Olesen and Tudvad (2004: 99). As they write, this phrase “Millionair-Spleen-Heroism” “betegner en livstræt æsteticisme” [“signifies a life-threatening aestheticism”].

5 “In our day, it has become somewhat prestigious to be depressed [tungsindig]” (EO I:185; cf. EO II:381).

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(0), or Sænkning (0).6 There is another term Kierkegaard uses—Kjedsommelighed

(“boringness”)—clustered in sections of Either/Or on the curious topic of existential

boredom, which we shall also examine in the following exploration of Kierkegaard’s

concepts possibly linked to depression. Finally, the robust concept of Fortvivlelse

(“despair”) is so characteristically Kierkegaardian, and so germane to our concerns here,

that we would be remiss were we to exclude an examination of it in what follows.

While the terms Tungsindighed (“heavy-mindedness”) and Kjedsommelighed

(“boringness”) are not unique to Kierkegaard, nor does he restrict himself to only these

terms, they nevertheless provide us with a foothold for looking further into Kierkegaard’s

philosophical concepts, for instance, of despair and the self’s relation before God, and how

his thinking relates to the melancholy of his day and the depression of our day. Moreover,

it is perhaps significant that Kierkegaard’s tungsindig is reminiscent of Luther’s use of

schwermüthiger (“heavy-minded”; “somber”; “melancholic”; “burdened soul”).7 And

Kjedsommelighed, if we are allowed to speculate, might be related to the “ked” root in

“acedia”: as Svendsen (2005: 24) writes, “it is conceivable that the Danish ked is

etymologically related to the Latin acedia.”8

6 I used the online, digitized SKS to search Kierkegaard’s entire corpus, both his published and unpublished works. (Note: some of these instances may appear in commentary/footnotes by SKS editors.) To get a better sense of what Danish terms were in circulation in the 19th century, I’ve referred to Ferrall and Repp (1843).

7 We see also in the following passage Luther associating melancholy with balneum diaboli: “Man sagt, und ist wahr: ubi caput melancholicum, ibi diabolus habet paratum balneum. (Wo ein melancholischer und schwermüthiger Kopf ist, der mit seinen eigenen und schweren Gedanken umgehet und damit sich frißt, da hat der Teufel ein zugericht Bad. [It is said, and it is true:…(Where a melancholic [melancholischer] and melancholic [schwermüthiger] head is, which deals with its own heavy thoughts and eats with them, there the devil has a bath]” (Besel 1860: 27).

8 When I wrote to him about this possible etymological connection, Svendsen admitted that it is almost entirely speculation. In the words of the Norwegian philosopher: “I haven't seen anyone else suggest this. Some have suggested that ‘kid’ might stem from Low German ‘keep’ or Frisean ‘kief’, and some also the Norwegian ‘keiv’ (twisted), but that is also mere speculation. As for my suggestion, I simply went by the 233

So it is that we undertake this examination of Kierkegaard’s Tungsindighed and related concepts in an effort to investigate their similarity, or lack thereof, with depression.

First, Kierkegaard’s thought continues yet extends the previous Christian tradition, its many instances of thinking and teaching about mental torpor or spiritual sluggishness.

Second, Kierkegaard, like many writers on this topic, was himself afflicted with melancholy or something quite like it, inheriting the mantel of “the melancholy Dane” from

Shakespeare’s Hamlet, who had long held it. Third, Kierkegaard’s unique emphasis on the self and “that single individual” reader, which reflects his position as the father of existentialism, as well as his continual yearnings and prophetic warnings to the state church, presages and anticipates the contemporary postmodern milieu in which we find ourselves, medicated,9 placated, and entertained,10 yet disconnected from self, others, and

God. Finally, Kierkegaard’s stature as Christian philosopher par excellence is nearly unmatched in the past 200 years,11 and his depth-psychological framework provides a unique exploration of the human psyche from the perspective of a Christian in relation to self and God.

I have named this chapter “Tungsindighed”, since it calls to mind the depressed feeling, that of being pressed down, a heavy weight upon the mind. But, as I have indicated

similarity in spelling and meaning, with the Danish expression missing the privative ‘a’, but otherwise retaining the ‘ked’ of ‘kedos’, meaning ‘to care about’” (p.c.).

9 See Gardner’s (2003) critical discussion on the very way in which we market “depression as illness, drugs as cure.”

10 See, for example, Neil Postman’s (1985) Amusing Ourselves to Death.

11 In his recent History of Western Philosophy, C. Stephen Evans estimates: “In my view Kierkegaard is the greatest Christian philosopher since the medieval period. In a way that is comparable to such thinkers as Augustine and Aquinas, Kierkegaard is as much theologian as philosopher” (Evans 2018: 491).

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above, I do not mean to restrict our investigation to only this term. I begin with an

examination of Tungsindighed in Kierkegaard’s Journals, Notebooks, and Papers, and then

in Either/Or. With respect to the related concepts of Kjedsommelighed and Fortvivlelse, I

have chosen to examine three published works in particular: Either/Or, The Sickness Unto

Death, and Works of Love.

6.1 - Tungsindighed

Kierkegaard employs Tungsind and its variants in primarily two places: (1) in

Either/Or through the pseudonyms A and Judge Wilhelm, and (2) in his own Journals,

Notebooks, and Papers.12 In this section, I will first examine his unpublished writings, then

Either/Or. Immediately, we are presented with a dilemma: on the one hand, Tungsind calls to mind a depressed state, one which seems a lot like non-culpable mental illness; on the other hand, there is at least a kind of Tungsindighed that clearly arises as a result of spiritual failure, much in the same way as acedia. This division is represented, in broad strokes, in

Kierkegaard’s Journals and in Either/Or, respectively. In Kierkegaard’s Journals, he does not use Tungsindighed in the sense that it is a sin or the result of spiritual failure. Rather, it is something Kierkegaard himself struggles with, a hand that he’s been dealt. By contrast, in Either/Or, there is at least a kind of Tungsindighed that arises as a result of sin or spiritual failure. Life makes demands on you, and you are unable or unwilling to comply. This discrepancy between the two senses of Tungsind might be due to the use of a pseudonym

12 By my count, which should not be counted upon for precision, E/O contains 56 instances of the word Tungsind or its variants. By comparison, SUD has 4, WL 1, CA 6, CUP 8, UDVS 8, CD 6, and PC 2. In all of his Journals, Notebooks, and Papers, there are upwards of 168 instances combined. [Source: SKS.]

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in EO, in which case, Kierkegaard does not necessarily endorse the view coming from

Judge Wilhelm; or perhaps there is a more complex explanation forthcoming.

6.1.1 - Tungsindighed in SK’s Journals, Notebooks, & Papers

Kierkegaard was a voluminous author, which is all the more impressive considering

his untimely death at age 42. In addition to an impressive array of published works, many

of them lengthy, his unpublished writings were carefully preserved for posterity. The latter

consist of journal entries, drafts of unpublished materials, and various editorial notes on

reading and other addenda. I am most interested in those journal passages “in which he

reveals himself to a degree that has few parallels,”13 especially with respect to his own melancholic condition. Since Kierkegaard’s Journals, Notebooks, and Papers14 stretch

across his entire writing career, any account this brief will necessarily be incomplete.

Nevertheless, this brief examination will give us a good initial look at how he views, in his

own words, his own melancholic condition.15

In a 1846 journal entry, he writes, “I am in the profoundest [deepest] sense an

unhappy individuality.”16 Yet, curiously, Kierkegaard in the same place attributes this deep

13 Crites (1970: 38).

14 I use this successive phrase “Journals, Notebooks, and Papers” as a catchall category. Others have titled these unpublished works as The Journals of Søren Kierkegaard (Dru: 1951); Kierkegaard’s Journals and Notebooks (KJN) (Cappelørn, et al., in 10 Vols.: 2007-2018); Søren Kierkegaard’s Journals and Papers (JP) (Hong, et al., in 8 Vols.: 1967-78); and Søren Kierkegaards Papirer (Pap.) (Thulstrup, 2nd ed., in 16 Vols., 22 Tomes: 1968-78; Heiberg-Kuhr-Torsting, 1st ed., in 11 Vols.: 1909-48).

15 For more on the relation between Kierkegaard’s concepts of despair and melancholy and our present-day understanding of depression, one would do well to begin with Cappelørn (2008), Hannay (2008), and Marino (2008).

16 Hongs’ translation of “Jeg er en i dybeste Forstand ulykkelig Individualitet“ (JP 5: 334 entry 5913 (Pap. VII 1A 126 n.d., 1846)). Cf. NB: 34 (KJN, Vol. 4: 34). Kierkegaard, in the very next paragraph of this entry, waxes poetic about his own “Tungsind”, indicating that this son is himself.

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unhappiness to something physical and mental, and hence pathological, rather than

spiritual: it is a “suffering which must have its deeper basis in a misrelation between my

mind and body, for (and this is the remarkable thing as well as my infinite encouragement)

it has no relation to my spirit.”17 He says that his spirit, by contrast, “perhaps because of the tension between my mind and my body, has been granted an unusual resilience.”18

Kierkegaard speaks of himself, in the third-person, as having inherited his melancholy

[Tungsind]—yet another indication that it is pathological and not due to spiritual failure:

“An old man, who was himself enormously melancholic…in his old age has a son who

inherits all this melancholia [Tungsind].”19

Later, in a journal entry dated 16 Aug. 1847, Kierkegaard writes, “I must get a

better grip on my melancholia [Tungsind].”20 Yet, even though he acknowledges his strong

desire to alleviate his own melancholy, which “until now…has reposed in the profoundest

depths,” he nevertheless, in the same breath, can see the bright side of things and express

gratitude:

[I]t has been kept down there with the help of enormous intellectual effort [Aands- Anstrengelse, “spirit-exertion”]. It is certainly clear that I have benefited others with my work and that God has approved of it and has helped me in every way. I thank him again and again for having done infinitely more for me than I had

17 Hongs’ translation of “ … Lidelse, der maa have sin dybere Grund i et Misforhold mell. min Sjæl og mit Legeme; thi (og dette er det mærkelige samt min uendelige Opmuntring) den staaer i intet Forhold til min Aand” (JP 5: 334 entry 5913 (Pap. VII 1A 126 n.d., 1846)). Cf. NB: 34 (KJN, Vol. 4: 33).

18 Hongs’ translation of “min Aand, der tvertimod maaskee ved det spændte Forhold mell. Sjel og Legeme har faaet en Spændkraft som sjelden er” (JP 5: 334 entry 5913 (Pap. VII 1A 126 n.d., 1846)). Cf. NB: 34 (KJN, Vol. 4: 33-34).

19 Kirmmse’s translation of “En gl. Mand, der selv var uhyre tungsindig (hvorledes vil jeg ikke nedskrive) faaer en Alderdommens Søn, paa hvem hele dette Tungsind gaaer i Arv” (NB: 34 (KJN, Vol. 4: 34)). Cf. JP 5: 334 entry 5913 (Pap. VII 1A 126 n.d., 1846).

20 Rumble and Kirmmse’s translation of: “Mit Tungsind maa jeg see at faae nærmere fat” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 193)).

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expected…with his assistance I have endured to the uttermost in my frightful suffering.21

Even in his suffering, Kierkegaard can see how God has sustained him and his work as an

author.

At this point in the same entry, Kierkegaard takes an unexpected shift. Although he

himself desires to get a better grip on his melancholy, he senses that “God wants things

otherwise.”22 Kierkegaard had begun his work as an author “with a burdened conscience,” leading him to strive to make his vocation thereof [his “Forfatter-Arbeiden”, or “author-

work”] of the highest “purity, selflessness, diligence”—though it seem “like madness to

the eyes of the world.”23 But now he senses an invitation from God in this season,24 as he

says, “Something is stirring within me that indicates a metamorphosis.”25 An invitation to

what, exactly? In his own words:

I must now remain quiet, by no means work too strenuously—indeed, hardly strenuously at all—not begin any new book, but try to come to myself and truly think the idea of my melancholia together with God, right here and now. In this way my melancholia may be lifted and Christianity may come closer to me. Until now I have protected myself against my melancholia with intellectual labor that keeps it at bay. Now—in the faith that God in forgiveness has forgotten the portion

21 Rumble and Kirmmse’s translation of “Det har hidtil hvilet dybest i Grunden, og den uhyre Aands- Anstrengelse har hjulpet til at holde det nede. At jeg har gavnet ved min Arbeiden, at Gud har billiget den, og hjulpet mig paa enhver Maade er vist nok. Jeg takker ham atter og atter, at han har gjort for mig uendeligt mere end jeg havde ventet…at jeg i min frygtelige Lidelse ved hans Bistand har holdt ud indtil det Yderste” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 193)).

22 Rumble and Kirmmse’s translation of “Men nu vil Gud det anderledes” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194)).

