Posted by: exiwp | October 23, 1987

Crisis Normalization And Depression: A New Approach To A Growing Epidemic (1987)

By Fred Newman

The following is based on a talk by Dr. Newman sponsored by the East Side Institute for Short Term Psychotherapy, on October 23, 1987 (later published in Practice: The Journal of Politics, Economics, Psychology, Sociology & Culture, 1987, Vol. 1 No. 3).

I do not wish to add my name to the long list of definition mongers. I believe that the search for definition is methodologically problematic. What 1 want to try to develop here is what it means to evolve an approach to depression which doesn’t have, amongst its presuppositions, the need to offer a definition of what depression is. I want to talk about why definitional approaches are less curative, less useful; less helpful-in fact, function negatively-relative to the treatment received by people we see in the “non-definitional” short term, social therapeutic approach.

A curious feature of our language (noted by many) is the humor sometimes obtainable by flipping subjects and objects in phrases or sentences. More often than not, such a flip produces both humor and insight. I’ll give you an example of what I mean. A much more precise title for Coyne’s Essential Papers on Depression would be Depressing Papers on Essentialism. These are indeed very depressing papers on essentialism! They all attempt to give not only a definition of depression hut an essentialistic characterization of the human being as a precondition for then discussing depression. “Depression must he understood as the common cold of psychopathology,” we are told. Exactly right. After all, depression, in one form or another, strikes not just handfuls of people, hut millions of people. The estimates given center around I out of 5 people. That figure is likely an underestimation, referring only to people who have received some kind of treatment. The number is surely higher since there is a continuum of depression. Indeed, it is often debated whether depression, qua clinical category, is actually an extension of depression as we know it in ordinary life. It is hard to do therapy for more than ten minutes without treating people who suffer from depression. And many of us here, I am sure, have gone through severe bouts of depression ourselves. Being depressed, then, seems almost an element of the definition of being human.

The DSM-Ill criteria for major depressive episodes further this question. Here is the definition (officially of depression, unofficially a partial definition of human being): “Loss of interest or pleasure in all or almost all usual activities and pastimes, characterized by symptoms such as the following: sad, depressed, blue, hopeless, down in the dumps; irritable-must be persistent but not necessarily the dominant symptom. At least four of the following symptoms must have been present nearly every day for a period of nearly two weeks (in children under six at least three of the first four): (1) Poor appetite or significant weight loss, when not dieting, or increased appetite or significant weight gain (in children under six, consider failure to make expected weight gains); (2) insomnia or hypersomnia:; (3) Psychomotor agitation or retardation, not merely subjective feelings of restlessness or being slowed down (in children under six, hyperactivity); (4) Loss of interest or pleasure in usual activities or decrease in sexual drive not limited to a period when delusional or hallucinating (in children under six, signs of apathy); (5) Loss of energy, fatigue; (6) Feelings of worthlessness, self-reproach, or excessive or inappropriate guilt. either may be delusional; (7) Complaints or evidence of diminished ability to think or concentrate, such as slowed thinking or indecisiveness not associated with marked loosening of associations or incoherence; (8) Recurrent thoughts of death, suicidal deviation, wishes to be dead or suicide attempt.” It goes on. So must we. Let’s try to move beyond definitional approaches.

Some experts suggest that loss is primarily emotive, some that loss is more cognitive than emotive; others say that loss is more interpersonal than either cognitive or emotive, and still others actually say that loss is chemical. The idea which comes across in these varying approaches to depression is that there are some kinds of loss which provoke or induce an inability to cope, and that this inability to cope is not specifically a sadness nor a feeling blue. Rather, the feeling state identified with depression is more appropriately identified as the lack of a feeling state. What cuts across many of these statements and points of view is that the essence of the depressive state is the experience of helplessness, to some extent a non-feeling, i.e., a seeming inability to any longer be responsive.

