Open Book

A Guide Through the Darkness

An ambitious new book offers a road map for depressed clients

Jim Naughton
Magazine Issue
September/October 2001
A Guide Through the Darkness

The Noonday Demon: An Atlas of Depression

By Andrew Solomon

Scribner. 443 pp. ISBN 0-684-85466-X


If you subscribe to a good Sunday newspaper, you are familiar with that peculiar journalistic hybrid, the travel article. This is a piece with two irreconcilable purposes. The first is to tell a good story, to convey the experience of the journey. The second is to provide useful information in case you are planning the same journey yourself. Unfortunately, if you are reading primarily for the first reason, the passages about where to eat and what things cost seem boggy and tedious. But if you are reading for the second, the author’s penchant for appearing in the foreground of his own photographs can seem self-indulgent and unnecessary.

In The Noonday Demon, Andrew Solomon faces the travel writer’s dilemma. He wants to tell us about his journeys in the country of depression: about his several breakdowns, his dying mother’s planned suicide and the treatments and insights that, ultimately, have given him a hard-won hope. But he is also compiling, as his subtitle puts it, an “atlas” of depression, and so he has much to say about treatment strategies, neurological research, addiction, suicide and the history and politics of the disease.

The best of the book reads like memoir. It is bleak but gripping, and graced by pitch-perfect insights like these:

“In depression, all that is happening in the present is the anticipation of pain in the future. . . .”

“. . . . if I didn’t allow myself the relief of contemplating suicide, I would soon explode from within and commit suicide.”

“The worst of depression lies in a present moment that cannot escape the past it idealizes or deplores.”

One wouldn’t wish Solomon’s experience on anyone, but readers are fortunate that depression struck someone of his intelligence and sensitivity, someone with the fortitude to wring from the disease so many of its secrets.

Solomon’s mordant humor is another of the book’s pleasures, as when he tells of the woman in Michigan who wrote to inform him that the secret to conquering depression lay in, “doing things with yarn.” Or when he writes: “When I hear of psychoanalysis being used to ameliorate depression, I think of someone standing on a sandbar and firing a machine gun at the incoming tide.”

When the burden of the book shifts from conveying experience to conveying information, Solomon is less successful. This is not to say that the reportorial sections of the book aren’t valuable. He has interviewed both widely and imaginatively. (In one of my favorite parts of the book, he describes eating “dried cod wrapped in seal blubber” while discussing a depression support group organized by several elderly Inuit women in Greenland.) His knowledge of the scientific–and pseudo-scientific–literature is more than adequate, if less than expert. And one can’t help but admire his willingness to expose himself to treatments ranging from EMDR, to body polarity, to an African animist ritual known as an ndeup in which he was rubbed down with millet and doused with the blood of a cockerel and a ram. For all that, however, Solomon, like the ardent travel writer, remains in the forefront of too many pictures.

The result is that Solomon’s interview subjects never become distinctive characters. He gives us background information, a bit of physical description and fat paragraphs of direct quotation, yet we don’t get the sense of having spent time in someone’s presence. Nor do we have the sense that Solomon’s otherwise keen powers of observation were deployed to their best effect. These shortcomings are especially noticeable in the chapter on poverty and depression, which includes numerous personal stories that don’t provide the uplift that Solomon intends because he runs one into the next in a notebook-emptying sort of way.

Similarly, when he is writing about complex scientific and ethical issues, Solomon has a tendency to value his personal testimony over exposition and argument. Too many sentences begin with “I am convinced” or “I am persuaded,” to which the only response can be, “Okay, now persuade me.” Perhaps the primary example of what might be labeled “It-Worked-For-Me Research” is Solomon’s endorsement of EMDR, which comes without much discussion of the fact that multitudes of therapists think it is hogwash.

That same spirit informs his treatment of psychotropic drugs, making it by far the weakest part of the book. Solomon is candid about the fact that his father is chairman of Forest Laboratories, the U.S. distributor of Celexa, and acknowledges that personal relationships no doubt color his view of the pharmaceutical industry. A more circumspect writer might, therefore, have taken special pains to present a balanced analysis of the industry’s influence on the treatment of depression in this country. But every time Solomon seems on the verge of such an analysis, he either testifies to the good character of industry figures whom he has known or veers off on a philosophical tangent. There is a small but significant hole at the center of this substantial book.