23 Rumble and Kirmmse’s translation of “Denne Reenhed, Uegennyttighed, Flid er det som i Verdens Øine tager sig ud som Galskab” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194)).

24 His remarks here indicate that this was only for a time. “I must remain here, on the spot, and be renewed inwardly. That toward the end of the autumn I might embark on a proper foreign journey for a longer period, is quite another matter” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 193)).

25 Rumble and Kirmmse’s translation of “Der rører sig Noget i mig, som tyder paa en Metamorphose” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194)).

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of guilt there is within it—I must myself try to forget it, though not through distraction, not by distancing myself from it, but in God, so that when I think of God, I must think that he has forgotten it, and thus myself learn to dare to forget it in forgiveness.26

This densely-packed paragraph is incredibly theologically rich. For instance, there are some things reminiscent of the advice given to us by the writers on religious melancholy to guard against melancholy and scrupulosity. As Richard Baxter had advised in the 17th

century, “Where you find your selves unable for a secret duty, struggle not too hard with

your selves, but go that pace that you are able to go quietly,” and “Be most in those duties

which you are best able to bear.”27 The usually prolific Kierkegaard felt he should slow his

writing, work not strenuously at all, not beginning any new book, but instead should quietly

“remain here, on the spot, and be renewed inwardly,”28 in order to “truly think the idea of

my melancholia together with God, right here and now.” By doing this, he says, “my

melancholia may be lifted and Christianity may come closer to me;” he can present not

only his melancholic suffering, but also hand over his control and autonomy, as a sacrifice

in order to be renewed inwardly. We witness here his realization that earlier in his writing

career, he was striving so as to earn God’s favor, for instance, aiming for purity “so pure

26 Rumble and Kirmmse’s translation of “Jeg skal derfor nu forholde mig stille, ingenlunde arbeide for anstrænget, ja neppe anstrænget, ikke begynde paa nogen ny Bog, men see at komme til mig selv, ret at tænke mit Tungsinds Tanke sammen med Gud paa Stedet. Paa den Maade maa mit Tungsind hæves, og det Christelige komme mig nærmere. Jeg har hidtil værget mig mod mit Tungsind ved Aands-Arbeiden, der holder det borte – nu maa jeg see, ved Troen om at Gud har glemt i Tilgivelse hvad af | Skyld der er deri selv at glemme det, men ikke nogen Adspredelse, ikke i nogen Afstand fra det, men i Gud, at jeg idet jeg tænker paa Gud maa tænke at han har glemt det, og saaledes selv lære at turde glemme det i Tilgivelsen” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194)).

27 Baxter (1673/1707, Vol I: 251).

28 Rumble and Kirmmse’s translation of “Jeg maa blive paa Stedet, og fornyes ind efter” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 193)).

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that it could pay off a little bit of the debt.”29 Until now, he says, “I have protected myself

against my melancholia with intellectual labor that keeps it at bay.” He had relied upon

himself to sober his own melancholy, or to distance himself from it, but in so doing, he

realizes that this was a masked attempt to achieve a work on his own, independent of God.

To summarize, we see in this brief examination of his journal entries that (i)

Kierkegaard seems to understand his Tungsind as an inherited or pathological condition, rather than a spiritual failure, which (ii) is itself bad: “with His assistance I have endured to the uttermost in my frightful suffering.”30 He also believes (iii) there is some freedom

of the will still present, since, although he is in the “profoundest sense unhappy,” he has

been able to combat or keep at bay his Tungsind with immense intellectual or spiritual

effort. Not his entire being is damaged. In the words of one commentator, “...in the

profoundest sense, yes, but not absolutely.”31 He thus (iv) sees this Tungsind as a

misrelation between body and mind, yet while his spirit (or intellect) flourishes. Finally,

(v) even though his Tungsind here is not attributable to a specific sin, it may be connected

to a more general spiritual failing, or impudence, or callowness, since Kierkegaard clearly

treats it as a weakness to be brought to God and understood with God’s help.

29 Rumble and Kirmmse’s translation of “at gjøre denne saaledes reen, at den kunde være lidt Afdrag paa Gjelden” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194)).

30 Rumble and Kirmmse’s translation of “…at jeg i min frygtelige Lidelse ved hans Bistand har holdt ud indtil det Yderste” (NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 193)).

31 Fernández (2017).

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6.1.2 - Tungsindighed in Either/Or (1843)

Either/Or was among Kierkegaard’s earliest published writings, and the choice to

implement a pseudonym was just as confusing to readers then as it is now.32 The work is

indeed strange in that it consists of two volumes, Volume I which is penned supposedly by

an unnamed aesthete referred to only as “A”, and Volume II which is fashioned as replies

to A from a certain Judge Wilhelm. Kierkegaard does not sign his own name as editor, but

instead uses yet another pseudonym Victor Eremita.33 These characters are, of course,

creations of Kierkegaard. Though I will examine one at a time in what follows, both

volumes of Either/Or should be taken as a whole so that we can gather more clearly the

continuity in Kierkegaard’s own thinking.

6.1.2.1 - Tungsindighed in E/O - Volume I. “Tungsind” and its variants, in the first

volume of Either/Or, appears only around 15 times, whereas that number rises to 41 times

in the second volume. This means that A does not use the descriptor nearly as much as

Judge Wilhelm does.34 Perhaps this is due to Wilhelm’s placement in the ethical sphere

32 McCarthy (1978: 56-57) explains, “As contemporary reviews and Kierkegaard's own annoyance indicate, the effect of Either/Or upon the Danish readers of 1843 was overwhelming rather than thought- provoking as Kierkegaard had hoped. In our own day, the effect upon the uninitiated reader is much the same. The Danish literary public was bewildered by its size and format, and even further distracted from the content by the seemingly endless series of ‘Chinese puzzles’ in which the author enclosed the work…In all this, the content of the work receded while the structure and the mysterious author commanded attention.”

33 “The identity of the real author engaged much attention, and Kierkegaard must be considered responsible for encouraging this first, by writing a letter in his own name against the rumor that he was the true author and then by writing letters in the name of Victor Eremita, the pseudonymous editor of Either/Or” (McCarthy, 1978: 56-57).

34 Still, those 15 instances in the first volume account for over double the next highest amount among Kierkegaard’s works I surveyed. (See fn. 12 herein.)

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and A’s placement in the aesthetic sphere; that is, Wilhelm can simply see more clearly

than A the harms that plague A.35

Volume I opens with collected scraps of paper by A called “Diapsalmata”,36 which

the editor explains “could best be regarded as preliminary glimpses into what the longer

pieces develop more coherently” (EO I:8). In the following passage, while there is no

particular vocabulary word that A uses, he so eloquently describes his own weary state of

mind (his “symptoms”) that it is worth reading:

I don’t feel like doing anything. I don’t feel like riding—the motion is too powerful; I don’t feel like walking—it is too tiring; I don’t feel like lying down, for either I would have to stay down, and I don’t feel like doing that, or I would have to get up again, and I don’t feel like doing that, either. Summa Summarum: I don’t feel like doing anything (EO I:20).37

Later, A will alternate (both in the “Diapsalmata” and elsewhere in Vol. I) between a few

select terms to describe his phenomenal state: Tungsind (“heavy-mindedness”;

35 Or, perhaps, that Wilhelm is more reflective than the aesthete A. Or, perhaps, that Wilhelm’s frequency of use simply (trivially) reflects his ringing indictment of the condition.

36 Related etymologically to “psalm”, this term roughly means “refrain” and is an overt allusion to Marcus Aurelius’ Meditations. Cf. Furtak (2009: 71-72).

37 Hongs’ translation of: “Jeg gider slet ikke. Jeg gider ikke ride, det er for stærk en Bevægelse; jeg gider ikke gaae, det er for anstrængende; jeg gider ikke lægge mig ned; thi enten skulde jeg blive liggende, og det gider jeg ikke, eller jeg skulde reise mig op igjen, og det gider jeg heller ikke. Summa Summarum jeg gider slet ikke” (sks.dk/EE1/txt.xml). This passage is taken from a longer journal entry which Kierkegaard himself wrote in 1837 (JP V 5251; Pap. II A 637), which suggests that perhaps he may have been wrestling with this very phenomenon. Kierkegaard reveals in a separate journal entry (JP V 5631; Pap. IV A 221) that even more of his own “aphorisms...could have been used very well.” Cf. the Hongs’ historical introduction in EO I:ix.

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“melancholy”),38 Sorg (“sorrow”; “sadness”),39 and Kjedsommelighed (“boredom”;

“tediousness”; “weariness”).40 The term Tungsind has no good English equivalent,41 so I leave it untranslated.

“Summa Summarum: I don’t feel like doing anything.” In my view, A seems to be experiencing something very much like acedia (though he does not refer to it by that name42). Not only is it symptomatically close, but Kierkegaard clearly locates the source of A’s ailment as a deeper spiritual problem or failure to live well before God. As a result of this ostensibly spiritual failure, A shrinks into heavy-mindedness, into spiritual torpor, with no motivation to do anything. This parallels the torpor acedia had associated with both spiritually imbued, important work, and with one’s feelings towards that work, towards that calling, and towards God. As Thomas warned, what begins as an aversion to the Lover’s demands can, as it rises to the level of reason, fester into mortal sin when it

“consents in the dislike, horror, and detestation of the Divine good (quae consentit in fugam

38 “In addition to my other numerous acquaintances, I have one more intimate confidant—my depression [Tungsind]. In the midst of my joy, in the midst of my work, he beckons to me, calls me aside, even though physically I remain on the spot. My depression [Tungsind] is the most faithful mistress I have known—no wonder, then, that I return the love” (EO I:20). “Wine no longer cheers my heart; a little of it makes me sad—much, depressed [tungsindig]” (EO I:41).

39 “I say of my sorrow [Sorg] what the Englishman says of his house: my sorrow is my castle” (EO I:21).

40 “How dreadful boredom [Kjedsommelighed] is—how dreadfully boring; I know no stronger expression, no truer one, for like is recognized only by like. Would that there were a loftier, stronger expression, for then there would still be one movement. I lie prostrate, inert; the only thing I see is emptiness, the only thing I live on is emptiness, the only thing I move on is emptiness. I do not even suffer pain” (EO I:37).

41 Cappelørn (2008) points out terms that are nearby, himself preferring “spleen”: “The German terms Schwermut and Weltschmertz, the French term ennui, and the English terms “Byronism” and “spleen” are all designations for the world-weariness, aestheticism, and loss of values that were common themes for European romantic writers. And it is in this group of terms that the Danish Tungsind belongs” (133).

42 As we see later, however, Judge Wilhelm expressly identifies A’s condition as acedia.

243 et horrorem et detestationem boni divini), on account of the flesh utterly prevailing over the spirit” (ST II-II.35.3.co).

Throughout A’s exhausted tirade, God makes little to no appearance (though gods and goddesses do receive mention)—this is little surprising since A is not a Christian believer. The objection might be raised then that A, as a nonbeliever, could not detest God so extremely, for he doesn’t even consider God in his own thoughts. However, we must remember that Kierkegaard is assuming the existence of the Christian God, the truth of

Christianity, and everything that comes with it. Given that this God exists, that this God has created A, has given A a meaningful specific calling or work, then the extent to which

A flees from that God-given work is the extent to which he flees from God and His will.

This is a key component of what I and my co-authors (Brandt, et al., 2020) call a

“perspectival account” of acedia that stretches across Kierkegaard’s various writings: acedia will manifest differently in the aesthetic sphere than it does in the ethical sphere, which has its own characteristic manifestations, which will differ from the religious sphere, and so on. So then, someone like A, who lives the aesthetic life, may or may not consider

God explicitly in his day-to-day goings-on or during his troubles; nevertheless, God is always present and A’s neglect is a kind of flight from God.

This association with acedia can aid in our understanding of A’s condition in a later section titled, “The Immediate Erotic Stages.” In many ways A’s contentment with the aesthetic realm amounts to a refusal of the human ethical task, which itself is a kind of slothfulness, or shrinking back from one’s calling. There in the aesthetic realm A is in love with sorrow, particularly the kind of reflective grief that is open-ended and lacks closure.

Sorrow “is aesthetically the one satisfying emotion that can be sustained long term. It

244 moves him towards a ‘tragic view of life’ that blocks ethical resolve and decisiveness.”43

Regard how A sings of melancholy’s sweetness, which is sweeter than grief or pain:

[B]ut grief (Sorg) and pain (Smerte) do not have the implicit contradiction characteristic of melancholy [Melancholi] and depression [Tungsindighed], do not have the ambiguity that is the sweetness in melancholy. Although desire in this stage is not qualified as desire, although this intimated desire is altogether vague about its object, it nevertheless has one qualification—it is infinitely deep.44

By “contradiction” Kierkegaard means a kind of tension or incongruity. What is different about “melancholy [Melancholi] and depression [Tungsindighed]” is their “intellectual content that makes possible this kind of endless sorrow that never achieves closure. One can always reinterpret the situation and find something new.”45 The “contradiction” which

A finds sweet in “melancholy [Melancholi] and depression [Tungsindighed]” is likely the tension between the temporal and the eternal with respect to human existence.46

43 Evans (p.c. via email, 2 Sep 2019). Clearly this attractiveness of reflective grief is appealing to A. Evans explains further, “What is attractive about reflective grief is that it lacks closure.” For example, look at the essay variously translated as “Silhouettes” or “Shadowgraphs” in which “all women who have been hurt, but all of whom have an ambiguity in their situation that allows them to debate within themselves what it means.” Evans (p.c. via email, 2 Sep 2019).

