Читать книгу Understanding the Depressions - Wyn Bramley - Страница 6

The Human Onion

Think of a human being as an onion. There’s a sturdy outer covering and vulnerable layers within. Not very poetic I know, but the analogy suits, because the human being and the onion are structured in a similar way. Should you peel back the “face” that a person shows to the world you will find layer upon layer of complex individual qualities behind it, be they deeply hidden or open for inspection, that have resulted from their unique life experience. Like the onion, each of those layers has an interconnected growth history. Possibilities still exist for them to grow, remain static or fade away. Let me now try to guide us through the main layers. Of necessity the diagram is two dimensional but try to keep in mind a real, spherical onion.

Genes

We will start at the densely wrapped centre. There’s not much that will yield to pressure or that will expand or shrink, in the way other layers can. This core is analogous to your set of genes. Long before your brain has even finished forming, before you have anything remotely akin to a personality, your ancestors have bequeathed to you in the form of your genes a bag of both potential and definite characteristics. Some can’t be changed – eye colour, left handedness, fingerprints. In the diagram these are represented by the blocked out centre.

You also inherit predispositions as well as certainties. For instance, a tendency toward anxiety, aggression, optimism or pessimism may lie within your genes, but it doesn’t necessarily morph into mental illness. It all depends on whether life’s vicissitudes draw out and reinforce the tendency or minimise the need to manifest it. These potentials surrounding the core are drawn as broken lines, just as in a real onion the deep embryonic shoots encasing the core can develop over time into a recognisable functioning layer or remain stunted, depending on growing conditions within and without the plant.

Upbringing 1

The nature/nurture debate

Having started at the centre of the diagram, we now work outwards, coming next to the huge area inside you that encompasses your upbringing; or rather, what you made of how you were brought up. For you participated in that process, had to somehow grow an identity out of it. You had to discover or decide who you were, how you were going to operate successfully within the universe of your family. You had to work out, albeit without consciously articulating it, whether and how to compete, share, declare a need, attack or defend yourself; whether and when your relationship with others in your home was best cultivated and enjoyed, and when it might be better avoided. Was your family experienced as safe and dependable or too emotionally threatening? Did it feel too close or too distant? Against this context, how difficult or easy did it feel to take pride in your strengths and achievements, or did you decide to hide or even reject them? Did you express your interests and pleasures or did you have to defend them against perceived saboteurs? All this work, your work, shaped your unique personality. It wasn’t dropped into your head ready formed.

So far, no one has been able to accurately calculate what proportions of family and genetic influence go to make up both the mentally healthy and unhealthy person, though clinical experience places enormous weight on how a child interacts with its carers. Here’s an example. Someone brought up in a violent household becomes violent too. Grandma on one side of the family is violent as well, but Granddad on the other is pious and withdrawn. Our violent person’s equally abused brother or sister turns out to be gentle as the proverbial dove. How much is genes and how much upbringing? Were brother and sister’s differing temperaments already sealed in by their genetic endowment, each having inherited different bits from the gene pool? Or were they fashioned from the disparate way each understood, reacted to and managed their relationships within the family? Common sense suggests there are complex combinations of Nature and Nurture operating here that can’t be judged by simple arithmetic.

We should also remember that we inherit “positive” tendencies too: curiosity, optimism, gregariousness for instance (though these can work as much against us as for us, depending on how we deploy them). Some of these qualities may offset or compensate for the “negatives”, but at birth all exist as merely potential, not actual, characteristics of the developing individual. They lie dormant. They are yet to be shaped by lived experience (upbringing) and of course the later learning/ unlearning/relearning process. Some children engage eagerly in learning about relationships whilst some are too sluggish and afraid to experiment – early conditioning or genetic predestination? Research cannot yet accurately quantify or map these determinants. We can only rely on educated guesses accrued from long clinical experience.

