Exploring the ontological ground underlying the conceptualisation of depression
[Thesis]
Ağören, Güler Cansu
Moss, Lenny ; Jackson, Mark
University of Exeter
2017
Thesis (Ph.D.)
2017
Conceptualizations of depression, this dissertation will demonstrate, are invariably structured by ontological presuppositions that constitute and define boundaries between individual and social, internal and external, body and mind, selfness and exterior, normal and pathological. Furthermore, the way in which these boundaries are set through the ontological ground underlying the modern bio-medical conception of depression are rooted in the history of Western philosophy, rather than corresponding to natural kinds discovered by neuro-medical science. Essentialist, internalist, and individualist assumptions arguably dominating contemporary practices regarding depression in Western medicine are not unavoidable and necessary, but are contingent symptoms of a certain ontological groundwork, that needs to be revealed and examined from a critical perspective to be able to deal effectively with possible deficiencies of the contemporary bio-medical model. In the following study, I focus on different historical conceptions that pathologise some altered form of affectivity that by contemporary lights we would associate with some manner of 'depression'. These include Hippocrates', Aristotle's, Galen's, and Burton's conceptions of melancholia; Aquinas' model of acedia; and the American Psychological Association's Handbook (APA's), Matthew Ratcliffe's, and Thomas Fuchs' accounts of depression. All these different ontologies are put through a categorical analysis consisting of six steps. In each step, each model is assessed regarding their positions between the two poles: melancholia/acedia/depression being (1) indigenous to the individual versus irreducibly social, (2) caused by internal versus external factors, (3) pathologised based on an individual versus a social dysfunction, (4) formed dependently versus independently in relation to personal characteristics, (5) defined as a bodily versus a mental phenomenon, (6) detached from versus entangled with the authentic self.
history of depression ; melancholia ; acedia ; dsm-5 ; phenomenology of depression ; externalism