Were you as shocked as I was when you heard the tragic news of Robin Williams’ suicide? I just stood motionless for a time, wondering why. Of course, people are complicated. I didn’t know Robin Williams. Sure, the comedian and actor that struggled with addictions and depression, but all that’s just surface stuff. His wife and kids knew he was in pain. But not even they knew how much. One’s struggles are so deeply personal. I’m sure they were as shocked as we were, probably more so. My guess is that he hid his pain from them too, out of love.
I’m sad. My heart breaks for him and his family. It breaks for all of us collectively too. The world just lost a unique and wildly creative perspective. Few people ever see the world as idiosyncratically as he did. We need perspectives like Robin Williams.’ People like him help the rest of us open our minds a bit further. His creativity was such a gift. Not as obvious though, but way more poignant now, was that he also carried its curse. There’s a dark side to creativity.
I’m reminded of the famous Jack Kerouac quote, “the only people for me are the mad ones, the ones who are mad to live, mad to talk, mad to be saved, desirous of everything at the same time, the ones who never yawn or say a commonplace thing, but burn, burn, burn like fabulous yellow roman candles exploding like spiders across the stars.” The burning, that’s what I want to explore. Because Robin, you were a Roman candle too. We all burn out eventually. I’m just wondering if maybe you didn’t snuff out your light too soon? I may be wrong. Again, each of our struggles is so deeply personal. But I can’t help but think it didn’t have to be this way.
I watched Wolf Blitzer interview Dr. Sanjay Gupta on CNN this week. Wolf astutely hit on this Jack Kerouac theme by asking Sanjay, ‘if the traits that made Williams a great comedian might also have contributed to his deep depression?’ Sanjay speculated this was so, and I agree. It’s easy to imagine how an innately strong, inborn passion could push a person’s emotional pendulum from manic to depressive and back. In fact, it’s so common that it’s almost cliche–the depressed and addicted comic, musician, artist, or writer. Sanjay went on to remark that there are no easy answers. And he’s right again. But if we’re to understand this problem better and hope to prevent the next artistic genius from killing himself, we’re going to have to make sense of the shadow side of creativity, and learn to work with it. I’ve found Jungian and Buddhist psychological to be very effective in this respect.
Secondarily, may I suggest that we start by thinking about disorders like depression and addictions more critically? Sanjay started the interview by reminding us that depression is a disease. I’m not criticizing or even contending with Dr. Gupta. The subtext of his comment was that depression is a serious condition and that it warrants serious treatment. I wholeheartedly agree. Yet, I cringe when I hear the word disease. I know, it’s my issue. But I do so because I know that words are powerful, and in this specific case, it can be misunderstood. Everyone regards cancer as a disease. But does the word disease mean the same thing when applied to depression and addictions? To anyone listening, it carries the same weight. Sure, depression and addictions meet the definition: a particular quality, habit, or disposition regarded as adversely affecting a person. But are we talking about the same thing?
Cancer is primarily a disease of the body. The most-effective treatments for cancer target the body. Psycho-spiritual-emotional interventions may help on the margins. But affirmations, prayer, healing touch, meditation, group therapy and the rest can’t hold a candle to the power of the latest biological and chemotherapies. Depression and addictions are different. They are primarily diseases (qualities, habits, and dispositions) of the mind and heart. Yes, they affect the body too, it’s a whole system. So brain circuits do malfunction. But these conditions are primarily diseases of meaning (thoughts of self, needs, wants, losses, threats, urges, inadequacies, injustices, etc.). For that reason, they are extremely context dependent. That is why a change in meaning can result in a change in being.
Long and short of it is lumping all these disparate conditions together under on label seems like a mistake. If we continue to call both cancer and depression diseases, then we need two categories: one for the diseases of the body, and another for diseases of the mind and heart. Treat the former with biologic and pharmaceutical interventions supported with integrative approaches for symptom management. Treat the latter primarily with integrative interventions, talk and group therapy, shadow work, and most especially meditation and mindfulness. Then, offer pharmaceuticals to manage symptom intensity. That’s what makes the most sense.
