Lena is a 27-year-old woman of Asian descent who has struggled with depression for the entirety of her life. Depression has been a constant presence for Lena and it has affected many areas of her daily functioning, including her capacity to maintain intimate friendships, romantic relationships, and a working career. In addition, she has struggled with issues of low self-esteem, feelings of shame, guilt, worthlessness, alienation, and alcohol abuse in an effort to cope with these feelings.
During the interview, Lena was able to express her feelings quite well. However, there was a palpable sense of tension in the room, as if she shared her story with great difficulty. The narration of her experiences seemed to be extremely emotionally taxing on her, and I was keenly aware of my own protective feelings toward her. I sensed in Lena an immense amount of pain as she began to slowly weave a narrative of her life. With many pauses, sighs, and labored exhalations, she revealed layers of her story. All the while, I was concerned about going too far, pushing too deep, and overwhelming Lena with the too-muchness of it all. My questions were tentative, as in: “Do you
think you would be comfortable telling me about_?” or “Would you
be willing to share a little more about ________?” I found myself making
many more empathic statements than I had in previous interviews regarding the difficulty of her experience, both in terms of the life circumstances Lena described and her experience in the room with me. At one point early on, I explicitly reminded her that if she wanted to stop at any time, it was perfectly acceptable for her to do so.
At the core of Lena’s depression is an overwhelming sense of subjective darkness that engulfs her capacity to make meaning of her experiences. One of the most significant causes of this difficulty is a profound sense of loss that is the result of a failure to develop close social bonds with another person who could reflect and validate Lena’s existence. Misrecognition, invalidation, and negation have been prevalent forces in Lena’s life, thereby making it even more difficult for her to articulate and symbolize her experiences. Lena believes that the origins of her anguish can be directly linked to her early childhood experiences of loss and ongoing interpersonal conflict within her family. As we spoke, I got the impression that each member in Lena’s family was battling his or her own individual demons, and that each was unable to disengage from this inner torment in order to heal themselves or support one another. It sounded as if the only means of co-existing between members of her family were hostile, negating, or completely detached. As such, there was no space in which anyone could find validation of his or her pain.