44 Hongs’ translation of: “...men Sorg og Smerte har ikke den Modsigelse i sig, der er eiendommelig for Melancholi og Tungsindighed, ikke den Tvetydighed, der er Sødmen ved det Melancholske. Skjøndt Attraaen paa dette Stadium ikke er bestemmet som Attraa, skjøndt denne anede Attraa med Hensyn til sin Gjenstand er aldeles ubestemt, saa har den dog een Bestemmelse, den er nemlig uendelig dyb” (EO I:76-77; sks.dk/EE1/txt.xml).

45 Evans (p.c. via email, 2 Sep 2019).

46 In a later passage, “The Tragic in Ancient Drama Reflected in the Tragic in Modern Drama,” A opines about a new, stronger form of tragedy that remains outside the ethical, contrasting sorrow with pain. “Sorrow (Sorg) always has in it something more substantial than pain (Smerte). Pain indicates a reflecting upon the suffering (Lidelsen) that sorrow does not know.” As Evans helpfully explains, “The categories used here are influenced by Hegel. For Hegel sorrow is something more ‘immediate’ in the sense that it stems from your identity as a family member or member of society. While ‘pain’ here refers to something more individual, something that you feel because of what you have done, or how you think about what you have done or how you think about what has happened to you. So modern societies are more individual and reflective, while ancient Greece was more ‘substantial’ in the sense that identity was given by the social organisms that one belonged to…” Hence, although “the tragic element is stronger in the ancient world; modernity is always threatening to bring in the categories of guilt, which brings the ethical in” (Evans, p.c. via email, 30 Aug 2019).

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6.1.2.2 - Tungsindighed in E/O - Volume II. While A is to some extent self- reflective, he is unable to see his own position for what it really is. Judge Wilhelm, on the other hand, is astute enough to recognize A’s malady, and in his diagnosis of A, we can see that Wilhelm is familiar with both acedia and the “genius” sense of melancholy:

It is clear that Kierkegaard has in mind—by having some obscure, inarticulable notion in

the mouth of Judge Wilhelm—both the vice of acedia and Romanticism’s melancholy, the

latter of which is seen as “somewhat prestigious” to have, and the former of which is clearly

undesirable.48 This is why Wilhem also writes, “I readily concede that in one sense being

depressed [tungsindig] is not a bad sign, for generally it happens only with the most

endowed natures…being depressed [tungsindig] has almost become the status that

everyone covets.”49

47 Hongs’ edition: EO II:185. Cf. Kierkegaard’s 1839 journal entry which directly touches upon this passage, EO II:381. Unfortunately, the Hongs’ translation, though it is the standard translation today, renders the Danish “Tungsind” (literally, “heavy-minded”) as the more loaded and presuming term “depression”. Kierkegaard of course did not use the term “depression”, which would not have been in common usage at that time, but neither did he elect for the contemporary Danish word “Melancholi”. So it is a mistake to simply identify Kierkegaard’s notion of “Tungsind” with our notion of “depression”. Cf. Ferrall and Repp (1843: 197). Kierkegaard knew the word “Melancholi”, as evidenced by a cursory search of SKS.

48 By the end of the 19th century, from a psychiatric perspective, “melancholy” had become virtually synonymous with “depression”. Earlier periods in the history of psychiatry were limited in their nosologies, often using either of the general categories “mania” or “melancholy”, then specifying further from there. Thus “melancholy” was previously understood to encompass a wide spectrum of disorders, not only an excessive or prolonged sorrow. Cf. Hosack (1821: 58).

49 Hongs’ edition: EO II:189.

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But in the main, Wilhelm is adamant that A’s Tungsind is an objectively bad

condition, even a state of sin, and least of all a mood that one merely falls into.50 “It is the

sin of not willing deeply and inwardly, and this is a mother of all sins.”51 In a word, “the

main constituent of the actual depression [Tungsind]” is a certain “immediacy that [is]

repressed.”52

To understand, consider that Wilhelm locates A’s Tungsind as an undesirable state

between the aesthetic and the ethical, the result of his being “immediate spirit” which is

“ripe for immediacy” yet stuck “bound up with all the earthly life.”53 As such, to his own

rhetorical question, “What is Tungsind?” To Wilhelm, “It is hysteria of spirit”—a primal

response to the forestalling of a deep desire to “transfigure [forklare, “explain”] itself in

itself.”54 In Tungsind lies something unexplainable [Uforklarligt].55 (A recognizes this

himself, calling it “the ambiguity that is the sweetness in melancholy.”56) The “spirit wants

to gather [samle] itself together out of this dispersion [Adspredthed “abstractedness”,

50 Pieper (1935/1986) notes this when he discusses despair, a kind of which (despair of weakness) Pieper argues is acedia. “Today when we speak of despair we are usually referring to a psychological state into which an individual ‘falls’ almost against his will. As it is here used, however, the term describes a decision of the will. Not a mood, but an act of the intellect. Hence not something into which one falls, but something one posits. The despair of which we are speaking is a sin. A sin, moreover, that bears the mark of special gravity and of an intensity of evil.”

51 EO II:189.

52 EO II:188. We receive a rather worked-out account of depression [Tungsind] from Wilhelm in (EO II:185-194) situated near the beginning of a lengthy correspondence to A, “The Balance Between the Esthetic and the Ethical in the Development of the Personality.”

53 EO II:188-89.

54 It is interesting that Wilhelm describes the spirit’s reaction here as “hysteria” (Hysteri), a rather active and even defiant response, when we might expect rather a despairing response.

55 “Der ligger noget Uforklarligt i Tungsind” (EO II:189).

56 EO I:76-77.

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“scattering”];” the dis-integrated self wishes to be free of this incongruity between finitude

and infinity; “the personality wants to become conscious in its eternal validity.”57 When

this “movement is halted,” he says, “if it is repressed, then depression [Tungsind] sets in.”58

The only remedy, as far as Wilhelm can see, is an opposed movement, a “bowing

in true humility before the eternal power,” at which point “the depression [Tungsindet] is

essentially canceled, although the same individual may suffer many sorrows and troubles

in his life.”59 These subsequent sorrows and troubles are practically unavoidable, however, as there is always some small residue of Tungsind, “but this is linked to something much deeper, to hereditary sin [Arvesynden].”60 Wilhelm does not put much hope in medicine,

since, he says to A, “you scarcely assume, as do many physicians, that depression

[Tungsind] inheres in the physical, and, strangely enough, physicians nevertheless are

unable to eliminate it.”61 Note that this is consistent with a view that medicine can nevertheless mitigate or suppress its symptoms. But an existential unwillingness to

57 EO II:189.

58 EO II:189.

59 EO II:189. “But the person who wants to be eminently endowed will have to tolerate my placing the responsibility upon him and his capacity to be more at fault than other people. If he looks at this in the proper light, he will not see this to be a disparaging of his personality, even though it will teach him to bow in true humility before the eternal power” (EO II:189).

60 EO II:190. The fuller statement is actually this: “But even the person in whose life this movement occurs most calmly and peacefully and at the right time will still always retain a little depression [Tungsind], but this is linked to something much deeper, to hereditary sin [Arvesynden], and is rooted in this, that no human being can become transparent to himself.”

61 EO II:190.

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become, or inability to attain, ethical resolve and decisiveness, “Only the spirit can

eliminate it, for it inheres in the spirit.”62

6.1.3 - Evaluation of Tungsindighed

Clearly, Tungsindighed lends itself to close parallels with depression. The

combinatorial and literal nature of the Danish language, with its “heavy-mindedness”,

evokes the classic image of a “depressed” or “pressed down” condition. Tungsind’s close

association with acedia, especially in the aesthetic life of A, requires that we consider

Tungsind as some sort of spiritual failing, sin, or weakness—at the very least a kind of spiritual callowness. At any rate, it is certainly not an ideal condition to be in, as it is contrary to a properly directed and flourishing life. On the other hand, it is interesting that in his Journals, Notebooks, and Papers Kierkegaard goes so easily on himself, these mitigating explanations at the ready; while Tungsind is certainly still a failing, a struggle which he hopes to overcome, we do not see any severe censure of the condition such as was witnessed with Judge Wilhelm commenting upon A.

These two sources, while they seem in tension, actually present a unified understanding of Tungsind. The first key is to remember that, in both places, Tungsind is a non-ideal condition which is contrary to, or destructive to, rather than conducive to human

62 EO II:190.

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flourishing.63 Second, assuming a perspectival account of acedia,64 while A inhabits the

aesthetic realm, Kierkegaard himself does not. Kierkegaard was not so presumptuous to

consider himself to be in the religious sphere (and this is one reason why he dons a

pseudonym “Anti-Climacus,” who is a “Christian to an extraordinary degree,”65 rather than

using his own name). Yet in the invitation to metamorphosis, recall that Kierkegaard feels

compelled to remain quietly and think of his melancholia together with God. Rather than

keep it at bay, Kierkegaard says, “I must myself try to forget it, though not through

distraction, not by distancing myself from it, but in God, so that when I think of God, I

must think that he has forgotten it, and thus myself learn to dare to forget it in

forgiveness.”66 This cooperative effort, to work together with God through one’s own

weaknesses, suggests that Kiekegaard’s invitation to metamorphosis is an invitation to the

religious sphere. At this sphere, Tungsind is still a bad condition, but it is one to be worked

out in cooperation with God. This explains why there is no harsh censure of Tungsind at

this point, since the human being is where he needs to be, in right relation with God; and

why it is harshly censured in the aesthetic sphere, since this failing itself, which allows the

63 The worry here is obviously the stigma associated with calling an action or habit “bad”. To circumvent this, we can follow general categories as those laid out by Kent Dunnington (following Aristotle), who runs into a similar trouble in his work on addiction: “To call an action or a type of action ‘good’ is simply to affirm that it is a fitting component of a worthwhile way of life. To call an action or a type of action ‘bad’ is to deny that it is fitting to a worthwhile way of life. Assuming that addiction is destructive rather than conducive to human flourishing, addictive behaviors are bad” (Dunnington 2011: 37).

64 Brandt, Dahm, and McAllister (2020).

65 Kierkegaard explains, “The pseudonym is named Johannes Anticlimacus, in contrast to Climacus, who claimed not to be Christian; Anticlimacus stands at the opposite extreme: a Christian to an extraordinary degree―I myself push it only to the point of being a perfectly simple Christian” (NB11: 204, 1849 (KJN, Vol. 6: 125)).

66 NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194).

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human being to neglect and wallow in the sensuous, is a hurdle in the way of right relation

to God.

What shall we say, then, about Tungsindighed’s relation to depression? I do not

suppose, as some authors do, that Kierkegaard had in mind our contemporary notion of

depression. Take for instance, Gordon Marino, whose plain statement suggests just this

thing:

Kierkegaard uses two Danish terms to refer to depression, tungsindighed and melancholi. Vincent McCarthy [1978: 54–57] argues that tungsindhed, which could be roughly translated as heavy mindedness, has deeper and more broody connotations than melancholi. Abrahim Kahn [1985b] disagrees, arguing that the two terms are synonymous in Kierkegaard’s writings.67

While he follows it up with an informative comparison between seeming synonyms, his

initial claim—that these terms refer to depression—is much too sudden. Cappelørn, for his

part, considers Tungsind to be in the same tradition as melancholy and a whole host of

related conditions, and surely the similarities are easy to identify:

In Kierkegaard’s writings, then, Tungsind must be regarded as the continuation of a long tradition that goes back to the Greek melancholy, through the medieval acedia—through reformulations, reinterpretations, refinements, and supplementations—on to the contemporary “spleen,” Schwermut, and ennui” (Cappelørn 2008: 133).

The similarities are too obvious to deny; however, Cappelørn is mistaken that these hail

from the same long tradition with its root in ancient Greek μέλαινα χολή [melaina chole]:

as we have seen, acedia [ἀκηδία] has its roots in 4th-century Christian monasticism.

