Malinconia e Suicidio I

Malinconia e suicidio I: considerazioni cliniche
Melancholy and suicide I: clinical

considerations
P. Castrogiovanni, C. Pacchierotti
Clinica Psichiatrica, Università di Siena
Parole chiave: Suicidio • Malinconia • Depressione • Psicopatologia

Key words: Suicide • Melancholy • Depression • Psychopathology
È parte integrante della storia della psichiatria l’osservazione che un tipo particolare e “misterioso”
di malattia mentale – la Melancolia – sia quasi inesorabilmente legata all’altrettanto difficilmente
comprensibile decisione di morire per suicidio. Il suicidio è un comportamento reso unitario dal
gesto, che ha finalità autolesive aventi come oggetto la vita stessa, ma tutt’altro che unitarie sono le
vie che conducono ad esso. Al suicidio possono giungere i pazienti affetti da ogni tipo di
depressione, e non soltanto di depressione, ma il “percorso” psicopatologico con cui il paziente che
presenta quel tipo particolare di depressione che è la melanconia è verosimilmente diverso da quello
per il quale giungono al suicidio altri tipi di depressioni. Rivedere la letteratura di epoca recente su
tale argomento è tuttavia molto complesso, sia perché soltanto negli attuali sistemi classificativi sono
stati codificati precisi criteri per distinguere la depressione malinconica dalle altre forme di malattia
depressiva, sia perché i numerosissimi studi condotti sul comportamento suicidario nella malattia
affettiva ci forniscono informazioni interessanti sul piano clinico, cognitivo, biologico, senza tuttavia
indagare specificatamente il sottotipo depressivo. Per tali difficoltà, è indispensabile affrontare
questo argomento partendo dalla definizione di malinconia, così come è giunta – quasi intonsa – da
Ippocrate al DSM IV (1), e dei suoi aspetti caratterizzanti, per prendere poi in esame i rapporti fra il
comportamento suicidario e quegli elementi della depressione ritenuti essere costitutivi, nucleari
della melanconia.
Definizione di malinconia
Nell’importante trattato “Della natura dell’uomo”, attribuito a Ippocrate o a suo genero Polibio e
scritto in data anteriore al 400 a.C., si ritrova una prima definizione del termine “melancolia” (= bile
nera) ed anche una ipotesi patogenetica dei disturbi dell’umore. In base alla Teoria dei quattro umori
fondamentali (sangue, bile gialla, bile nera e flegma), la salute veniva definita come un ideale
equilibrio tra macro-cosmo e micro-cosmo individuale, in cui ogni eccesso ed ogni difetto
inducevano un dismetabolismo e quindi una condizione di malattia. Individui costituzionalmente
melanconici, ma non per questo ammalati, più facilmente incorrevano in malattie di tipo depressivo
a causa, ad esempio, di un’estate troppo asciutta. La Teoria degli umori testimonia una concezione
organica della malinconia adottata anche da Platone ed Asclepiade, che è passata indenne attraverso
l’evoluzione del pensiero greco e latino (se ne trova traccia in Lucrezio, Seneca e Galeno), ed ha
influenzato la ricerca psicopatologica fino all’età moderna.
Mentre nel linguaggio comune il termine “malinconia” è spesso utilizzato come sinonimo di
tristezza, in certi contesti della nosografia psichiatrica esso ha indicato non una qualsiasi forma di
deflessione dell’umore, bensì i quadri clinici di depressione profonda, con sintomi neurovegetativi
oltre che cognitivi. Già nel I secolo d.C., per esempio, Areteo di Cappadocia distingue tra “vera”
malinconia e forme reattive, identificando la prima come caratterizzata da tristezza profonda,
disturbi del sonno e dell’appetito, idee di inguaribilità e di morte, e suggerendo per le seconde una
sorta di psicoterapia orientata a riconoscerne le cause.
Con le teorie psicodinamiche, il richiamo ad una ipotetica patogenesi conflittuale per i quadri
depressivi attenuati portò alla frammentazione della psicosi maniaco-depressiva: le gravi forme,
espansive e melanconiche, mantenevano una indiscussa unitarietà, mentre una parte dei disturbi
dell’umore veniva collocata nella vasta categoria delle “nevrosi” e delle personalità abnormi. Da
allora le “depressioni esogene”, che comprendevano le forme “reattive”, legate ad eventi di grande
significato esistenziale ed emotivo, le forme “nevrotiche”, dovute a conflittualità inconsce, e le
forme “somatogene”, determinate da fattori di natura fisica, sono state contrapposte alle “depressioni
endogene” (dette anche “vitali”, “primarie”, “somatiche”, o, appunto, “melanconiche”), in cui non
era possibile identificare fattori esterni di natura psicologica o fisica che ne avessero determinato
l’insorgenza. In quest’ultime prevalevano i sintomi neurovegetativi, i deliri olotimici, le tematiche
autolesive, la familiarità, la tendenza alla ricorrenza ed alla stagionalità, mentre nelle forme
“psicogene”, in cui mancavano i sintomi neurovegetativi, prevalevano i sintomi ansiosi, le lamentele
fisiche, la labilità emotiva, l’insonnia iniziale e la reattività dell’umore agli eventi esterni, senza
frattura nel continuum storico individuale, ma con una certa comprensibilità e derivabilità alla luce
del contesto biografico-esistenziale. Il termine “Melancolia” assumeva quindi, come del resto già in
Ippocrate, anche un’accezione etiologica, indicando un certo tipo di depressione: quella
caratterizzata da una base biologico-costituzionale. Ed a ben guardare, in tutta la psichiatria tedesca,
ed anche in Kraepelin (2) e Tellenbach (3), il termine “melancolia” è usato per descrivere la
sindrome nucleare, in cui etiopatogenesi biologico-costituzionale e quadro psicopatologico
caratteristico si fondono configurando il prototipo della depressione endogena, ben lontana da quella
“major depression” descritta negli attuali sistemi classificativi.