Upbringing 2

The consequences: relations with your Self

Your attitude to your own Self has a bearing on mood. The more you like, enjoy, feel proud of your own Self, the more your mood will hold up, whatever is occurring in your life. The more you doubt, disapprove of, are ashamed of your Self, the more readily undermined will be your mood. You can act confident, unafraid, anxiety free, but acting doesn’t make it so. If you have a pretty unfavourable secret attitude to and beliefs about your own worth and attractiveness to others, you’re clearly vulnerable when something bad happens. A job loss or ending of a relationship may confirm long held suspicions that you are a hopeless failure, that it must be your fault, and your mood collapses. Lack of self-esteem is learned, not genetic, and is a huge risk factor for many. It has to have arisen from early family “messages”, overt or unspoken, deliberate or not, sent to you and absorbed by you as a child, aided and abetted by your self-critical interpretations of them. But don’t forget that messages can to some extent be decoded and rewritten later on.

What is it then, that determines which of three people who lose their job becomes a) merely unhappy, b) little ‘d’ depressed, and c) big ‘D’ Depressed? The one who reacts with ordinary unhappiness is the one who, in the struggle we all go through to manage and learn from the early interpersonal forces around us, has grown a sense of Self that’s sturdy enough to withstand minor knocks. On being dismissed – a rather big knock – they’re disappointed, angry; they may be tearful, may shout at their partner, get drunk and maudlin, temporarily doubt their abilities. But there’s no black cloud of self-loathing, no click clunk of that seat belt trapping them in forever. They don’t hear hope scuttling away into infinity. (These descriptions are not inventions, hyperbole. They are how Depressed people really experience their temporarily disordered mood.)

The second person’s usual relations with their Self aren’t that good, due to early experiences where affirmation and encouragement were absent or where there were many separations from the family. They try to bolster their wavering self-esteem by being competent and dependable at work. Outward reassurance of their worth makes up for the lack of it inside. If that individual’s personality is also genetically loaded with a proneness to low mood and then they are sacked, it’s likely they’ll become small ‘d’ depressed.

If our third person is also self-doubting and under confident, whilst being genetically subject to big ‘D’ from time to time, this job loss risks triggering another period of their illness. We still don’t know to what degree, if any, a secure childhood reduces the likelihood of relapse or recurrence in big ‘D’ depression.

We may not be able to alter our genes, but quality therapy can certainly help with issues of poor or negative regard for our Self, thereby increasing our resilience to Depression. There are no fast fixes in this area, despite many false assurances to the contrary. Tracing your own development, looking through a more adult and compassionate lens at those early formative years, can be as painful as it is illuminating. But for many, such a demanding project proves healing and mood-lifting in the end. Many derive emotional nourishment from their counselling encounter, of a quality rarely if ever received as a child, providing a miniature model of what good relationships outside the counselling room could be. As hope walks in, low mood walks out, though there may still be much work to do.

The Memory Store

Progressing outward from the deep core of our onion, through the area of upbringing, we next come to the memory store. As we have seen, our temperament has some genetic basis though the experts aren’t sure yet to what degree. This is over-layered by the effects upon us of all those early relationships in the family (or other unit) that drew out, inhibited or even created a counterweight to those built-in propensities. We can’t change what happened or failed to happen. We can’t put the clock back, re-configure our very origins, though with therapeutic help we might learn to make peace with our early history. As we grew up we accumulated a rich chronicle of memories, documenting the vast amount of day to day interactions between ourself and our early attachment figures. Many of those memories and the feelings associated with them faded, whilst others were laid to rest yet refused to disappear completely. As we shall see, some were deeply buried, but proved capable of resurrection given auspicious circumstances.

Also recorded in our memory store are subsequent influential relationships with teachers, relatives, club leaders, tutors, and of course lovers and close friends. These newer figures functioned as moderators, reinforcers, growth or destruction agents for the already established but still adapting Self. Our emotional ties with these significant people profoundly affected the way we perceived and evaluated that Self, allowing it to further develop, repair old wounds even, or in sad cases to shrink into the shadows.

Though genes may impose some limitations, it’s relations with others, good and bad, past and present, that determine whether or not we are in good odour with our Self, and hence how vulnerable we might be to mood imbalance. Because we are a living organism, our capabilities are always available for expansion or fine-tuning as well as injury and deterioration. Thus our relational abilities – to ourselves and to others – have a future as well as a past and the one does not have to repeat the other. This hopeful belief is what brings many into counselling, or into becoming counsellors themselves.