Perhaps Cappelørn merely wanted to highlight Tungsind’s symptomatic similarity with melancholy and these other conditions, in which case he is right. It is true, on the one hand, that Tungsind does share a close symptomatology with melancholy, sometimes rising to

67 Marino (2008: 259n).

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the level of pathology, while evoking the same existential dejectedness as Schwermut and

ennui. On the other hand, acedia’s characteristic feature is that it is a sin, a condition for

which one can be held culpable, and we have already seen above Tungsind’s close

association with acedia. The fact is, Tungsind is both. A resolution of this tension is

forthcoming if we remember the same keys from before. First, Tungsind, like all of these

conditions, is a non-ideal condition, not conducive to flourishing, and is therefore bad.68

Second, we must keep in mind a perspectival account of the individual and what level or

sphere she inhabits. In the aesthetic sphere, Tungsind receives a harsher indictment,

because here it enables and amplifies that very neglectfulness which keeps her away from being properly orientated towards God. In higher spheres, however, where she is properly related to God, Tungsind is on its way to becoming healed and redeemed in a cooperative

endeavour between creature and Creator, and one’s degree of culpability is, in a sense,

relaxed, as grace sweeps in and covers over.

The question as to whether Tungsindighed is, or is a kind of, depression is too

simplistic. Depending on what the asker means, I will answer differently. On bio-

reductionistic models of depression, certainly no, for Tungsind cannot be reduced to the

non-spiritual. On descriptivist models of depression, such as what the DSM offers, a

qualified yes, with the caveat that, while (an instance of) Tungsind may very well qualify symptomatically, one cannot forget the spiritual element, the vertical axis between human being and transcendent God, which is left out of such descriptivist accounts. On a new

68 Here I depart from the Romantic view that sees melancholy or depression as a good, since it has genius or artistic redeeming qualities. Perhaps it does have these qualities, but that does not change the badness of the melancholy itself. And the fact that such qualities are “redeeming” indicates the badness of melancholy in isolation.

252 pluralistic account of depression, such as I have been suggesting here, Tungsind most certainly is a kind of depression, belonging to this genus on account of its spiritual etiology and its spiritual remedy.

6.2 - Kjedsommelighed

The Hongs translate “Kjedsommelighed” in EO to the English “boredom”, but

Kierkegaard’s Danish paints a much more robust picture. Instead of using the words

“Kjedsomhed” (“boredom”) or “kjedelig” (“boring”), words which he uses elsewhere in his authorship,69 Kierkegaard seems to have actually combined the words together into

“Kjedsommelighed”: “boring-boredom” (or “boring-ness”).70 It cannot be said for certain whether Kierkegaard coined the term, yet it appears in the works of only a handful of other authors contemporary to the Dane.71 As Kierkegaard understands it, Kjedsommelighed is closely evocative of, or perhaps is a symptom of, that old vice of acedia, especially in its twofold effect of idleness and restlessness. Similarly, A’s supposed solution for boredom, though it is ultimately found wanting, brings to mind some of the remedies that Cassian

69 In both volumes of EO in particular, according to SKS, “Kjedsommelighed” appears eighteen times, “Kjedsomhed” zero times, and “kjedelig” twice. In fact, “Kjedsomhed” appears only twice in Kierkegaard’s published writings, once in his unpublished writings, and once in his journals.

70 This latter suggestion of “boring-ness” comes from Marilyn G. Piety. She points out the fact that “the ‘-hed’ ending in Danish is like the ‘-heit’ ending in German…That is, ‘it converts and adjective into a noun and usually denotes an abstract quality’” (p.c. via email, 25 Jul 2019). While I take her point, the best translations for “-hed” or “-heit” don’t always generate the English suffix “-ness” (e.g., schön (“beautiful”) + -heit → Schönheit (“beauty”); Kind (“child”) + -heit → Kindheit (“childhood”); Christ (“Christian”) + - heit → Christenheit (“Christendom”)). This point is only minor, however. Whatever translation we choose— “boring-ness” or “boring-boredom” or even “boring-dom”—it will necessarily be unnatural sounding to anglophone ears, as it must evoke something more robust than the usual connotation of “boredom”.

71 Examples include theologian Henrik Scharling (1836-1920); poet Karl Adolph Gjellerup (1857- 1919); educator Christian Flor (1792-1875), “saa vilde Kjedsommelighed og Følelsen af den underordnede Rolle”; and journalist Richard Kaufmann (1846-1894).

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had offered for acedia, like perseverance in one’s task, stability of place, and detachment

from worldly things

6.2.1 - Kjedsommelighed in Either/Or (1843)

Shrewd to a fault, A devises his own method for eliminating his boredom

(Kjedsommelighed): “The Rotation of Crops.” Ordinarily, the bored person seeks to

remedy his boredom by changing his external circumstances (e.g., moving to the city,

moving to America, eating with new cutlery, etc.),72 or else by engaging in work

characterized by “indefatigable activity” merely to avoid his boredom.73 But “Changing

the Soil” will only get one so far. This indefatigable activity, A recognizes, “shuts a person

out of the world of spirit and places him in a class with the animals, which instinctively

must always be in motion.”74 It is in some sense a remedy to one’s boredom—if we mean by “boredom” one’s sullen abulia or velleity as we see in the first effect of acedia—since it gets a person up and moving. But even this kind of remedy is not lasting, as such temporary diversions cannot amuse for long, and so it is not an ideal or complete solution.

Instead, A proposes “changing the method of cultivation and the kinds of crops,”75

that is, varying oneself and one’s moods in order to maintain a level of change and diversity

in one’s activities that will sustain interest and thus stave off boredom. His solution is to

escape to the interesting or the amusing, or to turn everything which is otherwise mundane

72 EO I:291-92.

73 EO I:289.

74 EO I:289. Recall the restlessness (e.g., an urge to leave one’s cell, to depart the cloister, etc.) that the Desert Fathers had described as one of the twofold effects of acedia.

75 EO I:292.

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into the interesting or amusing, such as the fly,76 or the sweat on the lecturer’s face.77 A

does acknowledge that this solution sometimes leads to more boredom but, he is convinced,

“only insofar as it is used incorrectly.”78 The point is to change oneself and one's

perspective such that anything can be interesting. In any case, on A’s view, it is not idleness

that is the problem; it is boredom. “To be sure, idleness may be the occasion of losing one’s

property, etc., but the noble nature does not fear such things but does indeed fear being

bored.”79

To be clear, boredom is a problem specifically for the aesthete. First, it assumes a

nature and telos of human beings that is incongruent with reality, as A puts it, “man’s

destiny is to amuse himself.”80 A replaces what he takes to be a work/idleness antithesis

regarding man’s purpose with a amusement/boredom antithesis. In reality, both are

problematic. As Karsten Harries argues, “the polarity of the interesting and the boring

replaces the traditional polarity of good and evil; similarly it replaces the traditional

polarity of beauty and ugliness.”81 Second, and relatedly, A’s difficulties eliminating

boredom reflect the emptiness of an aesthetic life view and how difficult it is to live this

way successfully. This also helps to explain why an aesthete like A, who finds the

76 EO I:25.

77 EO I:299.

78 EO I:291. “It seems doubtful that a remedy against boredom can give rise to boredom, but it can give rise to boredom only insofar as it is used incorrectly. A mistaken, generally eccentric diversion has boredom within itself, and thus it works its way up and manifests itself as immediacy” (EO I:290-91).

79 EO I:289.

80 EO 1:290.

81 Harries (2010: 98).

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interesting in the most mundane, can come to enjoy melancholy—when in reality it is an

objectively bad state of being, as we saw Judge Wilhelm argue.

6.3 - Fortvivlelse

The topic of despair leads us directly to Kierkegaard’s The Sickness Unto Death. In

Danish, the word for “despair” (fortvivle, Fortvivlelse) derives from the word for “doubt”

(tvivl).82 This intimates a close relation, even in Kierkegaard’s mind, between existential despair and intellectual doubt. Doubt is to the mind (or thought) as despair is to the

personality: just as doubt marks the mind, despair marks the personality with indelible

psychological effects. Alastair Hannay points out, “The Danish Fortvivlelse, like the

German Verzweiflung, bears ‘two’ (tvi) on its face, so the suggestion of complexity is

conveyed here even more directly than in the case of ‘despair’ and its cognates.”83 This complexity Hannay refers to is a kind of “double-mindedness” as we see in Purity of

Heart.84 To doubt is to be of two minds; similarly, despair is being split apart from God, which entails being split apart from oneself. This widening chasm, in both respects, is essential to Kierkegaardian despair and should be kept in mind when we analyze both the objective and subjective perspectives of increasing kinds of despair below.

Edward F. Mooney’s (2008) volume includes an instructive survey on the contemporary literature concerning Kierkegaard on despair and melancholy, or depression,

82 “for” functions as a kind of magnifier, or intensifier, prefix, to mean something like “super-doubt” or “mega-doubt”.

83 Hannay (1998: 329).

84 “In Purity of Heart, a signed work, Kierkegaard asks whether despair isn't ‘simply double- mindedness’” (Hannay 1998: 329).

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in the form of a 3-essay section titled “Melancholy and Despair.”85 Heading up this section

is Gordon Marino’s essay “Despair and Depression,” which Mooney introduces with the

following laconic remark: “Marino takes Sickness unto Death to show the contrast between depression, a nonreligious concept, and despair, a theme that Kierkegaard develops

Christianly.”86 The truth is, Marino dips indiscriminately into both the pseudonymous writings (EO, CA, PC, EUD, PV, SLW, R, SUD) and the autobiographical journals of

Kierkegaard, in order to support a tenuous thesis. As we shall see, there is no such hard and fast distinction between “depression, a nonreligious concept, and despair, a theme that

Kierkegaard develops Christianly,” between “the night of the psyche and the night of the spirit,” as Marino claims.87 Certainly despair is a religious and existential state, which

Kierkegaard riffs on in various ways, but it does not follow that Kierkegaard thought that

“depression” (Marino’s term) was only a psychological ailment or nonreligious concept.88

In this section, I examine how closely this kind of religious or existential despair

(Fortvivlelse) overlaps with Tungsindighed (i.e., does despair necessarily manifest as

Tungsindighed?), drawing primarily from SUD and EO.89 I conclude with a brief look at

85 Mooney’s (2008) volume is Ethics, Love, and Faith in Kierkegaard. Part 3 is titled “Melancholy and Despair.” It includes the following essays: “Despair and Depression” by Gordon D. Marino; “Spleen Essentially Canceled—yet a Little Spleen Retained” by N. J. Cappelørn, translated by K. Brian Söderquist; and “Kierkegaard on Melancholy and Despair” by Alastair Hannay.

86 Mooney (2008: 7). Marino’s essay actually first appeared in Kierkegaard in the Present Age (Milwaukee: Marquette University Press, 2001) and is reprinted in Mooney (2008) with the kind permission of the press.

87 Marino (2008: 121).

88 Hannay, writing in and referring to the same volume, notes that “personal depression” is, perhaps idiosyncratically, “Marino’s term for Tungsind” (2008: 147).

89 “The most comprehensive treatments [of despair] appear in two works that virtually span the authorship, Either/Or and The Sickness unto Death” (Hannay 1998: 330).

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WL, where despair “enters integrally into the discourse,”90 in order to examine the role that proper self-love should play as a corrective to Fortvivlelse and other conditions we have discussed.

6.3.1 - Fortvivlelse in The Sickness Unto Death (1849)

No work in the Kierkegaardian corpus contains more uses of the word

“Fortvivlelse” (“despair”) and its variants than The Sickness Unto Death.91 This comes as

no surprise for readers of Kierkegaard. The sickness that leads to death just is despair.

Immediately Anti-Climacus clarifies for us that being in despair does not necessarily entail

feeling as though one is in despair:

The common view has a very poor understanding of despair. Among other things, it completely overlooks (to name only this, which, properly understood, places thousands and thousands and millions in the category of despair), it completely overlooks that not being in despair, not being conscious of being in despair, is precisely a form of despair.92

Despair permeates so deeply, that being unaware of being in despair is precisely one kind

of despair.93 As Josef Pieper would later echo, there is a clear distinction to be made

between despair and one’s awareness of it.94

90 Hannay (1998: 330).

91 And it is by a wide margin. By my admittedly unscientific count, there are as many as 791 individual instances of the word in SUD. The work that comes closest to that is perhaps EO, in which there are 198, followed by WL (101) and CUP (99).

92 SUD: 23.

93 “The Despair That Is Ignorant of Being Despair, or the Despairing Ignorance of Having a Self and an Eternal Self” (SUD: 42ff.).

94 “Despair (except, perhaps, one’s awareness of it) is not destroyed by ‘work’, but only by that clear-sighted magnanimity that courageously expects and has confidence in the greatness of its own nature and by the grace-filled impetus of the hope of eternal life” (Pieper 1935/1986).