Questi ultimi, attraverso un taglio descrittivo ed ateoretico, hanno pian piano abbandonato la
dicotomia endogeno-reattivo, di significato etiologico, ed hanno scelto di usare delle specificazioni
esclusivamente di carattere sintomatologico anche per i sottotipi di depressione. Già il DSM-III (4)
prevedeva una serie di criteri per la diagnosi di episodio depressivo maggiore “tipo melanconico”.
Nel DSM-III-R (5), a tal proposito, sono stati aggiunti tre elementi anamnestici (assenza di Disturbi
di Personalità, pregressa remissione di Episodi Depressivi Maggiori, risposta favorevole agli
antidepressivi), a sottolineare l’utilità di mantenere distinto questo sottotipo di depressione ai fini
prognostici e terapeutici, mentre non sono più considerati indispensabili l’anedonia e la mancanza di
reattività agli stimoli positivi; sono stati infine aboliti la richiesta di “una qualità particolare di umore
depresso”, la cui specificità risultava indimostrata, e di “colpa eccessiva o ingiustificata”, che appare
presente, in effetti, in molti quadri con manifestazioni psicotiche congrue. Nel DSM IV (1), la
dizione “con caratteristiche melancoliche” è una specificazione che può essere applicata ad un
Episodio Depressivo Maggiore nell’ambito di una Depressione unipolare o bipolare. I criteri
diagnostici richiesti sono più simili a quelli del DSM III (4) che non del DSM-III-R (5): viene
reintrodotto il concetto di “distinta qualità di umore depresso” (diverso per esempio dalla perdita di
una persona amata) e di eccessivo o inappropriato sentimento di colpa, mentre è esclusa la
validazione in base al decorso naturale o alla risposta al trattamento, dal momento che entrambi i
criteri sono già inclusi nella definizione.
Nonostante la situazione paradossale che la Melancolia, considerata il “core” del disturbo
depressivo, sia continuamente ridefinita e manipolata, anche l’ultima edizione del più autorevole
sistema classificativo ribadisce, sebbene con intento clinico-descrittivo, l’esistenza di tale sindrome,
ed anzi ne recupera il concetto di ineffabile ma reale specificità della tinta affettiva, quand’anche la
rilevazione standardizzata e l’analisi statistica evidenzino differenze di ordine prevalentemente
quantitativo fra depressione “endogena” e “nevrotica” (6). Anche oggi quindi si riconosce l’esistenza
di una particolare forma depressiva le cui peculiarità vanno al di là dell’assenza di fattori
precipitanti, e che si caratterizza, oltre che sotto il profilo clinico per la presenza di sintomi
neurovegetativi, anche per specifici aspetti genetici, neurofisiologici e di risposta ai trattamenti
somatici. Lo stesso DSM-IV (1), riconoscendo nella Depressione Melanconica la maggior presenza
di alterazioni nei test di laboratorio, sembra sostenere che si tratti di una malattia profondamente
organica, fisica, “endogena”, caratterizzata da una globale perdita di energia vitale, in cui qualsiasi
evento di vita anche temporalmente collegato all’insorgenza del quadro clinico assumerebbe il ruolo
di semplice fattore scatenante che agisce su una discrasia di origine costituzionale slatentizzandola.
Frequenza del suicidio nella malinconia
Nella depressione il suicidio è molto frequente: Goodwin e Jamison (7) (1990), sulla base di 30
lavori, riportano un tasso di suicidio nella malattia maniaco-depressiva oscillante dal 9 al 60%, con
una media del 19%, tasso almeno 30 volte superiore a quella normalmente osservata nella
popolazione generale. Svolgendo l’indagine dalla prospettiva opposta, diversi Autori (8-10)
riportano che una percentuale intorno al 60% dei suicidi soffriva di malattia maniaco-
depressiva. Importanti difficoltà metodologiche, tra cui le continue modifiche dei criteri diagnostici,
hanno fino ad oggi impedito di distinguere in modo preciso eventuali differenze di rischio suicidario
nei vari sottotipi di malattia affettiva.
Da un punto di vista storico, il suicidio da quando, nel diciottesimo secolo, ha iniziato ad essere
inquadrato in un’ottica non più filosofica o romantica ma come conseguenza di una malattia
mentale, è stato considerato tipico della forma melanconica della depressione. Montesquieu, nel
1748, distingueva il suicidio eroico dei Romani, inquadrabile nel loro modo di pensare, dal suicidio
degli Inglesi, da considerarsi come l’effetto di una malattia. Pinel (11) nel 1791 sottolineava con
meraviglia come gli Autori sia antichi che moderni, che hanno descritto ogni tipo di ” malinconia
nervosa “, abbiano trascurato “quella forma caratterizzata da un disgusto insopportabile per la vita, o
piuttosto da un desiderio irresistibile di darsi la morte, senza che si possa trovare una causa” … “ed
in cui l’attaccamento alla vita lascia il posto, a causa di una malattia, ad un desiderio irreversibile di
darsi la morte”. Anche Freud (12) in “Lutto e melancolia” (1917) considera il suicidio nell’ambito
della dinamica della malinconia, spiegando la tendenza al suicidio del malinconico col rivolgimento
dell’aggressività contro il proprio Io. Dai relativamente pochi studi in cui si è cercato di identificare
quali tipi di depressione siano più spesso associati con le condotte suicidarie, è emersa la elevata
frequenza del suicidio nella depressione endogena. Circa la metà dei depressi suicidi di Chynoweth e
al. (13) (1980) soffriva di “depressione endogena” e dallo studio di Alessi e al. (14) (1984) risulta
che i soggetti diagnosticati con disturbo affettivo maggiore hanno più alta tendenza al suicidio e
commettono tentativi di suicidio più gravi. In una casistica di Helgason (15) (1964), il 17% di un
campione di suicidi erano affetti da disturbo bipolare, mentre il 7% erano “depressi nevrotici”.