We are usually too busy or too wary to wander about the memory store, but its contents can unexpectedly jump out at us, more than once and in completely different settings. In thinking about memory in relation to the Depressions, I’m not referring to nostalgia, reminiscences, photo album memories, to be taken out and enjoyed. Rather do I mean scraps of long forgotten conversations, barely registered at the time. Or they could be complete mini-dramas suddenly recalled as they are eerily repeated in the present. A musical refrain from a distant radio might flood the unprepared mind with the memory of an entire relationship; not so much actual events as the conflicting, unresolved feelings linked to that attachment. A cupboard in a friend’s kitchen unaccountably disturbs, till one day the wood grain is recognised as similar to a father’s coffin twenty years ago. This then is a secret store, the memories not normally sought, or even retrievable, though in therapy some are more retrievable than others. Many memories are themselves beyond recall but the pain, anxiety or sensitivity connected to them remain in that store, and are provoked once more in certain present circumstances, as I show below.

Which comes first? Does heavy mood pile up outside the door of the memory store, eventually so weakening it that memories leak out? Or are those memories so powerful that they fight against their confines and erupt into awareness given the least opportunity, so precipitating low mood? For if memories have been put to sleep, locked away, surely they must be upsetting ones, capable of wounding the Self? As with the nature versus nurture debate we can’t know for sure; we can only make educated guesses on a case by case basis. Here is an example from my own life. Did the lingering effects of my past, safely stored away for decades, determine the way I handled the present moment, or did the current situation so re-enact the past that my memory store’s security was abruptly breached? Either way, a short little ‘d’ depression followed.

A marital row

My partner called into the pub for “a quick drink” after a tough day at work, there to bump into two old mates. He returned home hours later, just as I was considering phoning the hospitals. Not being a self-pitying cry-baby, I turned my hurt feelings into rightful indignation and yelled at him for being so selfish and unfeeling. He hadn’t even let me know he was delayed. A trifle worse for wear and looking tired, he ignored my tirade and settled himself on the sofa. I was not going to get an apology. I went for him again: “Stop ignoring me! Honestly, you’re heartless. I could be lying unconscious and bleeding on the pavement and you’d just step over me!” He looked up wearily, reached for the remote, clicked, and said “Don’t be such a bloody drama queen”. I was taken a-back, felt he’d switched me off as he switched the TV on. I was overcome with such sudden and extreme distress I feared physical collapse and staggered up to bed.

For the next few days I carried on as usual, but no matter how I tried I couldn’t rid myself of an all-pervasive black mood. It felt as if the earth’s atmosphere was being pressed down by a pall of ever thickening soot, no light or movement anywhere. I had to push myself to do anything, had to drag myself out of bed in the mornings. If this was some reaction to the row, it was totally out of proportion, and anyway we had by now talked all that through. What on earth was happening to me?

Then one night I was jolted awake, presumably by some dream. There was a little girl, still as a statue, staring out of our bedroom window bathed in brilliant, unnatural light. I shook my head – a momentary hallucination – before it, she, vanished. With the ease and practice of long habit, I fell to free associating (letting one thought and emotion drift around and eventually link itself to another). I was finally able to piece together what it was that had escaped my memory store to overwhelm me at the end of that row.

I began with the child at the window. Could she be me? She looked about five or six, pigtails. I had pigtails. The light, what about that strange light . . . ?

As a child I was extremely curious about and sensitive to the world about me, the physical as much as the interpersonal. I had intense emotional reactions to animals, people, nature. Ideas in themselves fascinated me; where did they come from? I asked endless questions which no one seemed able to answer. Everyone decided I was “highly strung” and I was teased about it frequently. I felt a freak, but if it kept them happy. . .

Around five or six years old, I woke one morning to find the world a fairyland of snow and ice – the real thing, deep and crisp and even, glistening and twinkling in bright sunlight. I was entranced, spent the entire morning at the window gazing out at it. I stood very still, afraid that to move or breathe might disturb this vision of loveliness that I was encountering for the first time. Mum kept calling me away but gave up in the end.