Even in his least satisfying chapters, however, Solomon manifests an agile intellect and a passionate engagement in his subject. The book is less an atlas of depression, as the subtitle would have it, and more a companion–a garrulous, articulate, highly informative and overly opinionated companion whose breadth of knowledge and experience entitle him, for the most part, to the occasionally idiosyncratic way in which he relates his story.



New and Noteworthy


Short-Term Therapy for Long-Term Change

By Marion Solomon, Robert J. Neborsky, et al.

W. W. Norton. 198 pp. ISBN 0-393-70333-9


Twenty-one years ago, the British therapist David Malan indulged himself in a bit of wish-fulfillment, imagining a psychodynamic therapy that was brief, fast-acting, long-lasting, widely applicable and free of complications such as transference. This volume, to which he is a contributor, describes and analyzes the surprising strides that researchers and clinicians have made toward that goal.

The authors have a deep appreciation of early psychoanalytic thought, yet they are fully aware of the shortcomings of analysis as a treatment. As a result, their insights seem fresh, yet deeply rooted, like new fruit from old vines. They have identified three keys to successful short-term therapy: a) concentrate on issues of resistance to the exclusion of other concerns; b) bring transference into the open whenever it is detected; and c) bring clients to a physical experience of their buried feelings.

The book is attractive in its intellectual honesty. Unlike some innovators, the authors aren’t shy about submitting their findings to peer review, and they have included a forward in which Lewis L. Judd, former director of the National Institute of Mental Health, congratulates them on their progress, but concludes that they have not yet persuaded him that their approach is as effective or as easily taught as disease-specific therapies.


Whispers from the East

By Frances E. Steinberg and Richard G. Whiteside

Zeig, Tucker & Theisen.165 pp. ISBN 1-891944-04-5


Hasty readers should be advised that Steinberg and Whiteside’s book improves substantially after the last sentence of the first page which reads: “The book is not intended as a ‘how to,’ but as more of a spiritual tickle, an understanding that sits to the left of awareness.” Indeed, the text is almost entirely comprehensible from that point on–no small achievement when Westerners are enthusing about ancient Eastern wisdom.

The authors understand that when speaking of emotions, every utterance is figurative, and that therapists are only as good as the metaphors at their command. The metaphors of Eastern medicine, they suggest, are especially useful in describing individuals’ natures, mental processes and group dynamics. In 14 patient chapters, they introduce readers to concepts as simple as yin and yang and as complex as the “law of the five elements,” which holds that the natural transition of emotions is from joy to contemplation; contemplation to grief; grief to fear; fear to anger and anger to joy. The book at times becomes a bit too schematic–would you want your patients to know that, after they left, you consulted a table to determine whether they were more wood than metal or more water than earth? But that is probably inevitable in introducing readers to a system of symbols this intricate. Therapists of an impressionistic bent will find this book especially useful.


The Shattered Self: The End of Natural Evolution

By Pierre Baldi

MIT Press. 220 pp. ISBN 0-262-02502-7


If Pierre Baldi is correct, the therapist of the future . . . well, there won’t be any therapists in the future. That’s because there won’t be any selves in the future, at least not as we now understand them. Baldi, a professor of information and computer science and biological chemistry at the University of California at Irvine, argues that as our minds and bodies become more malleable (via genetic engineering, among other things), our collective identity will become malleable as well.

“Genomes, computations and minds are rather fluid and continuous entities both in space and in time,” he writes. “Individually, we are just samples of this continuum. The boundary between the self and the other, the self and the world, the inside and the outside has begun to blur and ultimately may evaporate entirely.”

This is a provocative, unsettling book, that inspires contemplation of “the self,” even as it predicts the self’s demise. But Baldi’s arguments would prove more compelling were they more nuanced. In this book, he seems far too eager to sweep aside opposition to the self-less future with the broom of inevitability.