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Kierkegaard’s Anti-Climacus analyzes despair first from an objective

perspective,95 then from a subjective perspective.96 These are not mutually exclusive; in

fact, they must be understood in terms of one another. Even so, for the sake of space, I shall

leave to the wayside a full explication of the objective perspective. Suffice it to say here

that, objectively speaking, a human being is “a synthesis of the infinite and the finite, of

the temporal and the eternal, of freedom and necessity.”97 To the extent that these are

misrelated, or not properly balanced, the self is in despair. For instance, a human being has

both temporal and eternal natures; if he indulges in the temporal to the detriment of the

eternal, not only is he in despair, but he is so precisely because he is an unbalanced or dis-

integrated self. (Recall the “tvi” (“two”) in “Fortvivlelse” (“despair”).)

From the subjective perspective, there are at least three major kinds of despair.98

As defined by consciousness, there is first the despair mentioned earlier—despair that is

ignorant of being despair, which is by far the most common type.99 “Such a despair, in

comparison with more active, defiant forms, almost possesses a kind of innocence. Here

the problem with the person is simply that she does not understand that she was created to

95 SUD: 29ff.

96 SUD: 42ff.

97 SUD: 13.

98 Depending on how we carve the joints. Here, they are (1) unconscious despair (SUD: 42ff.), (2) despair of weakness (49ff.)(which can then be divided into (2.i) despair over the earthly (50ff.)—particular (51ff.) or general (54ff.)—and (2.ii) despair over the eternal (60ff.)), and (3) defiant despair (which can then be divided into (3.i) despair over the earthly (68ff.), (3.ii) despair over the eternal (70ff.), and (3.iii) demonic despair (71ff.)). And recall—this is only from the subjective perspective!

99 SUD: 45.

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be spirit.”100 While innocent in some sense, the person in this despair is ignorant of her

own deplorable condition, and so is, another sense, further from salvation.101 The vast

majority of human beings are in unconscious despair, which, by definition, is unlike what

we normally call “despair”.102

Beyond unconscious despair, there lies a “continuum of degrees of consciousness

of despair.”103 Despair here is conscious of being despair, Anti-Climacus says, “and

therefore is conscious of having a self in which there is something eternal,”104 that is, which

does understand that she was created to be spirit. This initial stage of conscious despair—

and second major kind of despair—is the despair of weakness, or despair not to will to be

oneself, that is, not to realize one’s eternality and immediacy.105 There are more and less

severe cases of despair of weakness. “In less severe cases of this type, the person despairs

over some particular, earthly thing,” or, if he is more reflective, “despairing not just of this

or that, but over the whole of earthly goods.”106 The more severe cases involve despair “of

100 Evans (1990: 79).

101 “Though unconscious despair seems almost innocent in comparison with a defiant despair, this does not mean that a person in this form of despair is nearer to salvation. To the contrary, a consciousness of despair, though it intensifies despair as long as she remains in despair, can wrench a person out of despair altogether. Remaining ignorant of one’s despair can be a way of imprisoning the self in its deplorable condition” (Evans 1990: 79-80). As Anti-Climacus himself puts it, to consider despair purely abstractly, “without any thought of someone in despair, it must be regarded as a surpassing excellence.” Why? “The possibility of this sickness is man’s superiority over the animal; to be aware of this sickness is the Christian’s superiority over the natural man; to be cured of this sickness is the Christian’s blessedness” (SUD: 15).

102 Anti-Climacus even goes so far as to say it is “not despair in the strict sense” (SUD: 13).

103 Evans (1990: 78).

104 SUD: 47.

105 SUD: 49ff.

106 Evans (1990: 80). Cf. SUD: 50ff.

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the eternal or over oneself.”107 “This despair,” Anti-Climacus remarks, “is a significant

step forward. If the preceding despair was despair in weakness, then this is despair over

his weakness, while still remaining in the category.”108 To put it another way, the person

here, in this kind of despair,

…understands that it is weakness to make the earthly so important, that it is weakness to despair. But now, instead of definitely turning away from despair to faith and humbling himself under his weakness, he entrenches himself in despair and despairs over his weakness.109

Interestingly, this “despair over one’s weakness” manifests itself in “a sort of hidden self

that Kierkegaard calls Indesluttethed [‘shut-up-ness,’ ‘becoming withdrawn’].”110 It is

when someone “may be outwardly well-adjusted and sociable, but the outwardness is only

a ‘false door’ that the true self hides behind.”111 If we are looking for a corollary in

psychiatric diagnoses of today, we might search for one in “masked depression,”112 or perhaps “perfectly hidden depression.”113

The final and most intense form of despair is the despair of defiance, that which is more conscious of being in despair; the self is “in despair to will to be oneself.”114 Again,

107 SUD: 60.

108 SUD: 61.

109 SUD: 61.

110 Evans (1990: 80-81). The Hongs translate this as “inclosing reserve” (SUD: 63).

111 Evans (1990: 81).

112 Healy (1996, Vol.1: 431).

113 Rutherford (2019).

114 While this kind divides further, as we saw with the previous kind (despair of weakness), Anti- Climacus makes a point “thus to show that the formula always is: in despair to will to be oneself” (SUD: 68).

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this can be more or less severe, in ways that parallel the earlier tier, with its division of

despairing over the earthly and despairing over the eternal. In less severe cases, which Anti-

Climacus calls “stoicism”,115 the self in defiant despair is an “acting self,” one which arrays

and relates to itself via “imaginative constructions” it has made of itself. Such constructs

may come in the form of splendid-looking virtues, “like oriental poetry, they fascinate for

a moment,” whereby “the self in despair is satisfied with paying attention to itself” and its

achievements, and attempts “to bestow infinite interest and significance upon his

enterprises.”116 But such endeavours are never fully satisfying: by it, the self “recognizes no power over itself,” no true Sovereign; meanwhile, it is like “stealing from God the thought—which is earnestness—that God pays attention to one.”117 This parallels

despairing over the earthly, while also despairing to will to be oneself, apart from God.

By contrast, in more severe cases, the self in defiant despair is “acted upon”—rather than actively courting “imaginative constructions” of itself, it is instead passively hindered

by the temporal. The infinite self “feels itself nailed to this servitude,” this intractable

inability to rid itself of a difficulty or imperfection of its concrete self, “something the

Christian would call a cross, a basic defect, whatever it may be.”118 So chained down, the

self becomes “unwilling to hope in the possibility that an earthly need, a temporal cross,

can come to an end. The despairing person who in despair wills to be himself is unwilling

115 SUD: 68. Although Kierkegaard indicates that the term is not completely fitting. On the facing page, we are called back to this theme with the terms “imperturbability” and “ataraxia” (SUD: 69).

116 SUD: 69.

117 SUD: 68-69.

118 SUD: 70.

262 to do that.”119 He assumes a “Heaven can’t help” attitude. This parallels, and is a kind of, despairing over the eternal,120 while also despairing to will to be oneself, apart from God.

The greatest and most dangerous form of despair, at the greatest degree of consciousness, is “demonic despair”. It is defiant despair in willing to be one’s own self.121

“It is not even in stoic self-infatuation and self-apotheosis that this despair wills to be itself…No, in hatred toward existence, it wills to be itself, wills to be itself in accordance with its misery.”122 The self in this kind of despair is like the “misprint” who wishes to prove to the author that he is a bad author.123

By way of evaluation, how, then, does Fortvivlelse compare to depression? Is it a kind of depression? As before, it depends on what we mean by depression. On bio-

119 SUD: 70.

120 Anti-Climacus explains more adequately the way this parallels despairing over the eternal when it is despair of weakness. “In the preceding pages, the form of despair that despairs over the earthly or something earthly was understood basically to be—and it also manifests itself as being—despair of the eternal, that is, an unwillingness to be comforted by and healed by the eternal, an overestimation of the things of this world to the extent that the eternal can be no consolation. But this is also a form of the despair, to be unwilling to hope in the possibility that an earthly need, a temporal cross, can come to an end. The despairing person who in despair wills to be himself is unwilling to do that. He has convinced himself that this thorn in the flesh gnaws so deeply that he cannot abstract himself from it (whether this is actually the case or his passion makes it so to him), and therefore he might as well accept it forever, so to speak” (SUD: 70-71).

121 To borrow a locution from Jeff Hanson; Anti-Climacus uses the same phrasing “one’s own self” for this as with the other kinds of defiant despair: “despair to will to be oneself” (SUD: 68).

122 SUD: 73. “Not even in defiance or defiantly does it will to be itself, but for spite; not even in defiance does it want to tear itself loose from the power that established it, but for spite wants to force itself upon it, to obtrude defiantly upon it, wants to adhere to it out of malice—and, of course, a spiteful denunciation must above all take care to adhere to what it denounces. Rebelling against all existence, it feels that it has obtained evidence against it, against its goodness. The person in despair believes that he himself is the evidence, and that is what he wants to be, and therefore he wants to be himself” (SUD: 73).

123 “Figuratively speaking, it is as if an error slipped into an author's writing and the error became conscious of itself as an error—perhaps it actually was not a mistake but in a much higher sense an essential part of the whole production—and now this error wants to mutiny against the author, out of hatred toward him, forbidding him to correct it and in maniacal defiance saying to him: No, I refuse to be erased; I will stand as a witness against you, a witness that you are a second-rate author.” (SUD: 74).

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reductionistic models of depression, certainly no, because Fortvivlelse cannot be reduced

to the non-spiritual or fully captured by biological models.124 Fortvivlelse is primarily a misrelation between the divine God and the human self, and, in turn, a misrelation between the self and itself.

On descriptivist models of depression, such as what the DSM offers, yes and no— and my yes-answer comes only begrudgingly and without optimism, an indication that this option is not at all very satisfying. First, only some kinds of Fortvivlelse would be

recognizable as depressive-like. Subjectively (“as defined by consciousness”), conscious

despair can symptomatically mimic depression in the sense that it can check off the boxes,

but conscious despair need not exhibit depressive-like symptoms. Unconscious despair—

the most common—will likely not, either. And, in any case, this ignores the elephant in the room: God, the Sovereign, the Author. Objectively (“without regard to its being conscious or not”), Fortvivlelse fundamentally includes an agential and personal God and one’s relation to that God as components. Such descriptivist accounts are thus inherently limited, since they do not include these components. More strongly, if it is true that “psychological inquiries are about the human end of the equation, not about what, if anything, is on the other end of our perceptions,”125 then psychology is in principle incapable of approximating the full complexity of Fortvivlelse.

124 “While the depressed individual may, à la Kierkegaard himself, try and succeed at appearing happy, he is not happy. A person who is in fact happy is eo ipso not depressed. It is not, however, unusual for a happy person to be in despair. For another point of contrast, whereas depression always involves sadness, despair is not accompanied by a unique set of emotions. A walk through the psychospiritual portrait gallery presented in The Sickness unto Death will suffice to show that Kierkegaard believes despair to be compatible with both the blues and feeling in the pink” (Marino 2008: 123).

125 Ozorak (2005/2013: 227). She continues: “Most psychologists of religion have chosen to ignore this elephant in the living room. However, many good researchers are probably dissuaded from studying religion at all because they don’t want to share space with an elephant, real or not.”

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Suppose one thinks, that psychological inquiry is not so limited. That, in an

interdisciplinary approach together with and informed by philosophy and theology,

psychology does accommodate these components of Fortvivlelse, an agential God and

one’s relation to that God.126 On a new pluralistic account of depression, such as I have

been suggesting here, (some instances of) Fortvivlelse can certainly be a kind of

depression, belonging to this genus on account of its spiritual etiology and its spiritual

remedy.

6.3.2 - Fortvivlelse in Works of Love (1847)

I want to close by looking only very briefly at Kierkegaard’s signed work, Works of Love, which draws together many of the themes from the previous sections, including despair and one’s relation to God. The problem of proper self-love is particularly worth visiting. As we saw in the previous chapter, scrupulosity is a perverse form of self-love or self-preference—an improper application of self-love. Kierkegaard echoes this sentiment when he speaks about the suicidal. “When the depressed [Tungsindige] person desires to

be rid of life, indeed, of himself, is this not because he is unwilling to learn earnestly and

rigorously to love himself?”127 (One also might venture to include “unable” in the above,

considering depression’s association with catatonia and abulia, a point I revisit below.)

126 Perhaps “accommodate” is too weak. I do not mean to pay lip-service to, but to accommodate and utilize such theological principles and foundations as these from other scientiae in robust ways that make a meaningful difference to therapeutic treatment of the whole person, including his spiritual and character development. Such a Christian psychology, from a Christian perspective that is, will indeed look unlike today’s fashionable methodologically naturalistic approach which ignores the “elephant in the living room,” but it is also much closer to what Kierkegaard would have perhaps endorsed.

127 Hongs’ translation of “Naar den Tungsindige ønsker at blive af med Livet, ja med sig selv, er dette da ikke, fordi han ikke vil lære strengt og alvorligt at elske sig selv?“ (WL: 23).