Anche tra gli adolescenti, Robins e al. (16) (1985) hanno trovato una significativa associazione tra
comportamenti suicidari e depressione di tipo melanconico. Il vero suicidio rimane quindi ancorato
al campo delle psicosi in senso lato, tra cui spicca la depressione melanconica, mentre nelle
“nevrosi” prevarrebbe il parasuicidio.
Rapporto tra suicidio e caratteristiche nucleari della malinconia
Sembra quindi che suicidio e melanconia costituiscano un binomio fortemente coeso, in cui l’uno
rimanda all’altra quasi in una sorta di sinonimia.
Ma con quale dei vari aspetti nucleari della malinconia, tra loro coerenti ma pur sempre distinti,
correla di più la condotta suicidaria, stabilendo con essi un legame consequenziale? Oppure è un
“sintomo” che si pone “in parallelo” agli altri? In altre parole il suicidio è “derivabile” da uno degli
aspetti nucleari in particolare o è coerente con tutti, a costituire, insieme ad essi, un pattern unitario
quand’anche fenomenicamente variegato?
L’helplessness
Diversi Autori (17-18), da Beck (19) (1975) in poi, sottolineano come la presenza del sentimento di
mancanza di speranza (hopelessness) e di impossibilità d’aiuto (helplessness) sia uno degli indici più
attendibili di rischio suicidario. Tali sentimenti, d’altra parte, sono alla base della cosiddetta “triade
cognitiva” della melanconia (visione negativa di se stesso, del mondo, del futuro), che è strettamente
legata alla globale anergia del paziente melanconico. Prima di Beck, il tema della mancanza di
speranza era stato affrontato dagli Autori ad impostazione fenomenologica, come Tellenbach (3),
che nel 1961 scriveva: “la speranza costituisce un elemento basale della persona, un atteggiamento
esistenziale di base, una caratteristica fondamentale della storicità dell’uomo”. La speranza è legata
ad una trama di esperienze di formazione, mentre la coscienza del tempo chiuso dà luogo alla
disperazione. Nella disperazione viene colpito il fondamento ontologico dell’uomo; i parametri
spazio-temporali perdono il carattere del divenire e si immobilizzano, il futuro è visto
nell’impossibilità di ogni volere.
Da questo punto di vista, il suicidio del melanconico può essere visto come il suicidio di chi non
vuole più vivere perché non prova più piacere nella vita, di chi sente profondamente il vuoto della
sua vita, di chi perde la progettualità, quasi conseguenza razionale di un vissuto che razionale non è,
come quello della melanconia. La melanconia si traduce in perdita di speranza, una vita senza
speranza non è vivibile, quindi è preferibile interromperla volontariamente.
L’autoaggressività e la colpa
Storicamente, Lombroso (20) (1884) e Morselli (21) (1879) prima, Freud (12) (1917) ed Abraham
(22) (1927) dopo, avevano sottolineato i legami tra aggressività, malinconia e suicidio. Nell’ottica
psicoanalitica il suicidio rappresenta quasi sempre un omicidio mancato nel quale l’Io rivolgerebbe
contro di sé l’aggressività che sarebbe invece diretta primariamente verso oggetti del mondo esterno.
Anche dal punto di vista antropologico-criminale è stato più di recente focalizzato il legame tra
aggressività e suicidio, interpretando quest’ultimo come una manifestazione di appagamento
dell’aggressività che può essere inizialmente rivolta verso altri (23). Molti studi clinici, condotti in
rapporto alla patologia depressiva “maggiore” (concetto invero molto più vasto e sfumato della
classica malinconia), riportano uno stretto legame fra aggressività e condotte suicidiarie: una
maggiore aggressività generale distinguerebbe i soggetti depressi con tendenze suicidarie da quelli
senza (24-29). Ancora più recentemente, diversi Autori hanno sostenuto il legame tra aggressività e
suicidio nella depressione sulla base dell’osservazione che una diminuita attività del sistema
serotoninergico, notoriamente coinvolto nella patogenesi della malattia depressiva, si ritrova sia nel
comportamento aggressivo che in quello suicidario (30-34). La biochimica sembrerebbe quindi
suggerire che la riduzione dell’attività serotoninergica tipica della depressione, sarebbe responsabile
di una particolare vulnerabilità a sviluppare comportamenti aggressivi che potranno attualizzarsi
indifferentemente verso se stessi o verso gli altri. È evidente, però, che la presenza di un’eventuale
base biologica comune ai due fenomeni non permette di stabilire l’esistenza di un rapporto diretto fra
essi. La riduzione dell’attività serotoninergica, peraltro non confermata da alcuni Autori (35,36) e
comunque aspecifica in quanto riscontrata in diverse malattie psichiatriche ed in diverse dimensioni
psicopatologiche, potrebbe essere infatti condizione indispensabile ma non essere sufficiente.
