Citation

Müller C. Schweiz Arch. Neurol. Psychiatr. 2005; 156(3): 118-121.

Copyright

(Copyright © 2005, Zeitschriften)

DOI

10.4414/sanp.2005.01589

PMID

unavailable

Abstract

Despair is something very human, or even specifically human. We can observe animals mourning, but they are lacking the insight that the pain is inescapable. Despair is not only the business of psychiatrists but also of philosophers and theologians. Despair is a state, not a diagnosis like melancholy or depression. Theologians made these fine differentiations: accedia, tristitia and desperatio. As depression is not mourning and is also something else than despair. Despair is more vivacious than mourning or bitterness because there is also a rage that one's hope is destroyed. The philosopher Kierkegaard again and again dealt with the term despair. He even stated that human beings cannot not be desperate and it is a misfortune if someone has never been desperate. Despair is experienced differently through the different phases of life. There are also different causes. A crying baby who is hungry can at first sight be perceived as being desperate. There is a lack of hopelessness though. A toddler, however, who has lost his mother on a shopping tour can feel very hopeless. Adolescents can truly feel hopeless and desperate. They can shed bitter tears making the experience that they are not being understood. This abysmal feeling of not being understood or that someone does not want to understand often happens in that phase of life. In adult life other situations are typical for despair, especially when harm can be foreseen and how it could be prevented but it is impossible to translate it into action. The older we are the more likely are irretrievable losses, e.g. losses of beloved ones. At old age the own force decreases and the number of the losses increases. These "narcissistic offences" lead to a higher suicide rate among elderly people. This kind of hopelessness can be seen as despair but also as resignation or capitulation. Positive resignation and renunciation make it possible for elderly people to meet the inescapable experiences of loss. Working with depressive people means to look for the reasons of their despair, but also to feel desperate when there seems to be no way to help them. Every attempt to help the patient bounces off - because he insists on his hallucinations or she on her suicide ideas. The patient is blocking everything until the therapist also gets hopeless and sees no way out. Only when the patient feels the deep hopelessness and the true interest of his psychiatrist can he enter into a therapeutic alliance. Many strange ways in the history of psychiatry may be attempts of desperate psychiatrists to deal with the despair of their patients.

Language: de

Keywords

suicide; aged; adolescence; depression; Despair; pain; philosophy; review; mourning; psychiatrist; life event; melancholia; doctor patient relation; theology; narcissism; crying; baby; Phases of life