Finally we were called to the table to eat. I tore myself from paradise, to find myself literally blind! I screamed for help while Mum fiddled with pans and plates. I screamed again: “I can’t see!” Continuing to serve up, mum said crossly “It’s just the snow. Stop being so highly strung about it.” I was terrified, had never heard of snow blindness, and assumed it was permanent. And no one seemed to care! Panic stricken, I protested but was sent to my room to lie down in the dark, purportedly to cure me, but I knew I was not believed (I was being a drama queen).

My terror in that dark room was twofold; one that I might never see again so could not survive alone, and two that my adored mother whom I trusted totally and on whom my whole life depended did not believe me. She had not calmed and comforted me: instead she’d mocked and scolded, sent me stumbling blindly to my room. I was utterly alone, cast out, and everyone thought I was just making it up. How could such things be possible? Without my mum, centre of my universe, there was no hope of rescue. The world was now as black inside as it was outside. I could only conclude that I had failed her in some monstrous way, let her down. It could not be down to her: she, the embodiment of perfection. The whole thing must be my fault for being highly strung.

It never occurred to me then that there might have been a failure of empathy on her part – or on my husband’s when the ten o’clock news proved more important than my feelings of abandonment when he was so late. Once again I was condemned for being highly strung, a drama queen. The pain was unbearable. Was I never to be forgiven?

My sight gradually recovered over the next couple of days, but my faith in my previously sainted mother, and the husbands for whom she was the template, did not. Hence my rage at the casual lateness that had started the row in the first place.

Would the acute Depression have happened had my husband been more understanding or said he was sorry for causing me distress? Was it healing of an old wound that I was looking for, not a grovelling apology, as he’d assumed? Or were my memories associated with the snow blindness – being banished, extinguished – just looking for an excuse to burst out? Was I yelling at my mother – “Understand me! Rescue me! Believe me!” – as much as at my husband? Staying late at the pub certainly provided a golden opportunity for such a re-enactment to occur.

Perhaps without knowing it I had hoped for a better outcome this time, and when I didn’t get it the old despair took over. Whichever way round it was, I could now see the join-up between present and past. Having come to an understanding of my acute little ‘d’, I gave that poor kid a great big hug before leaving her behind.

Personal History

Look at the diagram again. As year by year you grow into your teens, then young adulthood, your genetic propensities (dotted line) combine with your early formative experiences plus that acquired memory store and its effects on you, to shape what sort of decisions and relationships you are going to persevere with and which ones you will let go of. Accordingly a unique personal history accumulates. Your educational and job choices, love affairs, how you spend your money, whether and where you travel, what hobbies you adopt, will all be largely determined by those background factors. They’re not down to mere chance. You continue building up a unique history, a set of attitudes, aspirations, fears and so forth that will shape the outcome whenever you have to choose a direction, major or minor, along life’s journey.

Whilst your memory store is relegated to the past, its contents kept behind closed doors, this Personal History layer is always readily available to you (unless you suppress it). It’s a chronicle comprising your mistakes and successes; situations you ran from or faced; situations that you learned from or let hurt you, that you never want to encounter again or can’t wait to have a re-run of and do it better this time. The items in this your personal file mould your dreams of a future way of life. You will seek something already designed in your head as a result of your historical choices and reactions to events. You will draw yourself a picture of just what kind of life in the future is going to make you happy, and which kind you wish at all costs to avoid.

As a young adult, more experienced and reflective, you may recognise some uncomfortable patterns in that history. When you look back, you see how some modes of relating or behaving kept repeating, bringing about unwanted consequences, despite your feeling good about other areas of your life. Perhaps you seek help to investigate their origins. The insight so gained enables you not only to straighten out some things but also to sharpen up the picture of how you want to live and relate to others in the next period of your life, how you visualise permanence, maturity, your mid and later years. This personal history can be a treasure or a curse. It can be deployed by you as an aid to wise decision making or you can choose to just ignore it and blame external life events as the sole cause of any unpleasant situation in your current life. To make constructive use of your Personal History layer rather than letting it make use of you, requires you to be highly conscious of it. For this onion layer can be an aid or a saboteur, depending on whether it is owned and used constructively or denied and left to come back and haunt you when you least expect it.