In un nostro studio (37), del resto, non è stata trovata una correlazione tra aggressività e suicidio:
sembra al contrario che il rischio maggiore di suicidio sia proprio quando non c’è espressione della
propria ostilità, ma invece prevale la visione negativa del passato, tipica della depressione
malinconica, sotto forma di rimorso/risentimento, quasi che l’aggressività durante la fase depressiva
e specialmente nella melanconia venga non rivolta verso il sé, ma annullata nella sua essenza, anche
etimologica, di movimento, che dal presente si rivolge verso il futuro, annullata dal prevalere nel
vissuto melanconico di riemergenze del passato: il risentimento (nei confronti dei comportamenti
degli altri) e il rimorso (nei confronti dei propri comportamenti) evocano marginalmente condotte
aggressive, ma poco hanno a che vedere con la aggressività, esprimendo uno statico soggiacere ad
una constatazione più che un moto attivo verso gli altri o verso se stessi. Quindi anche seguendo la
“pista” dell’aggressività nei soggetti malinconici con ideazione suicidaria incontriamo poco o niente
di relativo a valenze aggressive propriamente dette, ma approdiamo anche in questo percorso alla
colpa.
Infatti la prima variabile che differenzia i tre gruppi di pazienti esaminati nel suddetto studio (37)
(con normale desiderio di vita, con pensieri di morte, con tendenze suicide) è la colpa, e non le
componenti del comportamento aggressivo. La presenza simultanea di colpa e di risentimento, non
associata a comportamento aggressivo diretto, ha un’alta correlazione con il rischio suicidario.
Fin dall’interpretazione psicoanalitica, il senso di colpa è stato considerato alla base del suicidio nel
depresso. Secondo la Klein (38), dal momento che una delle difese primordiali contro l’istinto di
morte è la proiezione su un oggetto esterno, c’è da aspettarsi da parte sua un continuo timore di
rappresaglia; tale difesa quindi verrà pagata al prezzo di dover avvertire costantemente un
sentimento di colpa che sarebbe pertanto un appannaggio dell’uomo fin dai primi istanti di vita. In
stretto riferimento alla impostazione Kleiniana, Grinberg (39) sottolinea l’esistenza di due tipi di
colpa: quella persecutoria, derivante dall’istinto di morte e tendente all’autorimprovero ed al timore
della punizione, e quella depressiva, funzione dell’istinto di vita, che tende alla riparazione. Il
suicida, non riuscendo più a tollerare la persecutorietà della colpa, giunge a liberarsi di essa
immolandosi.
Il tema della colpa è stato affrontato anche dagli psicopatologi contemporanei: Callieri (40) (1961)
intende il senso di colpa come “qualcosa di primario che satura in sé tutte le esperienze di vita, come
un insopprimibile bisogno di umiliarsi, di punirsi, di annullarsi, di sopprimersi”. Secondo Milici (41)
(1950), dal vissuto depressivo all’ideazione suicidaria, all’atto, assistiamo ad un crescendo che
culmina con una reazione di morte: “Dapprima segni di aumentata disperazione … tristezza ed
introversione … senso di indegnità ed irrealtà … sensi di colpa: ho danneggiato la famiglia, il
mondo … ho ucciso il mondo … la morte è migliore della morte vivente … è meglio morire … sta
morendo … è morto … ogni cosa è morta”. Numerosi studi (42,43) basati sulla testistica hanno
rilevato la colpa come uno dei principali aspetti cognitivi presenti in soggetti con comportamenti
suicidari.
La colpa, individuata anche nell’ambito della psicopatologia di orientamento fenomenologico come
uno degli elementi nucleari della depressione melanconica, sembra essere quindi uno dei più
importanti fattori cognitivi che distinguono la transizione dall’attaccamento alla vita alle tendenze
suicidarie.
In questo senso, il suicidio del melanconico non sarebbe tanto quello, in un certo senso egoistico,
che sarebbe finalizzato a interrompere la propria vita divenuta invivibile perché priva di speranza e
piena di dolore, quanto atto di espiazione teso a liberare, più che se stesso dalla vita, il mondo da una
ignobile e nefasta presenza.
L’impulsività
Spesso il suicidio presenta tutte le caratteristiche dell’atto impulsivo: pericolosità dell’azione,
sensazione crescente di tensione prima di compiere l’atto, gratificazione o – meglio – sollievo nel
momento in cui l’azione si realizza, tentativo di resistenza unito a desiderio impellente. Non a caso
dunque tra i fattori di rischio per il suicidio compaiono elementi che notoriamente si associano ad
una maggiore impulsività, come lo stato misto, l’abuso di alcool e/o di sostanze, la presenza di
derealizzazione o di alterazione della coscienza. Riguardo all’incremento del rischio suicidario in
caso di “maniacalizzazione” del quadro depressivo (stato misto), occorre osservare come, anche per
quanto riguarda le caratteristiche della depressione, è stato dato particolare risalto all’agitazione
come elemento facilitante la messa in atto di comportamenti suicidari (44). È del resto osservazione
comune che i depressi ansiosi o agitati (ricordiamo che l’agitazione è tra i criteri di “Depressione con
melanconia”) compiono con maggiore frequenza tentativi di suicidio. Il comportamento suicidario si
impone, nei depressi ansiosi e agitati, con le caratteristiche dell’impulso repentino e brutale in un
momento di improvviso restringimento del campo di coscienza; ciò si verifica con maggior
frequenza in quella che veniva definita “malinconia involutiva”, in cui i pazienti passano da
momenti di stupore depressivo a momenti di estrema agitazione (“raptus melancholicus”). Il
rallentamento psicomotorio, infatti, appare meno direttamente collegato all’atto suicidario rispetto
all’alterazione psicomotoria di polarità opposta: Bradvik e Berglund (45) hanno messo in evidenza
come nei pazienti depressi con malinconia il rischio di suicidio è correlato all’insorgenza acuta ed
alla mancanza di rallentamento psicomotorio.
