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Darkness Visible: A Memoir of Madness
By William Styron. Vintage Books, 1991, 84 pages, $10.00.
Depression and suicide are mysteries to many people. Those who have neither experienced the pain and anguish nor been the passive receiver of someone with these feelings and thoughts may have difficulty comprehending and empathizing with someone who has. In addition, those who are experiencing the feelings and thoughts that accompany these states of being may have difficulty understanding what and why these feelings are. Supplementary to verbalizing the criteria of depression and how it may lead to suicidal thoughts, intent, or plans, reading about a person’s experience with major depressive disorder and their suicidal thoughts may increase the awareness and understanding of such an illness.
Darkness Visible, by William Styron, is just this kind of book, an autobiography of the experience of major depressive disorder. This short novel could be a helpful supplement to psychotherapy for numerous individuals, particularly someone experiencing depression or an individual that has a loved one suffering from depression. Although the symptoms of depression may vary, certain unvarying characteristics are presented in Styron’s novel.
Styron’s vivid portrayal of major depressive disorder explains the realistic and excruciating physical and mental pain of the illness taking over his body. He depicts the lack of a moment’s comfort from the ceaseless pain that refuses to lessen, and emphasizes the feelings of hopelessness as the touchstone that crushes the soul. These explicit details may unnerve the reader, but also help them feel the relentless pain of the illness. This intense, yet accurate depiction of depression can help label the often-unfamiliar feelings a depressed individual experiences. In addition, it may help others understand the lack of control experienced by individuals with this illness, removing the belief that the sick individual is being “willful.” Styron points out that ignorance of such an illness “demonstrates the outsider’s inability to grasp the essence of the illness” (p. 26).
In addition, this short novel could be very useful for individuals who have lost a loved one to suicide. Styron describes suicide as an action done to rid oneself of the pain of the illness. In understanding this, survivors may be able to come to terms with their loved one’s decisions without undermining their character, as well as realizing that it was out of their control. This understanding could be crucial to beginning the path of healing for survivors.
However, Styron’s book may not be useful for all individuals in one of the above circumstances. It is crucial to take into account Styron’s age of onset of depression, 60 years of age. This could cause an obstacle of relating for some, as the milestones occurring in his life vary drastically from those of an 18-year-old or even 40-year-old who may be experiencing similar feelings and thoughts. Therefore, it is evident that all issues that may be relevant to the individual reading the book may not be addressed as well as some that may not pertain to the individual. Additionally, Styron’s past addictions to alcohol and painkillers as well as the early loss of his mother are key factors that may have impacted his depression and suicidal thoughts. It is important to note that not all onsets occur as his did. In addition to environmental factors, depression can occur due to chemical and genetic etiologies. Furthermore, this novel may produce feelings of anger in survivors of suicide, regarding depression as an excuse and suicide as an easy way out. Finally, Styron’s book is written at a level in which an individual may need average or above average intellectual capability to comprehend and benefit from it. Therefore, psychotherapists should be cognizant of their client’s intellectual capability before recommending this book.
One possible danger of recommending this book to an individual with depression is the risk of the client not finishing the book. The initial six chapters discuss in depth suicides of numerous individuals who had major depressive illness, as well as describing Styron’s experience. If an individual did not read further the outcome would appear bleak and irresolvable. These chapters could be the deciding factor for an individual to carry out any suicidal intent or plan they may have already had. It is crucial that the individual is closely monitored in their reading and discussion of the book takes place each session, as well as encouragement to continue reading. It may be a good idea for the therapist to read or discuss, in greater depth, the remaining chapters during therapy, once the individual has finished. The therapist should make it a priority to be sure the client clearly understands the main theme; that if one can “survive the storm...to the eventual passing...one finds peace” ( p. 73).
Other issues that should be addressed in psychotherapy include current views of psychotherapy, effectiveness of current treatment, and the risk of not overcoming the illness. Styron discusses his psychotherapist’s advice to avoid hospitalization if possible due to the stigma attached to it. Today, hospitalization is often considered crucial and helpful for individuals with severe depression and suicidal thoughts. Most psychotherapists would most likely recommend it if the illness and suicidal thoughts are so severe that psychotherapy alone is not reassuring enough that the client is safe in an unsupervised living situation. In addition, psychopharmacology is often recommended as a sole treatment as well as in conjunction with cognitive therapy, both of which have proven effective for numerous cases of depression, without resorting to electroconvulsive therapy. However, a word of caution should be given regarding the variety of effects, or lack thereof, for different treatments on each individual and it should be noted that Styron makes no mention of other therapeutic approaches, such as humanistic or behavioral, that may benefit some individuals. Finally, although many people are saved from the illness it is important to be honest about the reality of the risk of suicide. Psychotherapists should not overlook this grave possibility, reinforcing the use of contracts with clients who present questions in the therapist’s mind that there is a risk of suicide.
Styron’s novel has many strengths that are important to note. The continual intensity and realness portrayed engages the reader immediately while revealing the pain and truth behind the illness, thus, giving this novel power to help numerous individuals understand depression. In addition, Styron emphasizes the importance of the dissipation of the illness and installation of hope that psychotherapy can offer. He offers words of encouragement for cognitive therapy as well as hospitalization, for those that require it. Finally, Styron emphatically proclaims that if depression had no termination then suicide would be the answer, however it is conquerable, proven by the many that have recovered from the disease.
Overall, Styron’s novel is a very good source of reference for addressing depression and suicide. Recommending this to a client should be done so with caution, but may benefit the individual in ways that psychotherapy alone cannot.