Present Life

And so you set about designing your future settled life, and how to make it happen. If and when it does, this precious, hard won way of life needs to be actively maintained in order to protect it from being intruded into or sabotaged by any remaining “issues” from your Personal History, Memory Store or Upbringing layers. The insulation and preservation job of this layer – what in the diagram is labelled “Present Life” – is therefore represented in the diagram by a thick dividing line. This layer covers over and separates itself off from old scars or unhealed wounds, just as the real onion generates a thicker layer to protect itself from interior infection or damage. In an emergency, should the outer skin be ruptured, this layer has also to take over its vital protective operations in safely holding in the entire organism, so it has to be tough. The more turbulent your personal history the tougher this protective layer will need to be, for fear of further internal events spoiling your hard won stability – say marriage, children and job satisfaction.

The space between inner and outer skin

On the other hand, someone with a relatively untroubled background may seek something more exciting, risky even, in adult domestic life. They are more open to and interested in their past life, may even wish to continue with it. They may also long for life right outside their “onion”, seeing all the chances and choices afforded by the external environment. They have little need of rigid boundaries, feel them as prison walls. Their partner sees in all this nothing but threats to hard won happiness. Much difficulty and even episodes of Depression can arise in the home when two contrasting Personal History layers have wrought very different attitudes and expectations about coupledom, children, money and the rest. Despite long association, the pair may have been unable to come to a compromise about the thickness of that Present Life boundary. Instead of blaming one another for their differences, it might help if both parties inspected one another’s personal chronicle to enable them to understand why their partner is so recalcitrant, why one doggedly pursues a sense of security while the other hankers after more adventure, looking fearfully outward toward the barrier posed by the thickest layer of all, the outer onion skin.

The Outer Onion Skin

The outer skin of a real onion is the tough boundary between the onion’s entire interior and the outside, dangerous as well as nurturing, world. In human terms the outer skin represents the individual’s public “face”, the big chunk of them that other people first meet, oblivious to the deeper not so “tidied up” chunks inside. In both cases the “face”/skin has the responsibility for stopping any “untidy” material that will make them “look bad” from seeping out, and to prevent any external assault from the environment from breaking in and damaging vulnerable internal structures.

Let’s take an example. An otherwise contented adult is destabilised by a brother’s death. The brother had been someone with whom our subject had been in rivalry for years and whom they hated and loved in equal measure. The impact of this event from the outer world threatens to break through the outer skin of the onion, cross the Present Life and Personal History area and break into the memory store, reviving all the dormant conflicts safely locked there till now. Should the subject’s tough outside skin and the next “Present Life” layer beneath it not be robust enough to act as a buffer between the outside world and the deeper inner layers, our subject’s sense of a coherent Self is compromised and the chances of an episode of Depression or other mental health problem is increased.

Outside the onion

Our daily lives are full of pressures from every quarter. We have money worries, career demands, tricky relationships to negotiate, exams to pass, illnesses to battle with, elderly parents to care for, the question of what to get for dinner tonight, finding time to exercise. The list is endless. The pressures of themselves don’t cause the Depressions but they can weaken our resistance to it. It’s noticeable that some people appear to withstand enormous pressure and others can bear very little. Why?

You need to imagine the usual tumult going on inside the onion (fragile relations with the Self, memories threatening their return, problematic residues of childhood, unstable personal history, unhelpful genes) pushing outward, demanding expression and resolution in the external world. Simultaneous real life issues are hammering at that onion from the outside causing reactions from within. No wonder we sometimes need to grow a thicker skin!

More external pressure can be borne by the individual with strong onion layers – good current emotional attachments, a reasonably happy childhood, a relatively peaceful and secure memory store and lucky genes. Less fortunate folk appear more vulnerable to an outside observer because they’re necessarily working so hard at their inner, unresolved agendas most of the time that there’s little energy left over for handling external crises or day to day domestic ones. These remain low on their psychological “to do” list. Yet other people ignore a rumbling inner world (its origins too frightening to contemplate) so long as their present day relationships and social lives compensate for earlier deficits, deprivations and conflicts. Thus their energies are invested outside their onion or in the area between the two thick layers (The Present Life layer and the Outer Skin), in order to keep this state of affairs going. They appear more adept at dealing with the outside world, but who knows what’s going on inside that’s being so efficiently defended?

