]14

Poster Summaries
HELPLESSNESS IN DEPRESSION: THE UNBEARABLE
RIDDLE OF THE OTHER
Stijn Vanheule (Ghent University. Belgium) and
Stuart T. Hauser (Judge Baker Children's Center)
From early on in his thinking, Sigmund Freud was attentive to the
issue of helplessness in psychic functioning. Whereas Freud linked
helplessness primarily to the affect of anxiety, later theoreticians like
Edward Bibring conceptualized it as linked to depressive affects. The
idea that helplessness is connected to depression is now well estab-
lished in both psychiatry and psychology. Within a contemporary
clinical psychoanalytic perspective, too, helplessness continues to be
an important topic.
The framework in psychiatry and psychology within which help-
lessness is most often studied is the learned helplessness paradigm.
Based on laboratory experiments with animals in the 1960s and I 970s,
Seligman (1972) observed that animals experiencing inescapable events
such as electric shocks, which no actions can control, develop dra-
matic symptoms of helplessness (e.g., passivity and despair). This
phenomenon of "learned helplessness" has since then served as a para-
digmatic model for studying human depression. Psychologists have
elaborated the original learned helplessness model, which explicitly
referred to psychoanalytic thinking, in a cognitive direction. The focus
shifted toward the explanatory or attributional style a person uses
in dealing with negative life events. A depressogenic cognitive style, in
which negative events are interpreted internally in stable global terms,
was considered an essential mediating variable for the development of
depression. Recently, critical voices have pointed out the limitations
of this dominant paradigm.
We studied helplessness using a different approach, that of narra-
tive inquiry. We start, then, from a most interesting branch of research
in current psychology, one unknown to many psychiatrists and clinical
psychologists.
Narrative inquiry addresses the particular ways in which people
use language and narratives in creating and elaborating their mental
realities. A basic assumption is that people construct representations
of the world by using speech. More specifically, narrative research
assumes that language is the tool we use in building mental construc-
tions of what is going on in the "real." By incorporating language,
POSTER SUMMARIES
and by using it the way we do, we organize reality and build a body
of knowledge of how things are. In this respect, narrating is a most
important human activity. By means of discourse, humans structure
their subjective world and build frameworks organizing and expres-
sing their understanding of aspects of reality. In this way, we attempt
to make sense of our experiences and attribute meaning to what we
call reality. Narrative inquiry considers the inner logic of how people
narrate on this reality, or on aspects of it. Narrative inquiry maps
aspects of reality as they are perceived and interpreted from the
perspective of the narrating subject. Noteworthy is the implication
that narrative analyses do not examine the extent to which narratives
adequately represent an outside "objective reality," or their conse-
quent degree of correctness. People's subjective use of narratives is
what this research focuses on.
The study we report here addresses how a specific group of
adolescents narrated their experiences of helplessness. By studying
transcripts of semistructured clinical interviews of an hour or two with
psychiatrically hospitalized youngsters, we map the logic of youngsters'
explanations as they talk about experiences of helplessness, and exam-
ine how they embed their helplessness in broader story lines. We
studied interview data from forty youngsters, all hospitalized in a psy-
chiatric inpatient unit at the time of the interviews. These youngsters
were admitted to the hospital for serious (and often multiple) suicide
attempts, school failure, andlor chronic escalating difficulties within
their families. The research question we explored is, Can repetitive
patterns or types of narrative construction be found in patients' accounts
of experienced helplessness?
In analyzing the data we first read the transcripts, systematically
identifying specific accounts of helplessness. In identifying help-
lessness accounts we took into account two criteria: (1) the protag-
onist (the "I" referred to by the narrator) presents him- or herself
as being or having been in a situation in which he or she does
not grasp what is going on, or does not know how to manage the
situation; (2) the protagonist gives accounts of overwhelming and
upsetting affects offering evidence of mild to severe despair or embar-
rassment. Applying this definition we located all episodes in the
interviews in which helplessness is expressed. Following is an illus-
trative example of an interview segment that we consider indicative
of helplessness.
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Poster Summaries
I couldn't concentrate on anything; I couldn't read anything, , , . I would
end up getting so bored (component 2) that when I tried to do anything
I couldn't force myself to do anything I'd just be really bored ....