As I understand Becker, what is common to both the experience of depression and the approaches to the experience is this loss of the capacity to cognitively, emotively, psychologically, culturally, politically “keep the whole damn thing together.” There has essentially been a breakdown of framework and meaning. With this breakdown, one becomes weighted down with a sense of helplessness (“learned helplessness”) because the life experiences which previously may have been nourishing, developmental, meaningful, and significant, no longer have that impact. The depressed experience is compounded by the fact that one is now going through life epistemologically aware of doing the same things one had always done (and. in the past, derived nourishment and pleasure from) but now these experiences give no pleasure. The depression, then, deepens due to what is effectively a kind of “learned helplessness.” In place of the ability to take experiences and fit them into an overall framework which is growthful, productive, and makes you feel human, cared for, capable, and alive, increasingly these same kinds of experiences now contribute nothing to your sense of self-identity. You become dead in life. You go through the motions. You might perform well-many, many depressed people perform very well. In some cases people don’t even know that they are depressed. They say “Oh that’s how I thought life was! I didn’t know that was a sickness! I didn’t know that could be cured.” In the midst of a rather severe depression many years ago, I could see that my life experience for some 15-20 years before was not all that dramatically different. I came to see that depression (almost as severe as what I was then experiencing) was what I had thought of as the normal state of life.

Once again let us change the initial premise of our investigation from searching for a cure for a disease, to searching for a cure for a normal state. This of course has serious socio-economic implications. For example, if you put up a shingle which says. “Only Normal People Come Here,” no one would know whether to come or not! People might come in and say. “I’m terribly ill,” and you’d reply. “Well, to tell you the truth, I don’t treat illness.” I do not treat illness-because much of what has been conceptually and socially defined as illness makes it, in my opinion, fundamentally incurable. A lot of people fail to appreciate the perniciousness of definition and categorization, fail to appreciate the perniciousness of language, and fail to appreciate the extent to which we have all been socialized by language and categories, including the categories of emotion, cognition and disease, such that if we persist in functioning within these categories, it is questionable whether we can ever make it out of them.

Starting from our quite different assumption, our anti-paradigm, if you will, how do we relate to folks who come to see us and lay out all of the symptoms described in the literature on depression! People tell us. “I feel sad, disempowered, listless-helpless. I don’t know what to do with my life. I’m thinking about committing suicide.” Those are very real things said by very real people, and they should not he denied or doubted. Millions of people feel this way, and some few come to us seeking help, and one cannot make fun of the people who are suffering, who are in pain. What do we do then, when people come to us depressed!

American culture, more than any other, has profoundly and dramatically lost a sense of history. Far from being a radical statement, this is the standard analysis of many people across the political, social and cultural spectrum. Over and over again it has been pointed out that the American sensibility runs roughly from the six o’clock news to the ten o’clock news. “What happened?” “What is historical?” “What is really going on?” The answer is what is momentary; it is whatever is presented in the media, largely on television. Our sensibility, such as it is, is mediated by an incredible barrage of words and images carefully shaped in such a way as to not simply create a certain picture, hut to explicitly create a certain sense of alienation from the sources and objects of that picture. That is, to destroy our sense of history. There is ample evidence to suggest that as a people, we have not simply been alienated from the process of work and production hut we have been alienated from the historical process of our own historical development. We have been denied the possibility of history as well as the actuality of history. People like Richard Sennett and others have noted the narcissism of American society. But the “Me Generation” is more than generational. The “me-ness” of American culture goes well beyond any single generation.

All over the world, people are astounded by the historical deprivation that is characteristic of our culture. We read in the European press of Europe’s fears of the Reagan administration. To be sure, part of that has to do with his programmatics. But it also has to do with the fact that Europeans quite correctly are fearful of a major power to whom they are beholden in a life and death sense, being run by someone whose paradigm of reality is the grade B movie or six o’clock news. Many people are concerned about a population, a president and a culture which over-identifies war, for example, as something that appears on television, which identifies profound social problems as images in a movie. We have, in many ways and for many reasons, evolved as a culture so thoroughly alienated from history as to make us profoundly vulnerable, in a momentary situation, to deep-rooted depression.

I am not suggesting that the more traditional elements discussed in classical papers and research on depression are irrelevant, however, I am urging that none of what is said makes a whole lot of sense unless we locate these analyses in some socio-psychological understanding of our particular culture, specifically our deprivation of history. In the absence of a historical sense we are enormously vulnerable to profound depression. Does this happen to individuals? Yes. Does it happen to masses of people? Yes. Is it of great concern?-certainly.

The study of how that occurs at the mass level is much more informative of how it happens at the individual level than the other way around. The study of mass psychology is much more informative of individual psychology than individual psychology is of mass psychology. Freud, and even his radical follower, Reich, did not fully appreciate this. They effectively believed that mass psychology is best modeled by an examination of the individual psyche. But it is clear, at least to me, that it goes the other way around.