The Outer Skin and the second Present Life layer regulate the exchange of all these forces across their boundaries, in whichever direction they flow, trying to maintain sufficient equilibrium to keep the whole human onion intact, in other words mentally healthy. In a real onion the outer skin protects the inner layers from getting bruised and possibly dying, while stopping delicate internal structures that are trying to grow or heal, or infections wanting to spread, from spilling out. All living things and systems share this structure in varying degrees of complexity and we humans are no different.

It’s important not to see the concentric circles of the diagram as rigid impermeable walls. They are drawn this way solely for clarity and convenience. The contents of the spaces between the circles (see labels) flow into one another, competing or combining with each other, boosting or diminishing the effect of one another upon the “onion” as a whole. Even if you have a fairly contented life now and it seems unremarkable to you, a closer inspection of your “onion” is almost certain to reveal earlier tensions between the various forces crossing and re-crossing its layers, before that way of life got bedded in. Mira just could not see that all this onion stuff had any relevance for her.

Mira’s “boring” story

Some years ago I had a therapist friend who was rather rich and enjoyed the benefit of a live-in nanny whose multi-talented husband was the gardener and odd jobs man. The three of us women often met for coffee at my friend’s home. Mira liked to tease us, rolling her eyes and yawning ostentatiously whenever we talked about psychology and therapy. One day she challenged us. “Look here, I’m perfectly ordinary, happily married, got a nice job and lovely flat, no hang ups. All that stuff about childhood things forming you, it’s rubbish. Life is just luck, accident. I tell you what, ask me anything, go on, anything. You won’t find a single thing that influenced my journey through life. I’m psychologically the most boring but happy person you’ve ever met. My background is irrelevant to how I turned out.”

My friend, her employer and pal, picked up the gauntlet and this is what materialised.

Mira came from a big family, which she chuckled about. They were a superstitious lot, going back at least three generations. To my friend and I these family tales amounted to accounts of obsessive compulsive behaviours and they seemed rife. Aunts, uncles, cousins, all seemed affected though only one ever had a diagnosis and treatment. Learned responses or genes? These behaviours were regarded as dotty and tolerated by all, frequently joked about. Mira too found them amusing, not at all worrying. A typical story was the one about Auntie Iris who was summoned for jury duty and refused to enter the courtroom before she’d polished all the brass door knobs. As he left the court the judge was alleged to have commented approvingly on their shine!

Mira grew up with several brothers and sisters in a warm household, her parents happy together though Dad was always jittery, worrying all the time about his job running his lordship’s stables. Eventually he took early retirement and devoted himself to his garden and his own horse. Mira adored him and admitted it upset her whenever he “fussed and bothered over every detail, getting more and more wound up”. Nevertheless she felt obliged to go along with the family myth, at least outwardly, that this was just a bit of eccentricity. Like everyone else she tried to jolly him out of it. Her siblings were happy, but “fusspots” as well. Her mother was the only really calm one and she and Mira got on well.

No obsessional thoughts or behaviours (as defined by my friend and I, not Mira) troubled Mira until she reached her teens and school exams. She was bright so was encouraged (pressured?) to try for a prestigious university but she’d never felt herself to be intellectually inclined. Boyfriends and the social world into which she was pitched at the same time all conspired to stress her. Only home and family felt safe. Each time she made forays into the wider adolescent world, tried to compete, as she put it, she felt anxious and miserable and began using ritualistic (she called them “peculiar and daft”) behaviours to relieve her tension. Having subliminally learned from years of watching her dad, she must have recognised the link between the pressures of conventional achievement and her “weird” rituals, for she found herself withdrawing from all the expectations placed upon her. She preferred to live quietly, tending and riding the family horse, and baby-sitting for pocket money.

In time she took a childcare course which she loved. She didn’t date until she met her husband through her church, and they went to live in a quiet village away from the hurly burly of the market town where she grew up. All her rituals vanished.

“You see, I told you, boring story,” Mira triumphantly proclaimed.

My therapist friend would not give up. “OK, so your life has turned out nicely, just the way you wanted it, but have you asked yourself why? Given what you’ve just told us, think of the different ways your life might have gone. What if your genetic proclivity to “fussing” had been stronger, or your childrearing less loving and supportive? What if your mum hadn’t offset the model laid down by your dad? Can’t you see that your nice family provided the conditions for you to grow into someone decisive, someone with the confidence to contravene the plan laid down for you by school and your peers? You broke the mould without feeling a failure – how many people can do that? That choice says a lot about your good relationship with your Self. And that in turn is down to your folks and your capacity to make good use of them, not luck!”