I was just really, really unhappy (component 2) .... I sort of wondered
why things weren't going right but I couldn't come up with any answers
(component 1) .... the logic gets sort of pushed aside and your emotions
take over.
In the second stage of our analyses we located and highlighted the
broader narrative contexts or episodes in which the helplessness
accounts are embedded. In a third and last stage, we systematically
studied all broader episodes, guided by the goal of gaining insight about
the ways in which each particular account was represented.
In the 40 interviews, we detected 26 accounts of helplessness located
in the stories given by 12 adolescents. As we studied the narrative lines
that adolescents built around their accounts of helplessness, we dis-
cerned three types of narrative composition, which we characterize as
three different story lines.
In our poster we discuss only the most dominant of these construc-
tions. In this story line the protagonist links an experience of helpless-
ness to disturbing encounters with others. Four sequences have been
discerned in this narrative composition (see Table 1).
Table 1. Sequential steps implied in Type 1 narrative construction
around accounts of helplessness
Step 1:
Step 2:
Step 3:
Step 4:
Interaction with a significant other.
Significant other engages in an unexpected action.
Effort of understanding the other's action. Conclusion: an
unspoken law has been transgressed / no stable law can
be attributed to the other.
Confrontation with a riddle at the level of the other's
intentions: he/she appears to be threatening.
First of all, an interaction takes place with someone the protagonist
considers a significant figure-someone who is trusted and in whom
one believes. Second, the significant other engages in an unexpected
action. It is as if there is a short circuit in the relationship between the
other and the protagonist, which causes tension in the latter. In a third
step, an effort of understanding the other's action takes place. However,
the action does not at all fit with the protagonist's ideas on how the
other should be, and thus leads to outrage. The protagonist either con-
cludes that an unspoken law has been transgressed, or that no stable law
can be attributed to the other's behavior. In the fourth and last step, the
POSTER SUMMARIES
protagonist expresses ideas about the nature of the other. The protago-
nist feels confronted by a riddle or enigma at the level of the other's
intentions. It is no longer obvious to the protagonist that the other has
good intentions. He or she now appears to be threatening.
An example of this type of narrative construction around experi-
ences of helplessness can be found in the interview with Billy (ficti-
tious name), a youngster troubled by the divorce of his parents (step I):
"My mother and father got divorced and I, like it was, I was in the
middle." What he defines as disrupting is not the divorce as such, but
the particular way in which his parents involved him in their troubles.
"My mother or father they'd tell me something, about what was
going on and everything" (step 2). The way in which they shared
details of their conflict is painful and intolerable to him (step 3): "It
was hard on me .... I don't want to have them telling me what's going
on and on, I know it's, being divorced they don't get along, but they
don't, like say, if my mother calls up I don't want my father to say,
well, she was complaining about this or that, or my mother, if my father
calls or something like that." Billy narrates that he was particularly
disgusted by the idea that he ought to decide issues his parents couldn't
decide, but that were in fact their responsibility (step 3). "I was
supposed to make a choice between living between my mother or
my father. I couldn't." After narrating the intolerable responsibility
he says he is burdened with, Billy describes his father as intrusive
(step 4): "It just seemed like he was getting on my back. I thought it
was like picking on me."
This fourfold structure of narrative explanation could be discerned
in the accounts of eleven participants. In total we observed it fourteen
times in its complete version, and six times in a shortened version.
We conclude that in this dominant narrative construction a disturb-
ing confrontation with another is pivotal: the other's intentions are
obscure; the protagonist is frightened; but he or she does not know what
to do. The protagonist's helplessness arises as a direct effect of not
knowing how to manage the "unbearable riddle" in the midst of the
other's intentions.
This result implies that therapeutic interventions with respect to
helplessness should not focus solely on mental states, cognitive or
affective. The function and the role of helplessness in the relationship
with the other should especially be explored. An implication for future
research is that types of narrative construction should be explored,
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Poster Summaries
refined, and validated with different populations, psychiatric and other
(e.g., school dropouts, delinquents).
REFERENCE
SELIGMAN, M.E.P. (1972). Learned helplessness. Annual Review of Medicine
23:407-412.
Stijn Vanheufe
Ghent University
Department of Psychoanalysis and Clinical Counseling
H.DunanUaan 2
8-9000 Ghent
8ELGIUM
E ~ m a i l [email protected]