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There are a couple of important ways despair (Fortvivlelse) relates to proper love, and, by extension, proper self-love.128

First, “Only when it is a duty to love, only then is love eternally and happily secured against despair.”129 That is, perfect love is incomplete unless it is a duty to love. Some are apt to think that passionate love, rather than dutiful love, is superior, and that “it might seem to be an expression of the strength of this love that it has the power of despair.”130

But this is precisely its weakness, for “even when it is happy it loves with the power of despair.”131 Spontaneous love is blown to and fro by the changing passions; the self with such passionate love “loves another person ‘more than itself, more than God.’”132

“However joyous, however happy, however indescribably confident instinctive and inclinational love, spontaneous love, can be itself,” such volatile love dips into despair at the sign of misfortune, and this despair is not a one-off, but it a sign of a much deeper despair one had been in all along.133 Love that arises from duty, however, is superior; it is

128 This is by extension in two ways. First, because self-love is of course a kind of love. Second, because loving others demands of the self. When love is a duty, it is proper love. (More on this below.) As such, when you love dutifully as you ought, “You do not have the right to become insensitive to this feeling [life’s pain], because you shall love; but neither do you have the right to love despairingly, because you shall love; and just as little do you have the right to warp this feeling in you, because you shall love. You shall preserve love, and you shall preserve yourself and by and in preserving yourself preserve love” (WL: 43, emphasis mine). For more on the problem of Christian self-love in Kierkegaard’s thought, see Lippitt (2013).

129 WL: 40. Italics in original. Cf. WL: 29. Kierkegaard’s concentrated discussion on despair in WL can be found in the closing portion of Section II A “You Shall Love,” where he discusses specifically love as duty.

130 WL: 40.

131 WL: 40.

132 WL: 40.

133 “When spontaneous love despairs over misfortune, it only becomes manifest that it was in despair, that in its happiness it had also been in despair” (WL: 40). This is likely the unconscious despair from SUD: 42ff.

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neither blown about by passion, nor is it a constraint on one’s freedom, since the self still

must decide whether to obey this duty.134

Second, more than duty is required: proper love requires the self directing its

infinite passion, not to something finite and particular, but properly to and through

something eternal. “The despair is due to relating oneself with infinite passion to a

particular something, for one can relate oneself with infinite passion—unless one is in

despair—only to the eternal.”135 Instead, it must relate with infinite passion to an infinite

object. Kierkegaard explains why:

In other words, what makes a person despair is not misfortune but his lack of the eternal. Despair is to lack the eternal; despair is not to have undergone the change of eternity through duty's shall. Despair is not, therefore, the loss of the beloved— that is unhappiness, pain, suffering—but despair is the lack of the eternal.136

Despair, rather, “is a misrelation in a person’s innermost being.”137 No finite fate, or event, or misfortune has the power to make a person despair, nothing like that “can penetrate so far and so deep.”138 These things “can only make manifest that the misrelation—was there.”139 Thus, the only protection against such despair is to secure one’s infinite passion

134 “But the person who answers, ‘In that case I shall still continue to love you’—that person's love is made eternally free in blessed independence. He does not say it proudly—dependent upon his pride—no, he says it humbly, humbling himself under eternity's shall, and for that very reason he is independent” (WL: 39-40).

135 WL: 40. Emphasis mine.

136 WL: 40-41. And: “If one speaks differently, it is because one frivolously confuses the highest concepts.”

137 WL: 40.

138 WL: 40.

139 WL: 40.

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to something infinite. To sum up both of these points, Kierkegaard says “there is only one

security against despair: to undergo the change of eternity through duty's shall.”140

Suppose, however, that which seems entirely plausible, that the despairing person

cannot bring himself to fulfill this duty, for he is stuck in the mire of his Tungsind. It is not

that he is unwilling, but he is unable to love, even to love himself. Kierkegaard is wise to

this worry, imagining the objection in a sardonic tone,

Marvelous words of comfort, marvelous compassion, because, humanly speaking, it is indeed most strange, almost like mockery, to say to the despairing person that he shall do that which was his sole desire but the impossibility of which brings him to despair.141

In other words, it is hideously ironic, almost mocking, to require the despairing person to

do something he cannot do, even worse because it is the very thing he desires to do.

Kierkegaard sees this impossibility, however, as evidence “that the love commandment is

of divine origin!”142 Neither passion nor sagacity (or, cleverness) can ensure a true, let

alone a lasting, love.143 Only the “shall” ensures that your love is genuine, because only

the “shall” can guarantee it. “The commandment consumes and burns out the unhealthiness

140 WL: 40. Italics in original.

141 WL: 42.

142 WL: 42.

143 Think, for example, of how you comfort the one who mourns (since “this shall of eternity” is everywhere). “If you have the ability to give to passion the expression of despair as not even the sorrowing one can do, it may soothe for a moment—but it is still false. If you have the sagacity and experience to provide a temporary prospect where the sorrowing one sees none, it can be refreshingly tempting for a moment—but it is still false. But this "You shall sorrow" is both true and beautiful. I do not have the right to become insensitive to life's pain, because I shall sorrow; but neither do I have the right to despair, because I shall sorrow; and neither do I have the right to stop sorrowing, because I shall sorrow. So it is with love” (WL: 42-43).

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in your love, but through the commandment you will in turn be able to rekindle it when it,

humanly speaking, would cease.”144

So it is with self-love. Just as with love, generally speaking, self-love must undergo the change of eternity through duty's shall. It must be a duty to love oneself. And proper self-love requires the self directing its infinite passion, not to something finite and particular, but properly to and through something eternal. Recall Kierkegaard’s remark:

“When the depressed [Tungsindige] person desires to be rid of life, indeed, of himself, is this not because he is unwilling to learn earnestly and rigorously to love himself?”145 This is thus a failure in one of two ways (or both): either because self-love is not construed as duty, or because self-love is not secured by the eternal. We can therefore surmise a kind of corrective in these cases of Tungsind, one must love oneself properly in both of these ways, for that is the “only one security against despair.”

6.3.3 - Evaluation of Fortvivlelse

I noted before the etymological similarity between the Danish “Fortvivlelse” and the German “Verzweiflung”, both of which mean “despair” and both of which contain the word for “two”. This idea of two-ness or duality appears, in some sense or another, in other languages. Readers of Aquinas may be familiar with the way the Latin “desperatio”

(“despair”) contains the word “spes” (“hope”), which is said to be its contrary. Similarly, the Old English “wanhope”, preserved today in the Dutch “wanhoop”, displays the relation

144 WL: 43.

145 Hongs’ translation of “Naar den Tungsindige ønsker at blive af med Livet, ja med sig selv, er dette da ikke, fordi han ikke vil lære strengt og alvorligt at elske sig selv?“ (WL: 23).

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between despair and hope: it is vain hope, or a lacking of hope.146 This lack of hope or

despair, comes into especially stark relief in the case of theological hope.147

Moreover, this notion in Kierkegaard’s account of Fortvivlelse that despair is a

splitting in two, a separation of the self from God (and the self from oneself), this feature

is also present and prominent in Aquinas’s account of desperatio. Hope, one of the

theological virtues, is an expectant waiting for union with God in the hereafter. By

definition, the proper object of hope is a future arduous good, in that it is difficult but

possible to obtain, either by oneself or by another; and this holds true whether we are

speaking of hope qua passion (ST I-II.40.1) or qua theological virtue (ST II-II.20.4.co).

Certainly a person can hope for ordinary things, when there are future goods that are difficult yet possible to obtain; it is the theological virtue of hope when its object is God.148

Despair is related to hope in that they both share the same (good) object; hope is movement

toward that object, while despair is movement away from it. Just as in Kierkegaard’s

account, despair for Aquinas can thus be seen as a kind of splitting apart from God, in the

sense that the spirit is over downcast (ex nimia deiectione, ST II-II.20.4.co) for the reason

146 The prefix “wan-” in both Old English and Dutch means “lacking” or “empty of”; the English word “vain” derives from the French “vain” and Latin “vanus” which mean “empty”.

147 God is its proper object. When the proper object is lacking, for instance because it has been replaced with something profane, then it causes one to despair. This is certainly not unlike how vainglory (“vana gloria”) operates: instead of resting assured and content in the real glory and worth bestowed on me by God, being made in God’s image, I become vain when I instead look to other things for that affirmation, when the ultimate source of recognition or approval is replaced by something profane. (Or on the general usage of “vain”: when I either seek after good things profanely (cheat to get recognition for an A) or seek after bad things instead of good (such as when I want recognition despite having done nothing—hence the Greek “kenodoxia“, or “empty belief”)). Cf. DeYoung (2009: 60-68).

148 From passion to theological virtue? Aquinas explains: “[H]ope has the character of virtue from the fact that it attains the supreme rule of human actions: and this it attains both as its first efficient cause, in as much as it leans on its assistance, and as its last final cause, in as much as it expects happiness in the enjoyment thereof” (ST II-II.17.5.co).

270 that it thinks that the good object is no longer possible to obtain, and so it delays and drifts apart from God.149

There are other striking points of similarity and continuity between Kierkegaard’s account of Fortvivlelse and others. Despair is born of acedia, according to Aquinas. This same acedia is precisely the sad, downcast state of mind (deiectiva spiritus, ST II-

II.20.4.co) which makes the spirit over downcast (ex nimia deiectione, ST II-II.20.4.co) in despair. Similarly, as some commentators have pointed out,150 there’s good reason to think that at least some of the kinds of despair that Anti-Climacus identifies in SUD is acedia, not least of which because both are sin.151 In fact, there is a strong association in the

Christian virtues tradition between acedia and despair: in Frère Lorens d'Orléans’ La

Somme le Roi (ca. 1279) and in the 14th-century Middle English translation of the same catechetical handbook, re-titled The Book of Virtues and Vices, despair (“desesperance”,

S; “wanhope”, BVV) is seen as the pinnacle of acedia. It is despair of God’s mercy, the pinnacle in the branches of sloth which bring man to an evil end; such despair often ravages man to his most self-destructive evil end, suicide.152

149 There is another way Thomas mentions that leads to despair, namely when the future good is no longer seen as good. “Now the fact that spiritual goods taste good to us no more, or seem to be goods of no great account, is chiefly due to our affections being infected with the love of bodily pleasures, among which, sexual pleasures hold the first place: for the love of those pleasures leads man to have a distaste for spiritual things, and not to hope for them as arduous goods. In this way despair is caused by lust” (ST II-II.20.4.co).

150 See Pieper (1935/1986; 1948/1952) and DeYoung (2015).

151 “Not a mood, but an act of the intellect. Hence not something into which one falls, but something one posits. The despair of which we are speaking is a sin. A sin, moreover, that bears the mark of special gravity and of an intensity of evil” (Pieper: 1935/1986).

152 Cf. Wenzel (1960b: 80-82). This branching hierarchy is repeated in the 14th-century manuscript Mireour du monde and in the Summa de vitiis et virtutibus of Peraldus, where despair (“desesperance”, M; “desperatio”, P) is again the pinnacle of acedia. The author of Mireour is apparently unknown, as was the work itself until relatively recently with Félix Chavannes’s (1845) edition after a manuscript was uncovered in tattered condition in the archives at the commune of La Sarra in 1835. However, S and M are so similar to 271

Whereas Aquinas sees hope as the contrary to despair, Kierkegaard sees faith as the

cure for despair. Kierkegaard nevertheless considers hope to be a manifestation of faith: it

is expectant faith. Faith is the self’s resting transparently in oneself before God, which can

be had, of course, in this life. Perhaps hope qua “expectant faith” is thus the same, but in

the life hereafter, when the self is in God’s direct presence. This vividly echoes the end of

hope in Aquinas, namely, the beatific vision and union with God. Although it is difficult

to uncover the exact relations,153 is clear that Kierkegaard considers faith, hope, and love

to be intimately interconnected,154 and work in concert together as powerful cures for the self in despair, the self torn apart and torn away from God in Fortvivlelse.

6.4 - Considered Judgment on Relation to Depression

We have surveyed the Kierkegaardian corpus for the concepts of Tungsindighed

(“heavy-mindedness”), Kjedsommelighed (“boring-ness”), and Fortvivlelse (“despair”).

Conceptually and phenomenologically speaking, there are numerous similarities between

these and depression, some of which I have already discussed in the above. Here I should

like to close with a brief assessment of these Kierkegaardian concepts taken as a whole,

and the promise they have for understanding and diagnosing the depression of today.

one another that it is possible they derive from the same author: cf. Wenzel (1960b: 75) and especially Brayer (1958: 3ff.).

153 Even apart from examining Kierkegaard’s usage of “hope” or “expectancy”, strictly etymologically speaking, unfortunately, there is no nice and simple connection—as we saw in Latin, Dutch, and Middle English— between the Danish words for “hope” (“håb”, “haab”) and “despair” (“Fortvivlelse“).