How did this mass social transformation called Nazism occur? Reich gives a complex, characterological answer which I can only summarize here. He argues that there are three levels to people’s characterological make-up. One element is fascistic, implying that there is the capacity for fascism in all of us. I do not accept that model. What I believe, and what we’ve come to see in our social therapeutic work, is that our normal social interaction is so profoundly alienated and lacking of a sense of historical connectedness that relatively minor changes in the actual process by which information is communicated and disseminated can create total transformation overnight. The absence of a sense of history leaves us extremely vulnerable. And this was very much the situation with German culture and German society in the 1920s.

This process, while in varying degrees cognitive, emotive and social, is not characterizable as any of these processes. Rather, it is a process of investigating if there is another sense of identity aside from the over- determined societal sense of identity. This societal sense of identity, in my opinion, is the ultimate source of the depressed state. This is not the same thing as saying that depression has social origins. To be sure, it does. The point is that the whole mode of our emotional organization, both its normalcy and its abnormalcy, is effectively organized by the categories, life interactions, and social roles of one super-ahistorical culture and society.

If we take depression as a normal as opposed to an abnormal state, then looking for the source of depression in its particularity means looking for the historical origins of the total social experience which leaves us vulnerable, in the face of particular historical stimuli, to an unraveling best described as losing our sense of identity because of having lost our sense of location in society.

In Anti-Oedipus (a very good book which I completely disagree with) the French psychoanalysts and philosophers, Guattari and Deleuze, say that, in the final analysis (pardon the pun), Freud’s greatest contribution was that he gave the madman social validity, a societal location: that what Freud did for the insane was to offer them a social contract, and say. We have a place for you. You’re not a devil, you’re not a demon, you’re not extra-societal-you’re merely insane. And we shall enter (“we” meaning the psychoanalyst and the patient) into a social contract which gives you a relationship to society. Having that relationship, you are now able to function in a more stable fashion whether or not anything else of any significance happens in these interactions, be they five or six or seven days a week. What is fundamentally curative, Guattari and Deleuze argue, is that contract. I believe this is by and large correct. I think that this contract with the maladjusted is of profound importance. R.D. Laing once said that the good news about psychoanalysis is that most people who practice it do nothing resembling what is contained in its theories for, if they did, they would do terrible damage to people. It is the contract that does the good work.

Now, if we want to move beyond therapy whose effectiveness is totally contained in its liberal contract, then we have to change the depressive person’s relationship not within or to society but within and to history. The distinction I am making here is the distinction between adaptation to society through a reorganization of one’s relationship to society and adaptation to history through a reorganization of one’s relationship (or a group’s relationship or a nation’s relationship) to history. History cures depression.

What does that mean? My colleague Lois Holzman and I have been doing research on these matters for the better part of a decade. In an article we wrote about three years ago, we pointed out that in our culture both thought and history have been profoundly over-determined by language. Others have observed that. Some people, including distinguished social scientists (e.g., the communicationist school in Palo Alto, California) go so far as to say that in point of fact, we should talk only about language usage because language usage is the closest approximation we have to both thought and history. They mention that any attempt to reach thought or history directly is ill-fated, that the study of human existence, of interpersonal behavior, of subjectivity, of life, is best accomplished by the study of communication.

The attempt to reach history, then, is inseparable from the attempt to understand the ideological limitations of a linguistically over-determined socio-pathology. The questions, “What is language?” and “What is language usage?” are not abstract, but questions about a social process which involves the very rich and complex phenomena of making sounds, making inscriptions, making marks, putting them together in certain ways, forming them verbally, etc. What is this extraordinary social process? And to what extent has this process emerged in such a way as to become identifiable with life itself and with history itself? In many respects, the process of reaching history is best understood as the process of self-consciously creating a new language-actually, an anti- language. Many people say that this is part of the Freudian tradition. Isn’t there, after all, a sense in which a new language is created in the process of psychoanalysis? Yes, but it is designed specifically to translate from one societally-bound language into another societally-bound language. What we are talking about here is the creation of a language (anti-language) whose specific function is to reach the historicalness of our social being.

We are, of course, in history right now, you know. Being in history, if you’ll permit me this word, is our “natural” state. The unnatural state, the pathological state, the abnormal state, is being in the limited location that is society. In the case of our particular society and its particular developmental route, this fundamental abnormality translates into a depressive population. There will be no cure for depression in the absence of breaking down all the ideological connectors to society.

