Volume 11, No.2, Fall 2016

Alleviating Suffering

Index and Editors' Introduction

In this book, I argue against the two most common views on depression: first, depression seen through the DSM diagnostic lens as a disorder to be treated by clinicians, and second, depression seen through the postmodernist lens as a social construct. My view is that there are kinds of depression that represent disease, and kinds that do not. In the former case, a biological approach is legitimate; in the latter case an existential approach is best. The general approach to psychiatry that can maintain this insight I call biological existentialism. I try to explain that existential approach, through the ideas of various thinkers and teachers of that school, and I also critique both the DSM-centric approach of the psychiatric establishment and the postmodernist nihilism of their critics.

Keywords: Jaspers, Karl; Kraepelin, Emil; happiness; depression; psychiatry; existentialism; postmodernism; biology; despair; diagnosis.

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Uncovering the Cause of Depression: A Medical or a Humanistic Approach?
Alina Marin | Queen's University, Kingston, Ontario, Canada

In his book On Depression, Dr. Nassir Ghaemi, Professor of Psychiatry at Tufts University School of Medicine, looks to philosophy and the history of psychiatry to explain the complexity of understanding depression, both clinically as a medical disease, and existentially as part of normal human experience. Citing the philosophical works of Aristotle and Karl Jaspers, among others, as well as the work of prominent contributors to the field of psychiatry, including Emil Kraepelin and Viktor Frankl, Ghaemi examines the complex causality of depression, the potential benefits of experiencing depression, and the drawbacks of living a life unexamined. This essay discusses some of the author's insightful observations and analyses.

Keywords: Jaspers, Karl; General Psychopathology; Ghaemi, Nassir; depression; despair; psychiatry; neuroscience; causality; ontological; existential.

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Reflections On Depression
Casimiro Cabrera Abreu | Queen's University, Kingston, Ontario, Canada

The professional and research trajectory of Nassir Ghaemi are reflected in his book On Depression. What follows is an attempt to highlight those salient aspects of his thinking that are clinically useful to the author of this brief review who is a practicing clinician. Ghaemi's masterful synthesis is clear and offers a meaningful blueprint to psychiatrists and other clinicians who are currently trapped by a sterile nomenclature. His insights, founded on rigorous epistemological and scientific grounds, are a wake-up call to many who wish to bring back rigor and humanism to their work with patients.

Keywords: Ghaemi, S. Nassir; psychiatry; psychopathology; phenomenology; depression; evidence-based psychiatry.

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Ambiguity and Nihilism: Comments on Nassir Ghaemi's On Depression
Daniel Adsett | Marquette University

This response to Nassir Ghaemi's On Depression develops some of the tensions Ghaemi highlights in contemporary debates concerning the efficacy of psycho-pharmaceuticals and the role of science in deciphering mental illnesses. I argue that both relativism and positivism share the same commitment to resisting ambiguity: relativism in psychiatry tries to eliminate ambiguity by reducing the relationship between pharmaceutical companies and patients to a pure relation of power; similarly, positivism tries to eliminate ambiguity with its belief that the human mind and human experience be understood ultimately in purely bio-chemical terms. Against both positions, Ghaemi emphasizes the importance of ambiguity in psychiatry: depression is not necessarily an evil, something to categorically resist. In many cases, the experience of depression reveals something true about the human condition and a subject's own response to the world.

Keywords: Jaspers, Karl; Ghaemi, S. Nassir; Havens, Leston; nihilism; ambiguity; relativism; positivism.

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Reflecting on On Depression: The Trap of The Happy Mean
Elena Bezzubova | University of California, Irvine

This reflection on Nassir Ghaemi's On Depression: Drugs, Diagnosis and Despair in the Modern World first touches upon the author's personal, clinical, historical, and theoretical facets of depression and despair as well as mania and happiness as a cogent demonstration of how seriously psychiatry needs philosophy. Ghaemi proposes biological existentialism for the role of such philosophy. This essay compares biological existentialism with an earlier conception of existential biology as attempts to resolve Cartesian anxiety inside of the methodological trap of psychophysiological parallelism. I outline three sovereign levels of addressing presentations of human life: biological facticity, clinical phenomenology, and existential authenticity to clarify the difference between the human and existential categories of happiness and despair; the clinical categories of depression and mania; and the biological categories of neurometabolic patterns. On Depression reveals how the needed integration of philosophy into psychiatry remains problematic

Keywords: Jaspers, Karl; Kraepelin, Emil; biological existentialism; biological facticity; clinical phenomenology; existential authenticity; depression; despair; mania; happiness.

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Hamlet: To Be Or Not To Be Who One Is
Eva Cybulska | London, United Kingdom

This essay examines the thoughts and actions of the eponymous hero Hamlet of Shakespeare's tragedy from the perspective of existential philosophy. The death of his father, the prompt remarriage of his mother and Ophelia's rejection of his love are interpreted as Jaspersian boundary situations. Burdened with the responsibility to avenge his father's murder, Hamlet faces an existential dilemma of either being a dutiful son or being true to himself. As he loses faith in the goodness of the world and confronts death, Hamlet enters a protracted phase of foundering, suffused with despair and self-loathing. The customary rational way of thinking fails him and his soul becomes shipwrecked. But this is also the beginning of Hamlet's journey toward authentic selfhood and becoming the Existenz that he potentially is. Affirming life with all of its absurdity in a moment of transcendence, he attains a kind of happiness that Camus addresses in The Myth of Sisyphus.

Keywords: Hamlet; Jaspers, Karl; Kierkegaard, Søren; Nietzsche, Friedrich; Sartre, Jean-Paul; Camus, Albert; boundary situations; foundering; Existenz; despair; solitude; masks; authentic selfhood.

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We Refugees: Standpoint and Border Ethics
Jill Graper Hernandez| University of Texas at San Antonio

This essay argues that a contemporary trend in analytic ethics, namely the use of second personal moral reasons, is hamstrung in its efforts to guide moral deliberation about difficult cases such as the plight of Syrian refugees due to its commitment to the formal constraint of the second person. Whereas second person reasons might be able to explain the objectivity of moral principles, they do not explain why we should care about the people to whom our obligations are directed. It is further argued that Karl Jaspers' moral philosophy constitutes a better guide for moral deliberation and is also better positioned to explain why you and I have moral obligations to distant others too, such as Syrian refugees. Framing moral reasons through a first personal plural standpoint has the potential to ground them existentially, and explains how the self is morally related to the plight of the Other.

Keywords: Jaspers, Karl; Syria; Existenz; ethics; moral reasons; encompassing; existential ethics; situation; refugees; second person standpoint; transcendence.

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