Coerentemente con tali considerazioni, nel Disturbo Bipolare, la cui diagnosi sembra essere il più
valido elemento predittore di comportamento suicidiario (46-49), il suicidio viene compiuto nelle
fasi di remissione della sintomatologia depressiva, specie se si verifica un “viraggio rapido” alla
condizione contropolare in cui si realizza la perdita delle condizioni di olotimia, con la conseguente
scomparsa di una relazione coerente tra umore e comportamento; il suicidio sarebbe quindi il
risultato di una condizione in cui la coscienza di sé è particolarmente labile, minata com’è da una
continuità temporale del sé ridotta al minimo, in quanto il soggetto si troverebbe a vivere due ritmi
temporali inconciliabili. La motricità e la determinazione propria dell’eccitamento maniacale
potrebbero giungere a togliere un freno all’ideazione depressiva, favorendo quindi il passaggio
dall’ideazione all’atto. Mentre sono contrastanti i dati riguardo al maggior rischio di suicidio nei
bipolari I (49,50) o II (46,47,51), è infatti provato un alto rischio nei pazienti bipolari in fase mista
(52,53), in cui le sensazioni depressive, la vigilanza mentale e lo stato disforico, accompagnati da
innalzati livelli di energia ed impulsività, sembrano rappresentare una combinazione critica.
In questa ottica si prescinde quindi da una comprensione dell’ideazione suicidaria, dal chiedersi da
dove nasca l’aspirazione a porre termine alla propria vita e quale significato rivesta nella dinamica
del vissuto melanconico, fornendo invece una giustificazione soltanto del passaggio all’azione.
Un’ideazione sempre presente, un proposito con essa coerente sempre accarezzato, ma frenato da
componenti inibitorie insite nella struttura stessa della depressione, diventano azione per la
disinibizione indotta dall’inserimento di componenti attivatorie contropolari.
Il difetto di insight
Le fasi percorse dal paziente con depressione “endogena” che arriva a suicidarsi sembrano essere
ben definite dal punto di vista cognitivista: 1) il considerare la necessità della morte come un
assioma, una proposizione cui si è giunti, ma che non ha bisogno di dimostrazioni; 2) la progressiva
impenetrabilità alla critica, che può diventare assoluta; 3) l’assenza o la scomparsa di una coscienza
di malattia: il paziente non trova, o non trova più, nell’idea del suicidio, e neppure nell'”affekt” che a
tale idea si accompagna, nessun significato patologico. L’idea in questione viene vissuta all’inizio
con un sentimento di paura: essa cioè viene avvertita come estranea (egodistonica) e pericolosa;
successivamente perde questo carattere terrifico, diventa patrimonio della psiche (egosintonica),
acquista addirittura un significato rassicurativo e protettivo. Le difese coscienti dell’individuo
(rappresentate da configurazioni etiche, proprie e/o della cultura, dalle situazioni affettive, dalle
condizioni ambientali, ecc.) perdono progressivamente la loro energia e lasciano il campo ai
complessi patologici relativi al suicidio. Occorre quindi ricordare che la progressiva “maturazione”
del fenomeno-suicidio, attraverso le fasi della paura dell’atto, della dichiarazione di intenzionalità,
del passaggio all’atto, si pone in relazione con una diminuzione, fino alla scomparsa delle difese
attive da parte dell’io cosciente nei confronti dell’invadenza suicidaria, e con la perdita di insight.
Caratteristica cognitiva del suicidio nei disturbi endogeni dell’umore è quindi la convinzione di
dover morire, che ha i caratteri dell’idea delirante (54).
Parlare di perdita di insight nella malinconia suicidaria vuol dire quindi riferirsi a quel
disfunzionamento cognitivo complessivo che, partendo dalla colpa irrazionale e dal risentimento,
attraversando stati di depersonalizzazione-derealizzazione, giunge alla convinzione delirante di
meritare la morte. L’ideazione suicidaria, pur non assumendo una configurazione psicotica in senso
stretto, si inscrive quindi nella tipica cedevolezza della sfera cognitiva presente in ogni depressione
malinconica, pur “senza sintomi psicotici”. Occorre ricordare a tal proposito come il termine
“insight” non indica un sintomo isolato che può essere assente o presente, ma è meglio
rappresentabile come un continuum di pensiero e di sentire, riferito a come la malattia inficia le
interazioni dell’individuo con il mondo (55).
Anche in questa prospettiva il proposito di togliersi la vita non viene spiegato, se non in termini di
consequenzialità cognitiva, ma se ne sottolinea il contesto latamente “delirante” nel quale la realtà
interna, più che quella esterna, si trasforma, viene sostituita da un’altra realtà, altrettanto vera: quella
della colpa, dell’assenza di un futuro, della inesorabilità dell’atto suicidario.
I sintomi psicotici
Studi (56,57) condotti su depressi psicotici in senso stretto, per esempio pazienti deliranti, non hanno
mostrato un aumentato rischio di suicidio, tanto che, secondo Mitterauer (58) (1981), “delirio e
suicidio si escludono a vicenda, in quanto il primo è una modalità di comunicazione, mentre il
suicidio è la negazione della comunicazione stessa”. Pinel (11) affermava che “la malinconia con
idee suicidarie è caratterizzata da un delirio circoscritto ad un solo oggetto, il disgusto per la vita;
esso diviene un’idea dominante che sembra assorbire tutte le facoltà intellettive. Altri Autori (59)
hanno invece riscontrato un rischio di suicidio nelle depressioni maggiori deliranti superiore rispetto
a quelle non deliranti; sarebbero le esperienze allucinatorie o le idee deliranti a contenuto di
indegnità, rovina, peccato, punizione, persecuzione e soprattutto colpa a dare giustificazione
all’autosoppressione (60-62), mentre meno correlati sono i deliri di malattia (61). Miller e Chabrier
(63) riportano un rischio suicidario particolarmente alto nei pazienti con Depressione Maggiore
Unipolare che presentino deliri di colpa associati a deliri di persecuzione.