Mira pulled a face and my friend, a professional lecturer as well as a therapist, pushed on.

“Think about becoming a teenager, Mira. Without being consciously aware of it at the time, you must have been affected by all those memories of your dad’s sufferings, how as a kid you couldn’t really help; but you were here for him now and needed things to stay like that. At the same time some part of you recognised your propensity for reacting to stress the same way he did, and what it had cost him. Rather than label yourself a misfit, a failure, as he had, you confidently rejected the ambitious future others expected of you. Also, of course, not leaving for university or getting married early meant you could stay with him till you were ready to go in your own time. Heavens Mira, without that positive start in your family you may have gone along with those external demands on you. You might have got depressed at losing your family long before you were ready, grieved over abandoning your lovely dad. You might have been pushed into a career and failed at it, the stress of it all making you ill with those rituals you seem to find so funny. Your contentment isn’t just happenstance: you were enabled to shape your own life and you seized the chance.”

“Codswallop!” declared Mira, all the same looking a bit shaken. I banged the table and demanded a truce. We all laughed, helping ourselves to another slice of Mira’s excellent lemon drizzle cake.

This is a clear case of Nurture winning out over Nature (assuming that the family trait was a genetic predisposition and not behaviours learned via unconscious imitation). Despite a pronounced family history, sound relationships in Mira’s home appeared to operate as an antidote. Mira’s denial of the seriousness of the family members’ symptoms helped her normalise her family’s traits so she didn’t have to worry about them until she was old enough to shape her own future and deal with them in herself; but the denial was only partial, as her self-preserving decisions about her future confirms.

Whatever you make of your childhood and the key relationships that followed, however valiantly you fought, Nature sometimes wins out anyway. You will have met people who seem mature, fulfilled, get on very well with themselves and others, show all signs of being well-adjusted, even happy. Still the axe of Depressive illness falls, sometimes repeatedly, and apparently unrelated to especial life events. They shouldn’t be blamed or blame themselves, nor subject themselves or be subjected to interminable therapy as if there is some elusive mystery to be dug up that will solve everything. This happens all too often however and only makes matters worse. Geneticists, neurobiologists and chemists are all working assiduously to relieve cases like this, but our knowledge remains patchy and inconclusive. Even if there were a mystery to be exhumed, some kinds of personality (Mira’s, for example) are fundamentally and resolutely opposed to looking inward and backwards. As the saying goes, they can be taken to the water (of therapy) but they can’t be made to drink!

Benevolent, enlightened childrearing doesn’t automatically guarantee you a Depression-free life in the future, though the odds may be weighted in your favour. Neither does a background of Depressions in the family, an unhappy childhood, and some awful memories lurking about in your store, necessarily prevent you from enjoying a happy life in the present. Indeed, strong loving attachments to others in the present can go a long way to reducing, neutralising or even countermanding negative past experiences while preventing the burgeoning of genetic leanings into Depression proper.

However, reliance on just one onion layer (say a contented present life) is risky. Should current secure ties be broken, due to divorce, say, or a loved one’s death, an extramarital affair or a business failure, then that protective Present Life layer can collapse, leaving the underlying layers exposed. If these are in a sufficiently robust condition they will hold firm and even temporarily take over the function of showing a reasonably okay “face” to the world until that layer can regenerate (till new affirming relationships are made in other words). But if a crammed memory store is now laid open, the delicacy of your relations with your Self uncovered, your questionable personal history laid bare such that all signs now point to a repetition of old mistakes, what chance is there of you staying well, especially if there are no replacement options on the horizon?

An individual’s apparent toleration of stress and misfortune is not proof of moral fibre, or even mental health. Neither is the temporary inability to bear it a sign of weakness: you can be strong and resilient on the inside and not on the outside, and vice versa. These are purely psychodynamic (literally “mind movement”) matters, as I hope this chapter has shown. All our onions have the same layers but are configured in endless combinations.