A person comes into my office and says, “I feel blue, depressed; suicidal.” “Why?” “I have suffered a great loss.” “How do you know?” “How do I know I have suffered a great loss? I have lost a loved one. She’s dead. She’s gone. She’s left. That’s a great loss. What do you mean how do I know?” “I appreciate all of that pain. I appreciate that experience. I appreciate your feelings. I empathize, I sympathize. But why do you persist in identifying it as a loss?” “To me it’s a loss!” “How did it get to be a loss?” “To me it is a loss. It is my personal loss.” “It may he your personal loss, but it is after all not your personal conception of loss.” Does this deny the validity of the emotional response?-Not at all. Rather, it speaks to the organization of emotionality, which is specific to the societal definition of who we are. And it raises-going back to the issue of definition-why it is that we have to accept these definitional, categorical locations at all, and how fundamental this question is to what we call depression.

This historical approach is most powerful when a person is in crisis, whether or not you wish to categorize that as depression. There more than anywhere must we challenge the societally over-determined affective- cognitive self-understandings. In its crudest form, Crisis Normalization Short Term Therapy looks like this: A person comes in and says. “Everything just fell apart. The stock market, my family, the world, it all fell apart.” And in the loudest possible voice, one has to work up the gumption to say “How do you know? What makes you believe that? Where did that happen? What gave you that idea? What the hell are you talking about?” As a social therapist, one takes the risk of having the patient think that you are out of your mind. But the question is a profoundly important question. “How do you know that? How do you know you’re in crisis? How do you know you’re incapable? How do you know that you can’t cope?” That is not said in the form of a pat-on-the-back-“You can really do it, kid.” Maybe you can’t do it; in fact, the presumption of being in crisis therapy is that you can’t do it. But the question is: “How do you know that?” “Why do you think that way?” “Why are those your emotive responses?” You must as a social therapist directly question the organization of emotionality when someone is in crisis because if you don’t, you will be leaving her or him in the situation of potentially being permanently locked into no longer having the capacity to cope, no longer having any sense of meaning, i.e., in what we have identified as the experience of societal identity being totally demolished. And the cure for that is not to help someone relocate or adapt, but to find a new place. History is the name of that place.

I hope you are not shocked. From the vantage point of attempting to define depression, they were the least pretentious. That is, the authors (in Coyne’s anthology) at least had the decency to say that what they were doing was simply discovering what they took to be techniques for dealing with symptoms. One might not like them; I myself have some very serious questions about them. They at least admit that we should not confuse our capacity to help people with having identified the source or the cause of a problem. In one particularly insightful paper (in Coyne’s collection), it was pointed out that the effectiveness of aspirin for the simple headache should in no way be taken to imply that aspirin deficiency is the cause of headaches. I think that is an important insight not only for biomedical approaches but for all approaches. All that I have said tonight should not suggest that we have the correct definition, causal analysis, ideological location, or understanding of depression. Do not make of me a definition-monger. In fact, what I am saying is that holding to a definitional paradigm is problematic. We are not suggesting that the “aspirin of history,” if you will, is giving a causal accounting of depression. What we are contending is that we have discovered a very effective aspirin-in history-which we call the Short Term Crisis Normalization approach. Thank you.

Well. I’d do precisely as I described. So it must be that you’re saying that that’s not a proper approach for the immediacy of this crisis. All the different approaches can and need be taken. The question is not which approaches you take, it’s rather what you take these approaches to be. This has a profound impact on the direct relationship in the real world. We are trained in such a way as to call the real world the world which exists simply at the object level of direct response to the immediate presentations. But this is the illusory, not the real, world. The real world includes the historicalness which is the process by which these objectified responses are but the immediate presentation. That’s the point I’m speaking to. So yes, of course, I have met such people and I treat such patients. They come to see me and those are exactly their responses. What I am insisting upon is that whatever one’s object-level approach, without the inclusion of historicalness one is effectively leaving something of enormous significance out of the treatment.

Now what does that look like? It looks like coming to terms with the historicalness of whatever immediate approach it is that you are taking. I personally believe that the approaches should be as varied as what is helpful for a human being in pain. But I don’t think that, in the name of pragmatism, we should buy in on the institutional categories so as to leave the person permanently locked in that position. I’ve worked with many people who have gone through a process where development is rekindled by virtue of a connection to this historical process. In my opinion:, if we cannot re-stimulate growth, then we are truly limited to aspirins. So I don’t want to leave anybody with the impression that what I’m here describing is an abstraction, because it does deal with the immediacy of a situation. One must. The issue is whether you’re completely organized by the immediacy of the situation. Everything that we’re taught and trained to do socializes us to be thus organized. What I am urging is breaking out of that kind of training, not by way of giving up what is most valuable about it, but rather by using what is most valuable about it. The search for definition is an invalid search. The search for historical location is a valid search. What techniques are used along the road?-All and any that are helpful. But not just treatment relative to finding some place for the person you’re relating to. No, not just giving someone a drug so we can find a spot for them. Not the activity of putting a label on somebody and putting them somewhere. No, not that.