Certamente aspetti psicotici, ideazione di colpa, mancanza di insight, ai quali il comportamento
suicidario appare correlarsi, sembrano costituire un pattern coerente, sotteso da mutamenti
drammatici nella sfera cognitiva. La compromissione cognitiva sembra rappresentare un livello di
gravità superiore del quadro depressivo, come se, alle disfunzioni biologiche che alimentano il
vissuto depressivo nelle sue componenti affettive e psicomotorie “di base”, se ne aggiungesse, non
necessariamente come fase evolutiva longitudinale del quadro, un’altra capace di sovvertire schemi
cognitivi altrimenti compatibili con il vissuto depressivo e capaci di costituire una “difesa” di fronte
al suo dilagare. Come se, metaforicamente, l’ondata depressiva più pertinente alle funzioni emotivo-
affettive dell’emisfero destro, in una ingravescenza del quadro tracimasse nell’emisfero sinistro a
invadere e coinvolgere anche le funzioni più razionali e “cognitive”, tipiche della specializzazione di
questo emisfero.
Una visione questa che sposterebbe il suicidio dalla patologia degli istinti (perdita dell’istinto della
conservazione di sé) così come collocato dalla classica psicopatologia descrittiva, a quella della
cognitività, come risulta dalle analisi statistiche condotte sulla rilevazione operata con Rating Scales
nelle quali il suicidio fa parte del fattore “disturbi cognitivi” saturato da colpa, ideazione paranoidea,
sintomi ossessivi e depersonalizzazione, nonché agitazione.
Rapporto tra suicidio ed aspetti longitudinali della malinconia
Decorso
Sono abbastanza controversi i dati riguardanti la relazione tra comportamento suicidario e decorso
della malattia maniaco-depressiva. Sono abbastanza consistenti gli elementi indicatori di un
aumentato rischio di suicidio all’inizio del primo episodio di malattia affettiva: alto rischio in
bipolari nella prima decade seguente il primo ricovero (64,65); il 40% dei suicidi entro i primi sei
mesi del primo ricovero, più del 50% nel primo anno (66); il 30% dei tentati suicidi ai primi sintomi
della malattia bipolare o durante il primo episodio depressivo, con intervallo medio di 5,5 anni (67).
Anche nelle forme di depressione con sintomi melanconici insorte dopo un evento importante, che
venivano denominate “depressioni endoreattive”, il suicidio comparrebbe a ridosso dell’evento
scatenante (54).
Il rischio di suicidio è comunque caratteristicamente presente in ogni fase nella malattia depressiva:
Himmelhock (44) ha suggerito che il suicidio possa essere, sia psicologicamente che a livello
neuronale, soggetto a kindling, o che, per meglio dire, in aggiunta agli aspetti biologici del kindling,
i pazienti divengano sempre più intolleranti nei confronti di ogni nuovo episodio di depressione,
aumentando così il rischio di suicidio man mano che la malattia si prolunga. Altri Autori,
distinguendo nelle depressioni endogene quelle “long acting” da quelle cicliche ricorrenti, indicano
come spesso il suicidio compaia solo dopo molti anni dall’inizio di una depressione cronicizzante, o,
nella ciclica, solo dopo un certo numero di episodi di malattia. Gli stessi Johnson e Hunt (67), pur
riportando la metà dei tentativi seri nel giro dei primi cinque anni di malattia depressiva, riportano
un range, davvero impressionante, di 27 anni. Merikangas e al. (68) hanno dimostrato come i
tentativi di suicidio siano maggiori nelle depressioni ricorrenti (20%), dove un netto miglioramento
si alterna a ricadute, rispetto alle depressioni a episodio singolo (3%). È da ricordare come questo sia
uno dei criteri longitudinali dell’episodio depressivo con caratteristiche melanconiche.
E anche se è clinicamente evidente la correlazione tra rischio suicidario e gravità dell’episodio
depressivo, è stata anche segnalata una frequenza inaspettata di suicidi (circa il 30%) in fase di
miglioramento (66-69). Questo apparente miglioramento in fase presuicidaria ha portato alla
formulazione di varie ipotesi: potrebbe riflettere la calma derivata da una decisione ormai
definitivamente presa, oppure un miglioramento clinico effettivo, seguito però da una forte dose di
frustrazione al ritorno dei sintomi, o un inganno deliberato del paziente verso il medico, il personale
dell’ospedale, la famiglia, al fine di non trovare ostacoli ai suoi propositi di suicidio; o ancora
potrebbe essere imputato ad una ripresa della vita con tutti i suoi obblighi e le sue responsabilità
senza più “l’alibi” della malattia, ma con ancora presenti sintomi residui invalidanti, o infine al
“vuoto” lasciato dalla scomparsa dell’ideazione delirante nella fase di remissione di una depressione
con manifestazioni psicotiche.
Forse però l’ipotesi più probabile è che si tratti di una calma reale “prima della tempesta”, causata da
mutamenti biologici o dalla transizione da una fase all’altra della malattia, ad esempio da
depressione a ipomania, mania o, come accennato più sopra, a stato misto.
Ciclicità stagionale e circadiana
Per quanto riguarda il rapporto tra comportamento suicidario e decorso della depressione maggiore,
occorre anche accennare all’esistenza, ormai ampiamente documentata, di una ciclicità stagionale e
circadiana del suicidio. Il tasso di suicidio sembra aumentare drasticamente in primavera ed autunno
ed in minor misura in inverno (nadir in dicembre) (70-73). Questo trend, che sembra prevalere nei
paesi a clima freddo (74), nelle aree rurali e nel sesso maschile (75), sembra essere ancora più
evidente nel caso in cui il comportamento suicidario sia sotteso da una depressione maggiore: il più
alto numero di suicidi nei pazienti gravemente depressi si registra infatti nei mesi di Maggio e di
Ottobre, in coincidenza con le ricadute degli episodi depressivi maggiori unipolari, o con i viraggi
della tarda primavera, o con gli episodi di depressione post maniacale, legati, secondo la maggior
parte degli Autori, alle variazioni del fotoperiodo (76).
