Abstract

In lieu of an abstract, here is a brief excerpt of the content:A Painful Lack of ConnectionChristopher Bailey (bio)Keywordsdepression, detachment (as a defense), empathy, evolution, masculinityI greatly appreciate the incredibly thoughtful responses to my clinical anecdote, “A Painful Lack of Wounds.” There is, in some more than others, a peculiar aura of detachment that, for me, evokes the very abyss (and its lack of an opposing force) that Colin and I found ourselves staring into that day. I realize, of course, that some level of detachment is necessary to allow airspace for intellectual arrivals and departures.Detachment, moreover, is a form of emotional and psychological escape. In contrast with physical escape, detachment makes something that is present seem absent and, in that regard, is more like camouflage than flight. In some of the responses, therefore, I find myself tuning out the intellectual labyrinth and tuning in to how well it obscures its creator. What wounds or weaknesses, I wonder, is the author trying to hide? Insulin-dependent diabetes? An inferiority complex? Cannot climb chain-link fences? Is he or she hiding these problems from him- or herself? Or just the rest of us?This drive to connect, to regain the biological and the personal, was the ultimate point of my anecdote. I am not suggesting that human beings are biologically built for warfare or that all forms of pathology, at one time, must have conferred some evolutionary advantage. But as omnivorous, social primates, we are definitely adapted for engagement (of all varieties).Certainly, we need to avoid overidentification or sweepingly premature conclusions. Still, no doctor would deny his or her nostrils if cued by a foul, fetid odor to examine a patient for bed sores or gangrene. Likewise, we cannot in our clinical efforts recoil from the same instincts for sniffing out pathology that once made us successful predators. To paraphrase Jeffrey Masson and Susan McCarthy, the authors of When Elephants Weep, when one feels, from observing a bear, that the bear is sad, chances are the bear is sad. To call this anthropomorphizing is a much less parsimonious explanation than the possibility that evolutionary cousins can accurately read one another. And if inter-mammalian empathy is not too much of a stretch, we can probably trust what we feel from an animal of our own species.Granted, it is a long way from feeling to formulation. I chose to write about Colin because he expressed a kind of craving I am finding in a lot of men these days. I do not doubt that cultural pressure, heaped on personal issues and genetic prerogatives, can push a man to place heroism at the center of his psychic universe. Nonetheless, I find it odd that ostensibly comprehensive formulations, like the biopsychosocial model, fail to acknowledge the greater ecosystem in which we dwell. The wheelchair-accessible communities we have created to detach from natural selection are [End Page 249] the same frictionless planes on which masculinity, like a grotesque evolutionary artifact, tends to stumble nowadays.In short, were we not so dependent on the very things we call progress, had we not atrophied from a well-adapted ape to one that can die of hypothermia in 50° weather, I doubt if Colin's insecurity (or anyone's) would be so great. Not that I did not challenge Colin on aspects of his self-doubt. But I did not see it as “inappropriate” either. And although I agree a sense of helplessness can be both cause and effect of depression, his self-doubt, to me, was more than just a “cognitive error” unconsciously conceived as cover for a dark mood. Nondepressed people, after all, score higher than their depressed counterparts on measures of self-deception. The same false sense of security that we, as a culture, have coasted on for decades was shattered for Colin in Iraq. And I believe that is a good thing.Related ArticlesFeature Article: Clinical Anecdotes: A Painful Lack of WoundsCommentary: The Nature of Proof in PsychiatryCommentary: Truth and Healing a Veteran's DepressionCommentary: Inappropriate RegretCommentary: The Cultural Context of Post-traumatic Stress DisorderCommentary: Explication or Explanation?Commentary: The Importance of What Psychiatrists Care AboutCommentary: Mourning or MelancholiaResponse: A...