Going beyond diagnosis to treatment, wouldn’t you say that the application of Social Therapy is to become involved actively in understanding and working on the social problems that contribute to depression and anger?

Strangely enough, I think the answer is no. In July, I gave a talk to the Congress of the Interamerican Society of Psychology in Cuba where I developed the conception of relating to the patient as a revolutionary. This means relating to someone as a human being capable of transforming her or his social environment. Whether one chooses to do so is another issue. In fact, it seems to me that it is most important to relate to someone as a revolutionary when the patient is not one. To put it candidly, I’m willing to run the risk that, if one empowers people, they will do progressive things. I have seen that when people are free from the constraints of societal definition, they do very positive, nourishing, and progressive kinds of things. Therefore, our concern is primarily to help people to become empowered and to allow their social activities to flow, as it were, from themselves. I am a very strong critic of so-called radical therapy. I think it failed: on scientific, social and cultural levels, to simply take the risk of empowerment and go from there. We have come to see that empowerment need not establish an end, because people will establish ends that are consistent with the continuation of empowerment. Empowerment feels good. Depression feels lousy. I’m ready to bank on that. People, as they are currently locked up and classified in society, are in serious trouble. They have to be helped from their state of depression into an empowered historical state. And from there, people need to be allowed to, as it were, roam free. I’ll take my chance on people in history.

I think that the natural state of the human being is powerful, not in chains. The work, then, is to help people not simply find another set of chains, or an accommodation to being in chains, or a way of painting the chains so we can pretend that they’re bracelets, but rather to come to terms with the social-historical origins of those chains. This is specific to different individuals, since we all have different histories and are imprisoned in various ways to varying degrees. These histories are critical for us to take control of. Taking control of our history has, as a precondition, not simply having a cognitive awareness of it, but restructuring or reorganizing of it. We only come to know our history by participating actively in its creation. Creating a new relationship or a new community-one that is qualitatively different, is part of creating a new history. It would be qualitatively different by being self-consciously determined, developed, built, and organized by those who participate in the process, which includes, necessarily, a constant engagement of the limiting circumstances of our current societal location. Now that’s an altogether different paradigm than adapting to a societal situation. It’s not adaptive to society-it s adaptive to history. I am not anti-adaptive. Let’s adapt to history-not to society.

Take a social problem like illiteracy. It is still the case that some people live right next door to each other and one person learns and the other person doesn’t. One could approach the issue of illiteracy, therefore, in a way which overly focuses on that kind of issue. Or one could approach the issue of illiteracy from the vantage point of the conditions which establish the mass phenomenon of illiteracy. This is what we must do vis-à-vis the issue of depression if we take depression not to be abnormal but a normal state. What I am urging here is a mass psychological approach, which has a profound influence on every individual who participates in the transformation of the conditions which produce depression, as opposed to an approach which seeks to identify the definitional causes of a particular individual’s depression.

Social Therapy purports to be a theory of human life which counts on the activity of human beings, not on the passivity of human beings. Isn’t the premise that human beings are nothing more than products of our environment antithetical to the conception of the human being as active? How is this contradiction resolved?

Let me try to answer that by talking more about depression. One of the ways we can approach depression is to try to eliminate loss. If we can do away with loss, then even by the criteria that the traditionalists have laid down, we probably can do something about depression. But most of the people who research and write about depression take both the phenomenological experience of it and the actual socio-historical phenomenon of loss as something which goes without saying. The issue then becomes figuring out what to do about how people respond to loss. But, what if we get rid of loss? What if we no longer have losses? Wouldn’t that be a breakthrough in the treatment of depression? I actually think we have a better chance of eliminating losses than we have of eliminating depression if we hold onto losses. I think that if we hold onto losses, depression simply follows.