È stata inoltre riportata l’esistenza di una ritmicità circadiana del comportamento suicidario: la
maggior parte degli studi riporta una distribuzione bimodale giornaliera del suicidio, con un primo
picco nella mattina (9:00-12:00) ed un secondo in serata (20:00-22:00) (77,78). La natura di questa
ritmicità, soprattutto del picco serale, ha subito diverse interpretazioni: se in generale si può pensare
che nella prima metà della giornata si verificherebbe un minor numero di suicidi in quanto gli
impegni socio-lavorativi potrebbero distogliere il soggetto dall’ideazione e dalla messa in atto di
propositi suicidari (79), nei suicidi con Depressione Maggiore la circadianità del suicidio è ritenuta,
su un piano biologico, il riflesso delle alterazioni circadiane degli ormoni e dei neurotrasmettitori,
tipiche delle depressioni endogene (80), e, su un piano clinico, un epifenomeno dell’alternanza
diurna della sintomatologia depressiva: se la maggior gravità della sintomatologia nelle prime ore
della giornata spiegherebbe il picco al mattino, la disinibizione delle ore serali potrebbe facilitare la
decisione di mettere in atto un comportamento autolesivo (81). A riprova dell’alterazione del sistema
circadiano alla base del caratteristico ritmo diurno del suicidio nel paziente depresso è il dato
secondo il quale il comportamento suicidario è fortemente associato con i disturbi del ciclo
sonno/veglia e quello attività/riposo: è stato osservato che i soggetti che conservano integri i ritmi
sonno/veglia ed attività/riposo presentano un minore rischio di suicidio, indicando che la persistenza
e l’integrità della ritmicità endogena può essere interpretata come un fattore prognostico positivo
(82).
È ormai un dato acquisito che nelle variazioni stagionali e circadiane della sintomatologia
malinconica e del comportamento suicidario ad essa legato possano giocare un ruolo chiave le
disfunzioni della ghiandola pineale, riscontrate separatamente in entrambe le condizioni (83).
Pertanto il suicidio nella malinconia sembra essere legato, in una prospettiva cronobiologica, al più
generale “disincronismo dell’orologio endogeno” caratteristico della depressione endogena, che
Tellenback (3) definiva come “malattia cosmica”.
Fattori psicosociali di rischio
Abbiamo già accennato al fatto che la Depressione con Malinconia presenta, oltre ad una maggiore
gravità clinica complessiva, una minor incidenza di fattori stressanti nella sua genesi (84). Questa
osservazione sembra essere valida anche per il comportamento suicidario del paziente malinconico.
Molti Autori concordano infatti nel ritenere che il suicidio, nella depressione endogena, sia
l’espressione di una via intrinseca all’individuo, relativo all’assoluta preponderanza del momento
introversivo su quello estroversivo, e che “il resto del mondo” perda così ogni possibilità di
influenzare il pensiero e il sentire del depresso: in questo senso gli eventi esterni avranno, al più, il
significato di un elemento scatenante, del primo o ultimo anello della catena.
In alcuni studi (85,86) è stato riportato come fattore di rischio l’isolamento sociale, ma in realtà è
difficile stabilire se sia causa del suicidio o conseguenza della depressione: da uno studio di Nelson e
al. (87) (1977) risulta che i soggetti depressi che attentano alla propria vita hanno come caratteristica
quella di preferire uno scarso coinvolgimento sociale, e mostrano nei confronti degli altri bassi livelli
di tolleranza.
Può essere chiamato in causa il disfunzionamento familiare, ma, anche in questo caso, è ipotizzabile
anche il meccanismo contrario: Keitner e al. (88) (1987), per esempio, hanno dimostrato come i
pazienti con Depressione Maggiore e comportamento suicidario percepiscano la propria famiglia ed
il proprio ruolo al suo interno più negativamente di quello che sia in realtà. Kosky e al. (89) (1986),
confrontando soggetti affetti da “depressione somatica” con e senza ideazione suicidaria, non hanno
riscontrato differenze rispetto a pregresse esperienze di abbandono, né a caratteristiche extrafamiliari
e sociali. Infine, Bradvik e Berglund (45) hanno dimostrato come nei depressi con Malinconia il
suicidio sia meno correlato ai fattori psico-sociali rispetto alle depressioni in generale: nel loro
campione di depressi con Malinconia morti suicidi, le pazienti di sesso femminile addirittura
avevano, rispetto ai controlli, meno malattie fisiche, ed avevano avuto con minor frequenza
un’infanzia oggettivamente infelice.
Conclusioni
Abbiamo quindi diversi elementi per escludere, in accordo con il lavoro di Bradvik e Berlung (45),
che il comportamento suicidario nella depressione melanconica sia influenzato da fattori psicosociali
o da eventi di vita; invece la familiarità, l’insorgenza spesso repentina di tale ideazione, la presenza
di correlati biologici, la ciclicità stagionale, l’impossibilità spesso di trovare una qualche
giustificazione razionale ad un atto che va contro i più forti istinti vitali depongono per il carattere
biologico, “organico” del suicidio, che lascia poco spazio ad atteggiamenti di tipo manipolativo, ad
incoraggiamenti, a consigli. Nel modello a sovrapposizioni di Blumenthal (90) (1988) per la
vulnerabilità suicidaria, il suicidio del melanconico vede dilatarsi l’area relativa al substrato
biologico, che può rappresentare una diatesi comune anche al disturbo psichiatrico stesso. Del resto,
colpisce il fatto che uno psichiatra ad orientamento psicodinamico come Glen Gabbart affermi che
“… i fattori determinanti del comportamento suicidario possono essere tanto biologici quanto
psicologici. Gli aspetti psicodinamici possono essere secondari rispetto ad eventuali modificazioni
neurochimiche. Pertanto, nel contesto di un approccio psicoterapico, dovranno essere massimamente
usate tutte le modalità disponibili di trattamento somatico…” E se questa affermazione è vera per
ogni comportamento suicidario, essa è certamente più pertinente in relazione ad un suicidio così
“biologico” come quello del depresso malinconico.
