Jacques, in As You Like It, says that he "sucks melancholy out of a song as a weasel sucks eggs." Robert Burton, as is well known, compiled one of the early masterworks of psychiatry in producing The Anatomy of Melancholia. James Boswell spoke in the most confessional of terms about his own melancholy and that of Samuel Johnson (although more might have been made of these accounts in the text). It seems that melancholy was so pervasive and entwined with protestant theology in the late Middle Ages and early modern England that it took on a certain social caché and became forged with the notion of a sensitivity to and perception of the ills of the world that only those of a more refined disposition could see. The more spiritual the nature, the nearer to melancholic crisis a person would be.

However, as Jeremy Schmidt describes in a scholarly, eloquent and informative tone, drawn it seems from his doctoral dissertation, melancholy and what became known as depression was always more than that. It was always linked with and colored by religious and moral, perhaps existential overtones, it was always an avenue to the soul. Schmidt traces the history of melancholy through its social history; putting perceptions and understandings in a context informed by scientism and the beginnings of positivism, religion especially the rise of Protestantism, the emergence of a bourgeoisie and the end of feudalism and philosophical concerns with the nature of humankind. Out of this mix comes a concept of what it might be to be truly human — and melancholy, it would seem, is part of the equation. Schmidt argues that we should not be too distracted by excesses of religious explanations of mental illness. Very few involved in psychiatry would subscribe to demonic possession as a root cause. However, for him, the early modern conception of melancholy as something that affected us deep in the core of our being, still seems to have some validity. Depression may be absolutely connected to the function of our neurotransmitters, but the experience of depression is something profoundly personal and human — and for some the very core of the human experience may be tied up in the word 'soul'.

Although it is a tricky question to define "early modern England", Schmidt begins in the seventeenth century when, to quote Christopher Hill, the world turned upside down. The radical nature of the social revolution brought about by the victory of the Parliamentarians in the English Civil War signaled a sea change in social relations. Even with the Restoration and Glorious Revolution there was not going back. Writers, physicians and philosophers such as Burton and Thomas Willis considered the melancholic to be in need of the services of both the physician and the philosopher. Melancholy was at one and the same time a medical and a moral problem — especially for the patient.

He bookends his discussion with the case of George Cheyne, a giant figure of his time, who, it might be noted, thought that melancholia and the torment of the soul only affected those of a higher intellect — the poor, ignorant and dull were rarely so troubled. It might be guessed that Cheyne suffered from depression himself — and just what Cheyne thought of himself may be surmised.

Schmidt elegantly weaves his historical accounts to the modern period, but it is in his conclusion that more controversial and dislocated material is to be found. He introduces, to no great effect or purpose with regard to his main thesis, some of the wilder shores of therapeutic approaches such as Tim LaHay, a soi-dissant Christian psychologist better known for his apocalyptic novels concerning the final rapture and ascent into heaven of the 'saved', who slightly retracted his assertion that most depression was caused by sin (not terribly helpful to most sufferers) but still prescribed being filled with the spirit as a the best solution to mental disorder. He notes also, M. Scott Peck's discussion of his own use of exorcism — and this from the man who seemed to be so reasonable and generous of mind in the very popular The Road Less Traveled.

Schmidt speaks of meaning-seeking, but does not consider the influential, and non-religious, non-religiose work of Victor Frankl and his interpretation of humanistic psychology. He does not, as would have been appropriate if he had wanted to pursue this inquiry more thoroughly, examine the numerous first hand accounts from the Twentieth Century of psychotherapy that had a profoundly spiritual character, see Siegfried Sassoon as just one example. Schmidt also uses the term 'depressives' in a way that would read quite differently and seem unacceptable if he were to say 'schizophrenics'. These aspects make for a disappointing end to an otherwise fine book. The scholarship is of a high standard, Schmidt writes elegantly and lucidly, he is able to bring a wide variety of examples and instances into a coherent narrative. It seems a shame that he should end with less moderation and balance than he has shown previously. He says, for example, that a psychopharmacological approach to care is "clinically dubious, even harmful" (a reader might be steeling for a Scientological rant at any moment), but does not consider equally the enormous influence of humanistic counseling, the growth of CBT, not to mention the ethic of care that underpins psychiatric nursing, where the primacy of the experience of the patient augments the fact that for most people the drugs work and enable them to function.

It is difficult to know exactly what purpose the concluding remarks of an otherwise well-balanced and interesting work serve. It may be that these areas are worthy of some examination, but this does not seem to be the place. Schmidt is much better when he sticks to what he knows, and perhaps readers should forgo the final pages.

© 2007 Mark Welch

Mark Welch, Ph.D., Edmonton, Alberta

Categories: Philosophical, MentalHealth