How To Be Depressed by George Scialabba

Author:George Scialabba
Language: eng
Format: epub
Publisher: University of Pennsylvania Press
Published: 2020-06-14T16:00:00+00:00

* All proper names have been changed. For the sake of consistency and clarity, the formatting of certain elements has been standardized, such as dates and units of measurement. No substantive changes, however, have been made to the quoted material.

III. Conversation About Depression

CHRISTOPHER LYDON (CL): George, I’m one of those friends of yours who is fascinated by and also grateful for your disclosure of your own clinical notes, the doctors’ and professionals’ notes on your state of mind, depressed mostly, over the last 30–40 years, mainly because we all live in the neighborhood of depression, our own or somebody else’s. And talking about it does seem a constructive step. But I also wonder why you wanted to put these notes on the record, and how you read them, how you would read them as a kind of work of literature.

GEORGE SCIALABBA (GS): They’re very far from literature. And they’re hardly written or composed at all. They’re a very distinct form of writing. They’re almost a form of anti-writing. It so happens that my current therapist teaches a course in how to write treatment notes. As we talked about this project of mine, she mentioned that, over the course of her career, 30 or 40 years, the note-writing process has changed drastically. It used to be a freer form, more candid and unhitched, uninhibited. Over time, as medical liability has become more of a concern and as the whole society has become more litigious, doctors have become self-protective, understandably, in a way. They’ve shifted and limited the focus, not to express what may have struck them or puzzled them, not to set down something in their individual voice, just because that’s an aspect of being human and being in contact with humans, but rather simply to give future clinicians, and in particular, emergency-room clinicians, something to work with if a crisis happens. The notes have become much more narrowly defined in their purpose and more guarded.

CL: There’s too much diagnostic lingo-bingo. I mean “severe endogenous depression, super-imposed on a schizoid personality.” What did the man say? How did he look? What human connection was made? Not to mention, all this incredible list of pills you’ve taken over the years, yet nobody at the core of this record seems to know what’s working, if anything’s working. Is anything better than a placebo? It’s all a kind of fantasy. This is a story without a plot, without characters, without hope, in a way.

GS: One of the things I have learned in recent years is that the definition of everything, including success in treatment, has been conditioned by the requirements of insurance companies and hospital administrators—the business side of the profession. In order to get paid for service, you need to be able to show the people who are shelling out that it works. And they demand quantitative measures, the equivalent of the corporation’s quarterly report. How do you quantify a long conversation in which a patient gradually sees the outlines of his or

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.