154 Robert C. Roberts writes to me in an email, “I tend to think that faith, hope, and love all criss- cross one another in Kierkegaard’s thinking: hope is expectant faith, but faith is love (see PF where faith turns out to be a kind of clinging friendship with the Teacher). Maybe thinking this way helps see the connection between the hopelessness of despair and the fact that faith is the opposite of despair in SUD” (p.c. via email 3 Oct 2019).

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Consider the following succinct observation made by philosopher C. Stephen

Evans in his short book Søren Kierkegaard as Christian Psychologist:

Depression for many is clearly linked to a loss of hope, of any genuine, meaningful possibilities. If I am a depressed person, I see myself as trapped, with either no possibilities at all or only possibilities that are trivial and meaningless. If this suggestion is sound, then depression is a malady that sometimes has spiritual roots.155

Indeed, Evans is right. Depression, according to the DSM-5, is often accompanied by

anhedonia (loss of pleasure or desire), which sometimes entails, especially at its height or

when paired with recurrent thoughts of death or suicide, apelpisia (απελπισία) or “loss of

hope”, coincidentally the Greek translators’ term for Kierkegaard’s Fortvivlelse

(“despair”).156 Hope and despair, recall, are related in that they share the same (good)

object. Whereas hope moves toward that object, despair shrinks away from it. Given that

the ultimate good is God himself, then one of the most amplified forms of depression at its

height is spiritual despair, a hopelessness as a result of finding true Goodness impossible

to attain, a state of being split apart from God and from oneself.

This is but one reason that reveals the glaring need to incorporate the vertical axis

or spiritual element into an otherwise naturalistic discipline of psychology in order to make

complete sense of depression,157 and Kierkegaard’s thought is arguably the best vehicle to

155 Evans (1990: 76). Here Evans is specifically discussing despair from the objective perspective, which I did not discuss at length, but which is consistent with many of the phenomena that happen with despair from the subjective perspective.

156 Holmboe and Isager (2001: 70). In fn.9: “…or Tvivl/Fortvivlelse (Zweifel/Verzweiflung, in English only doubt and despair; the Greek association for the latter term is απελπισία [apelpisia], loss of hope).”

157 Medicine, let alone psychology, is not under the sole ownership of naturalism, nor should it be. In response to a charge that “the study of medicine…favours a disposition to materialism,” Feuchtersleben replies that this charge is simply “unjust” (1845/1874: 8). “No one has more occasion than the physician, to recognise the power of mind and the perishable nature of matter; and if he do not attain to this recognition, the fault is not in the science, but in himself, in not having thoroughly studied it, for here, we may say as 273

accomplish that. Ironically, there have already been attempts in psychology and

psychiatry—not at the diagnostic level, but at the theoretical level, sometimes aided by the

use of narrative in literature—to account for some of these Kierkegaardian features we

have seen, but such attempts are found wanting as they approach the problem piecemeal.

The first, of course, we have already mentioned: depression is associated with loss of hope.

Second, relatedly, depression is associated with grander-scale existential and social

phenomena such as postmodern disillusionment, existential feeling, and disconnectedness

or “de-situatedness”.158 It is no wonder that Kierkegaardian despair is so fittingly compared

with contemporary experiences of depression. Third, depression is sometimes said to be

hidden or concealed.159 On the present account of diagnostic descriptivism, each of these features are either partially or entirely missing. With Kierkegaard’s account, on the other hand, we can approach each of these recognized aspects of depression in an ordered and coherent fashion, fully accounting for a self which both finite and eternal.

Physician and novelist Walker Percy once remarked that he adopted in his writing

the “posture of the pathologist with his suspicion that something is wrong.” Speaking of

his first major work The Moviegoer in particular, he says,

[T]he pathology in this case has to do with the loss of individuality and the loss of identity at the very time when words like the “dignity of the individual” and “self- realization” are being heard more frequently than ever…In short, the book attempts a modest restatement of the Judeo-Christian notion that man is more than an

Bacon did of philosophy, ‘when superficially studied it excites doubt, when thoroughly explored it dispels it’” (1845/1874: 8). Sir Francis Bacon, whom he favorably quotes, was a devout Anglican.

158 For instance Peteet (2010: 34) reminds us: “David Karp, in Speaking of Sadness: Depression, Disconnection, and the Meanings of Illness [Karp, 1996: 165–187], tied postmodern disillusionment directly to contemporary experiences of depression.” See also, for instance, Fernandez’s (2014) article titled: “Depression as Existential Feeling or De-situatedness?”

159 Rutherford (2019). Cf. Healy (1996, Vol.1: 431).

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organism in an environment, more than an integrated personality, more even than a mature and creative individual, as the phrase goes. He is a wayfarer and a pilgrim.160

On Kierkegaard’s understanding of heavy-mindedness, boredom, and despair, we have a fully fleshed-out account of the existential de-rootedness, the spiritual incompleteness, the loss of self, and, most importantly, one’s telos as movement towards God—none of which can be adequately grasped by a mere checklist of descriptivist diagnostic criteria.

160 Percy (1991: 246).

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CHAPTER SEVEN

Conclusion

“They pour medicines of which they know little into patients of whom they know less to treat conditions of which they know nothing at all.” — Voltaire1

Even if Voltaire never penned these words attributed to him, we are grateful for this wisdom which is just as applicable today with respect to depression. Physicians often know little more about psychiatric pharmaceutical drugs and how they work than that they

(usually) produce a desired outcome (in some people). Practitioners, on a business model of medicine,2 get too little face time with their patients, leading some healthcare workers to feel a deep sense of moral injury, feeling they’ve contributed to acts or outcomes that are morally transgressive.3 This problem is equally pernicious, if not more so, in mental healthcare.4 Finally, as we have seen, physicians know very little about the nature and

1 Attributed. See McDonald (2004: 103); Bewley (2008: 1).

2 “The present medical business model is riddled with inefficiencies, perverse incentives, pricing problems, third party intermediaries and multiple stakeholders that result in about 1/3 of medical spending being wasted. Patients are frustrated and doctors are angry,” says Arlen Meyers, M.D. (2017).

3 See, for example, Bailey (2020). “In Cumberland County, Pa., Mary Franco, who is now 65, retired early from her job as a nurse practitioner after a large corporation bought out the small private practice she worked in. She said she saw ‘a dramatic shift’ in the culture there after the change, where ‘revenue became all-important.’ The company cut in half the time for each patient’s annual exam, she said, down to 20 minutes. She spent much of that time clicking through electronic health records, she said, instead of looking the patient in the face. ‘I felt I short-shrifted them,’ she said” (Bailey 2020).

4 Over the decades, a common refrain among studies on provider burnout and decreased quality of care in mental healthcare: depersonalization. Cf. Snibbe, et al. (1989), Geurts, et al. (1998), Salyers, et al. (2015).

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cause(s) of the depression they seek to treat. Much of this can be attributed to (1) the

ahistorical posture in a field characterized rather by “state-of-the-art” care and “cutting- edge” research, and (2) the uncritical presumption of a naturalistic worldview which rules out any sort of robust wisdom or guiding principles from the Christian tradition when it comes to the nature or cause(s) of depression.

There are now a few ways to incorporate or synthesize this old wisdom into our current body of knowledge. This is assuming we are indeed attempting to incorporate findings that are prima facie in conflict with our current body of knowledge. This rules out positions such as (a) saying there is irreconcilable conflict, and (b) denying there is any conflict, perhaps because the entirely different domains not only set out to answer entirely different questions, but do so with entirely different categorial schema.5

Rather, I am taking a third position on which I am supposing that there is a deep wisdom in the way our authors understood the human person, including his affections, his mental life, and his relationship with God. That is, in all that follows, I am presuming the falsity of naturalism and the truth of Christian theism. Moreover, I am assuming that human nature has been virtually continuous throughout time, despite the cultural and linguistic barriers that are in place for understanding this nature. This enables me to place emphasis on and reify an individual’s state or “condition” (i.e., the current state of his mental states, affects, neurochemistry, dispositions to interact with the world, and so on) rather than reifying a particular term such as “melancholy” (which itself, in the final analysis, operates

5 For example, as with Stephen Jay Gould’s “non-overlapping magisteria” view of science and religion.

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more like a definite description than a rigid designator). Again, S.T. Coleridge does not

cease to “have melancholy” when the concept of melancholy becomes outdated.

In brief, the more general project before us is what I’ll call “resolving the relations” between depression and each of the historical conditions I have surveyed. The more specific route I favor is what I’ll call “synthesizing” these historical conditions with depression. One can imagine more ways to resolve the conflict or question of relations than that of synthesis, such as (a) and (b) above. One might also deny are capable of being synthesized, saying rather that they are real kinds, but we may classify or group them together nonetheless according to their shared family resemblance.6 But on this synthesis

approach, there are still a few different strategies available with how to proceed. Thus, I

begin with some general strategies for synthesis, then conclude with a discussion of

particular historical conditions.

7.0 - General Strategies for Synthesis

Here, given the constraints I have placed above, there are really only two main

options, and they differ roughly in terms of what gets priority: either the old or the new.

The first main strategy is a historical revisionism prioritizing the newer, contemporary

disciplines, such as psychiatry and psychology. The second strategy is to revise present-

day concepts of depression so as to include and preserve our reclaimed ancient wisdom.

6 For example, when there is overlap/conflict between the colors blue and green—i.e., as when we see a shade of color that could be either one—we invent a new term for this in-between shade, blue-green or teal or aqua green. We do not, however, revise or modify the original kinds blue or green. (We might say that we now realize their scope is wide enough to include an instance of each, but this is more an epistemic issue.) If we consider them real kinds, we do not consider them to be outdated or obsolete simply because of this apparent overlap/conflict. Rather, we remain rigidly faithful to the categories and move forward from there, retaining them as we invent new categories to classify anomalies. This would be akin to inventing, for example, a new name and category for whenever there is overlap/conflict between depression and acedia, depression and noche oscura, and so on. But that is not what I am doing here.

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Note that, at this level, it is not a disagreement between naturalism and Christian theism,

for I am presuming the latter in either case.

7.0.1 - Historical Revisionism

One is a historical revisionist strategy. We can give priority to contemporary psychiatry and be revisionist about our historical findings, synthesizing, where there is any conflict or inconsistency, in favor of present-day psychiatry. As a general strategy, I do not recommend this, since the historical evidence is quite clear: as I said before, just as it is inaccurate to say that alchemists were actually simply doing chemistry, it is inaccurate to claim that the Desert Fathers were simply doing psychiatry or psychology. However, we are after the truth, regardless of which paradigm we favor, so there may be instances in which the historical tradition had it wrong or had an incomplete body of evidence. Thus, opting for this strategy should be made on a case-by-case basis, not only when it comes to particular historical conditions, but also keeping in mind particular philosophical issues

(e.g., realism vs. nominalism about our terms, whether to include etiology in diagnostic criteria, etc.).

7.0.2 - Revising Present-Day Concepts of Depression

Second is a strategy revising present-day concepts of depression. There are actually several ways to do this, as we have seen already the many models of depression and various philosophical concepts that are in play. Recall the three strategies I briefly discussed in

Chapter One. First, one could use these historical conditions as evidence for there being a spiritual etiology for (at least some kinds of) depression. This entails, secondly, a pluralistic account of depression into kinds differentiated by their etiology, one kind of which is

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spiritual/religious depression. So there would be a spiritual kind of depression with a

spiritual etiology, and so on.7 (This may involve, of course, modifying one’s diagnostic

criteria for depression to include etiology.) Third, a distinct strategy which may be paired

with the first two: I also suggested that some of our historical conditions might not be

pathological or even harmful at all, opening the door for a non-pathological fallow season.

7.1 - Our Particular Historical Conditions

In addition to what I have developed at the end of each chapter, and in light of the

above, I want to briefly summarize how I envision faithfully construing the relation

between each of these historical conditions and depression.8 I must say that in the main, I

try to place priority on the older Christian wisdom, the second of the two strategies from

the previous Section.

7.1.1 - Caveat

This Caveat bears repeating, for it contains the crux of the issue, what lies at the

heart of much conflict between (methodologically naturalistic) psychiatry and these

historical conditions from Christian tradition: the following syntheses that I propose are

possible only insofar as the model of depression that is assumed presupposes a Christian

7 It stands to reason that embracing and moving forward with a pluralistic concept of depression would enable us to provide better treatments, in that they would be tailor-made and thus more efficacious. By getting a better grasp on the etiology of depression in this way, we can treat more than the symptoms; we can treat the whole person. For kinds of depression that are spiritual in etiology, this may involve spiritual direction, discipleship and mentorship, pastoral counseling, or various spiritual disciplines, to name but a few practices that encourage growth of the whole person.

8 As I said in Chapter Two Acedia, by “faithfully” I mean something like “assuming that one has a correct and proper understanding of both acedia and depression.” I hesitate to use the word “correctly” for two reasons. First, my construals may be incorrect. From this, second, it is apparent that calling a construal “incorrect” (i.e., false) can include (i) those which are faithful construals, or (ii) those which are not.