Scientifically speaking, then, our best shot is to go after loss and forget about depression. I don’t think this has to be seen in merely grandiose terms only. Loss is something we can learn to transform in the collective activity of changing the relatively mundane totalities of our daily lives. People tend to treat losses as somehow primordial: “Losses simply happen to us!” But they don’t simply happen: the concept and phenomenon of loss is particularized to a specific societal organization of human life. Can we do something about that? What would it take to change the whole societal arrangement? It probably falls outside the scope of the Social Therapy group! But it doesn’t follow that you can not make those kinds of changes within the limited environments of totalities that we relate to in our everyday lives. So it’s important that you don’t take what I’m saying as “we have to change the whole world and then people won’t he depressed anymore.” What I’m saying is that there is a methodology for the transformation of environmental and social totalities of a very mundane variety.

Why do you have to lose something? When you say it’s natural, are you suggesting that in all cultures-past, present, and future-people have the same reaction to, for example, the ending of a relationship? Is that what “natural” implies?

As a matter of fact, the ways in which people respond to relationships ending vary enormously from culture to culture.

There are cultures where people relate to endings of relationships as relatively natural parts of the life process. Some peoples relate to death, for example, very differently than we do. There are differences within our own culture, although to be sure, there is much overlap. But I’m trying to engage the issue of your insistence that it is a natural phenomenon rather than a socially determined one. It is not an integral part of the human being that we have to have the particular experience that you are identifying as loss. It is not natural at all. On the other hand, I’m not saying that it is unnatural, meaning that there is something wrong with it. We are, after all, products of the social conditioning of our culture, so we do, in fact, have these kinds of experience. They are deeply ingrained and profoundly reinforced, so much so that it is quite understandable that you would react to how I’m talking about loss by saying. “This is crazy! The feeling of loss is natural!” But if we pursue this a bit, we begin to see that it is not so much natural as it is, in a complex way, social. There are conditions which lead us to organize our environments in certain ways. So certainly the experience of deprivation is going to be one kind of experience in a society which is undersupplied and a different kind of experience in a society which is not undersupplied. Deprivation means very different things for different people in our culture, people of different classes, different ethnicities, etc. But again, I must add that I’m not even talking about broad socio-cultural changes to eliminate loss I actually think that people can learn to have a different experience of loss within the relatively narrow set of environments that we engage on a day to day basis. But to do so involves learning how to transform totalities. That is, the key activity that is the activity that we are free to do as human beings.

But to give a truly adequate answer to your question involves spelling out a whole new social therapeutic approach to depression. Since we don’t have time and I don’t have it totally clear, I can just begin to lay out some of the initial thinking. Why do I say that losses are bound to society more than to history? It is because I think that the social experience of life in history is not the experience of the alienated object which is subjective loss, but of the social process of which the object is but a description of one of its stages. Part of what it means to be in history is to experience the chair not as a commodified object, a product totally isolated from the social-productive process which led to it, but rather to experience the social-productive process. The name that we give to this relatively stable moment of its existence is CHAIR. But it is possible that there are cultures, not just futuristic cultures but past cultures, where the immediacy of the productive process leads to a totally different view of the world such that what is viewed is not alienated and separated-out objects, products or commodities rather, the viewed experience is social process. When the ontology of perception, i.e., what you view and experience, is social process, then the concept of loss is altogether different. In fact, it is not at all clear to me that under those circumstances loss has any meaning. Because what you actually wind up viewing is the transformation of the complex interweave of social process.

The notion of loss is very much tied to the development of commodified societies. Loss is fundamentally, in my opinion, an economic term. Does it have emotive meaning? Of course it does, because terms which are fundamentally economic come to have meaning in all areas of life. But this concept of loss is basically the elimination, destruction, obliteration of what is already the alienated product of the social process of development, production. Our world is filled with these alienated objects called commodities. Commodities behave in strange ways. For example, they can disappear. They can go out of existence in a way that social processes can’t. Social processes continue. Commodities go out of existence (which is rather convenient for those who produce them). Part of what we do in the Short Term Crisis Normalization model is, as it were, to get people out of their role-determined location in society and move them (modestly, to be sure) into history so as to elongate their sense of social process so they are not overwhelmed by the wrenching of the gestalt of their life, this gigantic element, this loss. This rupture is profound when your view of the world is of a framed object-you rip that out and it is exceedingly difficult to see the world. We attempt to deal not merely with the missing object-e.g., by trying to replace it (even though it is irreplaceable) or pretending that what happened didn’t happen-but with the frame of the picture. The primary focus is to break down that frame, because until you bust open that frame, the experience of deprivation will be so overwhelming, the sense of loss so great, that people can remain paralyzed in crisis. This positive process of opening up-rather than staying confined within-that frame, is an example of dealing with totalities rather than dealing with elements.

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