The myriad ways humans manifest repetitious patterns of suffering require us to be a little more thoughtful in our approaches to curing them. I’m going to miss Robin Williams. Had the context shifted somewhere in his past, through mind training, I believe things could have been different.
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Mark Pirtle
I am not at all as sure as you are that cancer is primarily a disease of the body: http://cigognenews.blogspot.it/search?q=cancer
Best,
Alessandro
Dear Assandro, thanks so much for you comment and link to the intriguing article. You hit at the heart of my feelings on “disease.” When examined closely, disease itself is so hard to pin down (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1299105/). For those readers familiar with the Buddhist concept of “Emptiness,” disease manifests in much the same way–it is both there, and not there simultaneously. I don’t doubt that cancer has a mind/context component. It must in fact. That being said, cancer’s mind/context component may be less amenable to influence by mind/context once cancer has manifested. My last post was an attempt to more carefully define the variable nature of diseases. Thanks again for your thoughtful comment.
Best,
Mark
From a fellow UK comedian, Russell Brand. A 180-degree take on all the questions. Maybe it wasn’t Williams, or mental illness, or addiction, or …. maybe it is the world we live in?
http://www.theguardian.com/commentisfree/2014/aug/12/russell-brand-robin-williams-divine-madness-broken-world
Dear Shelly,
I’m a huge fan of Brand’s. He has such an incisive mind and caring heart. He’s also had personal experience working to exorcise the demons that troubled him in his youth.
I read that column too. To some extend he’s right of course. For those of us who are sensitive to the larger interdependent world system problems–climate change, environmental degradation, over population, unbridled consumerism, and lack of political will–it’s extremely depressing. The only way I cope is to focus on what’s in front of me and try my best to do good. I practice a form on denial, I know. But my heart can’t hold all of that pain in any other way.
Thanks for sharing Russell’s work. I want it to find a wider audience as well.
Best,
Mark
As someone who spent over thirty years in what seemed to be almost one contineous cycle of threapy, ECT, medication and suicide ideation, I am concerned that the link between antidepressants and other psychogenic agents is being ignored in adults. Please note I speak on a personal level here.
Please elaborate. Thanks. Mark
Thanks Michelle for your contribution to our dialogue. We’re social animals. That’s why I believe “diseases” like depression are processes rather than discrete entities–verbs rather than nouns. As clinicians we need to account for the whole person, the context. Only then will conditions like depression and addictions make sense to us, and then our rational for treatment can fit for these conditions. Thanks again, Mark
Mark, what wonderful words. Such passion and want for the betterment of those considered emotionally diseased. What stood out for me was something you said about looking at these depression as a disease of the mind and heart. As a society we shy away from emotions. If we show them it’s considered a weakness and for men I figure this is one of the last things they’d want to be considered. The rate of suicide for men is alarming but knowing the taboo around emotional expression it shouldn’t surprise us either. Suppressing emotion is our public health issues. Etiologists and Sociologists could take a closer look at depression and seek out its origin. We might be surprised at their findings.
Robin Williams said it, “I used to think the worst thing in life was to end up all alone, it’s not. The worst thing in life is to end up with people who make you feel all alone.” This is one of the main elements of William Glasser’s Reality Theory (1965). The desire and innate need for emotional connection is so powerful that if we are unsuccessful in fulfilling this need we feel worthless and alone. Glasser stated, “…the need to love and be loved and the need to feel that we are worthwhile to ourselves and to others,” cannot be promulgated enough in a society that shuns emotions and rather seek amelioration of emotional problems in pill form (1965, p 9). To add to Glasser’s credit he argued, “what appears to be satisfactory relationships are not satisfactory for him, a condition often graphically illustrated by the case of many suicides. A person who commits suicide may have many people who are about him and he may be successful in his work, yet still leaves a note describing the overwhelming loneliness and isolation he feels” (1965,p12). We don’t need to go any further than this.