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theistic worldview. This is critical, since so many of these historical predecessors take this

vertical axis relation between man and God to be an essential component. As I have argued,

neglecting this spiritual dimension of the human person is a great mistake; without it,

psychology and psychiatry will otherwise be incomplete. We must instead envision a

Christian psychology or psychiatry (i.e., psychology or psychiatry informed by Christian

doctrine, practiced from a Christian perspective, etc.),9 which is superior in its ability to accommodate the vertical axis between God and human beings.10

7.1.2 - What to Do with Acedia

I gave a brief account in the conclusion of Chapter Two Acedia (based on

McAllister 2020) of one way to resolve the relation between depression and acedia. There

I pointed out the obvious non-identity between the two concepts, while arguing that, given

their overlap in symptoms, it is possible that an instance of acedia could also be an instance

of depression (or, at the very least, the matter is epistemically underdetermined). Thus, I

need not revisit the thesis of overlap or coextension here. But I do want to make a few more

general, summarizing comments on how to go about synthesizing the two.

Recall the ambiguity with acedia. Acedia qua disordered passion may very well be

an integral part of depression, understood as it is in psychiatry and psychology. (If it is a

rightly ordered passion, then it is good.) Unfortunately, to say how integral or how essential

this affect is would really go beyond the scope of this project.

9 I have mentioned before a few authors already doing this sort of project: Johnson (2007, 2017), Peteet (1994, 2010, 2012), Peteet and Elderon (2016).

10 Supposing one objects to the exclusive nature of a Christian (as opposed to Islamic, Buddhist, etc.) worldview approach, I can only say that I am working within my own tradition (and within the limits of human finitude), and others are welcome to do the same for Islam, Buddhism, and so forth.

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Acedia qua capital vice, that surreptitious logismos which creeps in slowly and

unseen, is altogether quite different from any available model of depression within

psychiatry or psychology—so long as those models are highly averse to the notion of

culpability for one’s own condition. After all, acedia is a Deadly Sin. Recall that this does

not mean it is the worst possible sin, but that it is a fecund seed for further, and worse, sins.

How averse one is to this idea of a sin paradigm for one’s sorrowful or listless state also

depends largely on what theology of sin one is assuming, whether as forensic transgression

or that which is antithetical to one’s natural telos of human flourishing or one’s ultimate

telos of beatitudo.11 (Catholic doctrine and Thomas’s Summa specifically cover a further

distinction in his discussion on acedia: venial sin and mortal sin.12) If we presume this

latter view of sin, it is easy to see the badness of acedia. It is a weighing down of the mind

in sorrow, such that it cannot think upon, focus on, or cling to the good; or, worse, is averse

to the good because it construes it as bad. Such a posture is really unhealthy for us humans,

whether that good be the Divine good or any derivative thereof, which are goods from God.

7.1.3 - What to Do with Tristitia Immoderata

Recall that my concern in Chapter Three Tristitia had been not the general passion

of tristitia, which is morally neutral in itself, but the specific kind of tristitia or the

11 Recall my point from Chapter Three Tristitia: it entirely depends on our conceptual framework of sin how we receive the news that tristitia is a sin. On one understanding of sin, sin is a forensic transgression of the law: “Thou shalt not,” and if you do, you receive the punishment. On another understanding of sin, prominent in virtue theory, sin is anything that is antithetical to one’s flourishing. If, as on Christian versions of eudaimonism, God is the ultimate end of our pursuit of the good, then sin, in the final analysis, is apartfulness from God. (As I said there, these are admittedly simplistic characterizations. In reality, the two views I bring up may not be mutually exclusive.)

12 Acedia becomes a mortal sin, and is most destructive, when it “reaches to the reason, which consents in the dislike, horror, and detestation of the Divine good [quae consentit in fugam et horrorem et detestationem boni divini], on account of the flesh utterly prevailing over the spirit” (ST II-II.35.3.co).

282 particular way in which (i.e., mode) tristitia exists in the soul. As for the mode, of course,

I mean tristitia immoderata, which is ungoverned sorrow, which can be had in two ways: either inordinate sorrow over a bad object, or sorrow (however excessive or not) over a good object. Sorrow over the good, if it is sorrow over the Divine good, (ST II-II.35.3.co), is synonymous with acedia and thus normatively bad. As for specific kinds, we saw that there was considerable overlap with the material of the preceding chapter on acedia. This is because acedia is a kind of tristitia, and it is due to their complex interrelationship throughout the formation of the list of Deadly Sins. In many cases, if not all, writers like

Cassian and Gregory, when they spoke of tristitia, they either meant acedia (in which case, everything I have already said for acedia will apply here) or a kind of “worldly sorrow” similar to what St. Paul spoke of. This latter kind leads to death when it is not properly moderated or unrestrained, or when it concerns things and desires of this world.

With respect to inordinate sorrow (over bad or good), this matches quite well with pre-DSM-III construals of depression, which took into account a patient’s contextual background, as opposed to those after 1980 which largely emphasized the severity of one’s symptoms. This is not to censure sorrow itself, but only when it is excessive: to sulk too long in sorrow, we need not be told since we all know by intuition and experience, is not good for our health.

7.1.4 - What to Do with Noche Oscura

Noche oscura is clearly non-pathological. On the contrary, it is formative and good, a time of strengthening and perfecting, a burning away the chaff of the things in us which are repugnant to God. I cannot see a way to synthesize this with depression, any more than

St. John of the Cross could for melancholia, so long as depression is understood as a

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pathological and deleterious condition. Perhaps Font i Rodon, Durà-Vilà, and Dein had this

much right, that the dark night is a non-pathological “religious” “depression”. A generic

“religious” is not far enough, though; it must be fully within the Christian Carmelite

tradition and informed by St. John of the Cross’s teachings on the dark night, which clearly

set this phenomenon apart as a formative time of purgation that, while painful, is guided

by Providence. Calling it “depression”—even with the preceding modifiers “non- pathological” and “religious”—runs the real risk of confusion. If we want to hazard calling it “depression” anyway, this entails that there will be non-pathological kinds of depression, kinds which need not perhaps require a physician’s care. This would break up the DSM’s monopoly on depression. This phenomenon could still reside in the domains of psychiatry and psychology, however, so long as it is seen in its rightful, non-harmful context: instead of being in a DSM or ICD as a disorder, this kind of “depression” would be more at home within the realm of positive psychology, alongside optimism, gratitude, practicing forgiveness, and being accountable to others and to God.

7.1.5 - What to Do with Religious Melancholia

Significantly, writers on spiritual aridity often knew of general melancholia, and they often sought distinguish it sharply from whatever was their particular concern: St.

Teresa of Ávila from spiritual turmoil and growth,13 St. John of the Cross from noche

13 St. Teresa of Ávila (1577/1905: 94, 175, 215). It is incumbent on the reader to know when St. Teresa is using “melancholy” in the sense of sorrowful affect or malady, or when she uses “melancholy” to mean “hysteria” (Cf. 215n).

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oscura,14 Joseph Symonds from spiritual desertion,15 and St. Mother Teresa of Calcutta

from spiritual darkness.16 Perhaps it is because these periods of aridity were seen as

normatively good, for self or others, whereas melancholia—whichever physiological

paradigm operated underneath it—was seen as pathological or harmful for the individual.

(There were of course exceptions, such as Romanticism’s genius melancholy, and this

simply restates what we have seen with respect to melancholy’s complexity and evolution

over the centuries.)

Religious melancholia was entirely a different matter. Virtually all the Post-

Reformation authors I surveyed were in agreement about two key features. First, it was pathological, and one could benefit from the physician’s care and Physick. Second, however, this was never seen as the only means to wellness, for “mixed diseases must have mixed remedies.”17 Indeed, since ““The Soul and Body are wonderful Copartners in their

Diseases and Cure,”18 they were of the mind to “never have the Phisitions cousell severed,

nor the Ministers laboure neglected.”19 This is undoubtedly due to their understanding of

the reliance of both soul and body upon God’s goodness.

14 St. John of the Cross (A.pro.4-6; 71-72; N1.9; 313-16).

15 Symonds (1642: 274-75). “There are two Sorts of Men…In the First, the Cause is natural, in the Second spiritual. As for the First Who are oppressed with Melancholy, that dark and dusky Humor, which disturbs both Soul and Body Their Cure belongs rather to the Physician, than to the Divine, and Galen is more proper for them, than a minister of the Gospel” (274).

16 As we saw in Chapter Four Noche Oscura, St. Teresa of Calcutta distinguished her condition even from noche oscura. Cf. Teresa-Kolodiejchuk (2007: 218).

17 Burton (1621/1847: 659).

18 Baxter (1682/1707, Vol. IV: 844-45).

19 Greenham (1598: 44-45).

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One wishing to synthesize this religious melancholy with depression would have a

strong case for a pluralistic model of depression. Such a taxonomizing has precedent not

only here, but also in modern psychiatry. Hence, we could identify a religious depression

which is pathological and treatable by medicine, yet also irreducibly spiritual in nature in

which case the minister’s counsel should be sought. Burton, for instance, considered

religious melancholy a species of love melancholy divided into two, one characterized by

excess (i.e., disordered approach towards God where the mode is love of God) and the

other by defect (i.e., disordered withdrawal away from God where the mode is love of

God). It would be unthinkable to treat such a malady without seeking a trusted pastoral guide.

7.1.6 - What to Do with Tungsindighed

There is also certainly overlap with Tungsindighed and depression. Kierkegaard

himself and his translators recognized the deep similarities between this and the various

melancholies of his day—and with acedia, for that matter. What I have said above about

acedia, then, will apply here where those two overlap, such as in EO.20 However, as I have noted previously, it is striking that Kierkegaard opts to use a descriptive term “Tungsind” over “Melancholi” to describe his own state in his journals. This opens the door for those who want to argue for a non-pathological sorrowful phenomenon. (Thus, “Tungsind” is ambiguous meaning either a sinful state of acedia or a non-pathological sorrow.) At the same time, however, Kierkegaard acknowledges the badness of his Tungsind, an indication that it may be pathological after all. (Recall, there are many passages where he suggests it

20 See my co-authored paper Brandt, et al. (2020) for a short yet comprehensive survey of Kierkegaard’s usage of, and extension or development of, the tradition of acedia.

286

is heritable, which may make more sense on a pathological view than on a view that it’s a

sin or a non-pathological sorrow.21)

Supposing that Tungsind is a kind of “depression”, then, for which one can obtain some relief with the physician’s care, here is what we can say. Critically, all of life is lived before God, and life with Tungsind is no different. Just as Kierkegaard worked cooperatively with God, together through his own weaknesses, upon an invitation to

“metamorphosis” as he described it; any patient and any physician who dared to care for this condition Tungsind must also work cooperatively with God. How? To use

Kierkegaard’s example, becoming well from this state involved a strategic kind of forgetting: “I must myself try to forget it, though not through distraction, not by distancing myself from it, but in God, so that when I think of God, I must think that he has forgotten it, and thus myself learn to dare to forget it in forgiveness.”22 Thus, psychotherapy

incorporating a rich Christian theological background would be useful to the physician

here.

7.2 - Conclusion

Thus ends this lengthy project. I hope to have accomplished only these modest goals. First, I have given a faithful account of each historical condition after undertaking rigorous historical research and investigation so as to put each condition into its proper context, viz., Christian tradition and wisdom. Second, I have teased apart the current-day hegemonic conception of depression as just a “chemical imbalance” or merely a “disease”

21 This cannot rule out the former, of course, since Original Sin is heritable since the Fall.

22 NB2: 136, Aug. 16, 1847 (KJN, Vol. 4: 194).

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by discussing numerous other models of depression. Third, importantly, I have discussed

the adverse influence that naturalism maintains over both our theoretical concepts of and

our diagnostic practices with depression. Fourth, I have begun to synthesize the old wisdom

from our authors with our present-day understanding of depression in a way that makes

sense to us while also preserving the integrity of a long history of Christian tradition. Fifth,

with this newfound knowledge, I have at the very least made a convincing case that what

we call “depression” as described by the DSM can be many different things, one of which

can be of a spiritual nature. Not that every instantiation of it does have a spiritual nature,

but that some might, and that there are good historical reasons to think this.

Here is what remains to be accomplished. Although I have laid out a few general

strategies for synthesis, and have even advanced an example in Chapter Two Acedia in addition to the Section above, the project of resolving all the relations herein is still very much unfinished. For starters, there are alternative ways to “resolve the relations,” as I have put it. One could, for example, instead of synthesizing, choose to identify any number of these conditions (depression included) as real kinds, incapable of being synthesized, but we may classify or group them together nonetheless according to their shared family resemblance. But even this particular project of synthesis which I have begun here is only a model going forward.

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