There is an ancient history associating depression with injury to the soul or its loss. By the soul, I mean that enlightening spirit or life-giving force that gives rise to those stabilizing, integrating powers that make a being whole and a person fully human.
Originally published in Humane Medicine, Vol. 11, No. 4, November 1995.
There is an ancient history associating depression with injury to the soul or its loss.(1-3) By the soul, I mean that enlightening spirit or life-giving force that gives rise to those stabilizing, integrating powers that make a being whole and a person fully human.(4) Such a person can find meaning and purpose in life and feel and experience optimism, sensitivity, receptivity, empathy and creativity. When the soul is attacked or a person feels disconnected from its life-sustaining force, the individual feels dead and often is so depressed that he or she wants to commit suicide. The "soul attack" victim becomes disabled or "not able" to function.
The etymological root of healing is haelen, which means to make or become whole.(5) Hence, healing involves a process towards wholeness that culminates in integrity and having meaning and purpose in life. Shamans, based on healing their own severe depressions associated with loss of soul, were able to help similarly troubled individuals to heal themselves.(6) In fact, the forerunners of modern mental health professionals were shamans or "doctors of the soul."(7) The archetype of the "wounded healer"(8) is something that ought to be near and dear to our hearts and souls. Hence, it is critically important to have a clear life-oriented philosophy that includes finding meaning for ourselves and helping others to do the same.
Plato described one of the seats of the soul as the heart, and therefore made a direct connection between the heart and soul. In other words, there is an archetypal basis to the popular song "heart and soul." The heart and soul represent the vital essence of the body and the psyche, which have long been artificially separated.(9, 10) Damage to the heart and soul often is self-inflicted by taking in harmful poisons such as nicotine and alcohol. Heart and soul attacks are associated with the possibility of the loss of heart and soul or death.
For many reasons, we need the term "soul attack" in our everyday discourse, just as we now have the term "heart attack." First of all, such usage would help us to overcome the stigma associated with depression and suicide; this, in turn, would encourage the acceptance of treatment and bring prevention programs into the mainstream of our culture. One indicator that the North American populace is receptive to the word "soul" is the current best-seller, Care of the Soul;(11) therefore, it seems reasonable to assume that people could readily grasp the meaning and importance of dealing with "soul attacks."
Paralleling our approach to "heart attack" victims and the provision of coronary care units, we ought to have psychical care units that provide intensive acute treatment for the souls of patients with "soul attacks." Hopefully, acceptance of the term "soul attack" would permit our decision makers to direct more resources to effective treatment, rehabilitation, and prevention. Persons with "soul attacks" are just as disabled as those with "heart attacks." In both cases there has been a death and loss. With "heart attack" victims, there is a death of cardiac tissue, and they need time for healing and regeneration. Following the acute phase, they require a slow and caring process with follow-up outpatient treatment and rehabilitation programs to prevent future "heart attacks." Persons suffering from "soul attacks" have psychic damage and suffer a "symbolic death" that I term egocide. Egocide (in contrast to suicide) allows the person to shed the dominant negative ego identity or "false self" (symbolic death) and to begin a new life based on one's "true self."(12) Just as a "heart attack" can be precipitated by a stressful event such as loss of job, a "soul attack" can be precipitated by a loss, such as the death of a loved one or a divorce. Egocide, i.e., symbolically killing the negative ego, allows for the needed death of a part of the person's identity, but the whole person lives. As in any crisis, there is dangerin this case, of suicidebut this crisis also provides an opportunity for growth and self-actualization.
How can society finance the subacute and chronic treatment phases? In addition to health insurance, often disability insurance is available to assist persons in their regenerative and longterm healing process. The treatment process always involves four factors: biological, psychological, social, and existential/spiritual.(13, 14) In each attack, we must address each of these factors. For "soul attack" victims, the healing process may involve antidepressant medication, psychotherapy, new job training or group therapy, as well as assistance in becoming reconnected to the soul and thereby re-establishing meaning and purpose in life. We must advocate more than the bare minimum, that is, more than just a "cure" and "survival." While a cure and survival are critical, we must place a premium on caring for the soul and supporting the individual during an ongoing healing process.
Healing, if attained, would facilitate renewed life without self-inflicted harm to the heart or soul. In other words, the experience of a life-threatening soul attack allows for the transformation of depression, brings to an end the preoccupation with acts to end one's life, and strengthens the spirit to enter the previous void of suicidal melancholia. A key aspect of this healing is to transform destructive energy into creative products and constructive actions. Art therapy (Jung termed it active imagination) is medicine for the soul. In fact, Appelfeld said that "only art has the power of redeeming suffering from the abyss":(15) And let's never forget that while science is essential to medicine, the soul is the vital spark of our healing profession and at the core of the art of medicine.
Summary of a paper presented at the 28th Annual Conference of the American Association of Suicidology; May 25, 1995, Phoenix, AZ.
Correspondence and reprint requests to:
Dr. David H. Rosen
McMillan Professor of Analytical Psychology
Texas A and M University, Psychology Building
College Station, Texas 77843-4235