We need to embrace that man is emotional and emotions is a natural part of us. It should be celebrate not shamed into secrecy. We cannot extract this from ourselves. Emotional liberation is something we cannot achieve in a society that cringes at the site of emotions and condemns anyone who displays them.
Mark, I agree with all of what you said and I couldnt have said it any better. Myself, I view depression as an attempt of emotional castration instead of a disease. The need for emotional connection (from birth to death), according to Glasser, is the cure. I am a believer in this.
I’ll reply to you all in one post. And thanks for your comments. There’s so much more to say, but I’m ever mindful of keeping my posts brief so as not to lose too many readers. A vivid imagination can be transfixing. I watch my daughter lose herself in playful fantasy and also recoil from unseen monsters hiding in shadows. Such is the power of the mind. Robin’s mind was more powerful than most. If we, as a society, want to be happier and healthier, we need to learn about the mind, what it is, and how to work with it. There’s no other option. And I’m not taking about brain activity here. I’m talking about one’s personal, subjective experience, which comes alive in mind, consciousness if you like. Although I’m not a Buddhist, Buddhist psychology has much to offer in this respect. It goes a step beyond Western Psychology, which mainly focuses on healthy ego function. Buddhist psychology introduces the “space” in which the ego arises. This meta awareness helps a person get a perspective on his perspective (perspective/personal self-narrative). Instead of refining the ego as a goal, one learns to go beyond it. That’s not to say you give it up. Ego has a role. One still needs to function in the world. But getting meta on oneself allows one to transcend the ego and egoic concerns. When one practices, one can experience distress without so much self-identification. A practitioner, in moments of clarity, can choose to rest in the peaceful stillness of empty mind. Mind-body diseases like depression and addictions require Western therapy to examine and refine the self-narrative (ego), but imperative to this process is skillful meditation and mindfulness. If medicine is needed to reduce symptom intensity, great. But pills should be adjunctive therapy. We need more psychologist to become deep and skillful meditators so that they can lead their patients to understand and work within their minds. Thanks again for your comments. If you find this discussion helpful, please share it within your social networks. Best to you, Mark
Thank you, Mark.
In you post you wrote:
“Depression and addictions are different. They are primarily diseases (qualities, habits, and dispositions) of the mind and heart. Yes, they affect the body too, it’s a whole system. So brain circuits do malfunction. But these conditions are primarily diseases of meaning (thoughts of self, needs, wants, losses, threats, urges, inadequacies, injustices, etc.). For that reason, they are extremely context dependent. That is why a change in meaning can result in a change in being.”
Although I was not at all surprised to hear that Robin Williams had taken his life, I do very much agree with your assessment of depression and addictions as “diseases” of meaning, which are sometimes coupled with a very real biochemical imbalance. Our perception of what is real and true is what strongly influences what we feel and think. And we are often unaware that we actually are able to get a perspective on our perspective, to observe our thoughts as merely thoughts, and our feelings as merely feelings.
Because I have often dwelled in the space of suffering and hopelessness, believing that the present moment was forever and could never change, I understand how people can act on the impulse to end their own lives.
But, of course, the present moment is not forever. And so then, “a change in meaning can result in a change in being.” And this is why is why it didn’t have to be this way for Robin Williams or ever for anyone.
Dear Jessica,
Thanks for your thoughtful contribution. We can influence the course of these “diseases” with skillful awareness.
Best to you,
Mark
In the news today, he was also struggling with the early symptoms of Parkinson’s disease, and did not want to disclose to the public. The diagnosis probably caused reactive depression and anxiety, the prognosis of Parkinson’s is difficult to handle for just about anyone – not much hope in sight.
There is so much to ask .I guess questions will remain unanswered. All i have to do is be silent for a while …just in memory of the greatest acting of Robin Williams -in Dead Poets Society film…
Mark I am not surprised at all if honest, a lot of the time his almost polar personality hides something very deep, his manic style almost covers a deep insecurity, I have a friend who is very similar and I grow very concerned about his very contradictory behavior sometimes.