A fronte di questa considerazione, dalla nostra rassegna appare tuttavia evidente come neppure in un
sottotipo più specifico di disturbo affettivo quale la melanconia possa essere proposto un modello
unitario di interpretazione del comportamento suicidario. Molte sono le variabili coinvolte, non tutte
inquadrabili in modo coerente in un unico profilo psicopatologico e/o biologico. È forse possibile (e
quindi in un’ottica preventiva necessario) delineare alcune componenti psicopatologiche, tutte
riscontrabili in un quadro di depressione melanconica così come è definita dagli attuali sistemi
classificativi (di cui ricordiamo gli inevitabili limiti descrittivi), più facilmente associabili a
comportamento suicidario.
L’agitazione, componente del quadro melanconico o comparsa in un divenire di disinibizione verso
una fase mista o una larvata ipomania, mobilizza valenze suicidarie, altrimenti inattuabili nel
contesto inibitorio della depressione, alimentate dall’invasione nel vissuto di un passato carico di
rimorso e/o di risentimento. Disinibizione, agitazione, talora impulsività, che troverebbero il loro
corrispettivo biologico in un abbassamento particolarmente accentuato del tono serotoninergico, così
come indicato da numerosi studi post-mortem su pazienti suicidi.
Componenti francamente psicotiche sono state segnalate da diversi Autori come fattori di aumentato
rischio di suicidio nel paziente malinconico, che può darsi la morte per incapacità a tollerare il suo
vissuto delirante o spinto dal contenuto stesso delle allucinazioni, l’una e le altre collegate
tradizionalmente ad una attivazione dopaminergica.
Un altro profilo è quello classico del paziente malinconico in cui il suicidio si inscrive in un magma
di vissuti ideativi negativi e totalmente impenetrabili alla critica come la “hoplessness”, il sentimento
di colpa, la percezione del tempo come chiuso ed inesorabile. Questa condizione appare francamente
cognitiva, e non ha ancora correlati biologici così chiari, ma paradossalmente appare forse la più
“somatica”, come l’estrema conseguenza di quella perdita di energia vitale, dello “spirito” nel suo
senso più classico, che suggestivamente è stata descritta dagli antichi come l’invasione della bile
nera.
Comunque nessuno di questi aspetti appare del tutto persuasivo, acquistando valore e significato nel
singolo caso, senza essere in grado di darci una comprensione esaustiva e generalizzabile del
percorso psicopatologico che culmina nel suicidio, così come i diversi correlati biologici dimostrati o
persuasivamente intuibili non ci giustificano niente di più che la verosimile natura biologica della
melanconia, e quindi, verrebbe da pensare, del suicidio. Forse altre chiavi di lettura del mondo
melanconico che consentano un’indagine a livelli psicopatologici più profondi potranno definire un
contesto strutturale in cui il suicidio più coerentemente si collochi
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Melancholia is a subtype of depression . People with melancholic depression often feel
extreme despair and guilt. They may struggle to feel any happiness, even when good
things happen in their lives.
Although melancholia can be difficult to treat, recovery is possible. A trained mental
health professional can help people with melancholia cope with their symptoms.
HISTORY OF MELANCHOLIA
In 400 B.C., the Greek philosopher Hippocrates theorized that the human body
contained four major fluids: blood, black bile, yellow bile, and phlegm. A human grew
sick when these fluids were out of balance in their body. An excess of black bile would
cause someone to become despondent and fearful. The Greeks call this
condition melancholia. It became the first term used for depression and the first way
depression was ever studied.
During the Renaissance, Europeans considered melancholia to be a sign of creative
genius . They glorified it through art, fashion, and written works. But by the 18th
century, the term returned to its clinical roots.
Around the 19th century, people used the term depression synonymously with
melancholia. Sigmund Freud ’s writings in On Murder, Mourning and Melancholia helped
modernize the concept of melancholia into its current definition.
WHAT IS MELANCHOLIA?
Today, melancholia is no longer listed as a standalone mental health issue. Instead,
the Diagnostic and Statistical Manual (DSM) lists it as a specifier for depressive
disorders. Rather than receiving a diagnosis for melancholia, a person is more likely to
receive a diagnosis of major depression (MDD) with melancholic features.
(Melancholia can also occur during the depressive phase of bipolar .)
To be diagnosed with melancholic depression, a person must present at least one of
these symptoms:
1. Loss of enjoyment from all (or nearly all) activities.
2. Lack of positive response to objectively pleasurable events.
And at least three of the following:
1. Despair that is not linked to loss or grief .
2. Loss of appetite or significant weight loss.
3. Psychomotor changes: Either physical restlessness or slowed movement.

4. Diurnal mood variation : Low mood that is worse in the morning.
5. Waking at least two hours earlier than normal.

6. Excessive guilt .
MELANCHOLIA AND OTHER TYPES OF DEPRESSION
Melancholia can look very different from non-melancholic depression. Compared to an
individual with another type of depression, someone with melancholia typically:
 Develops symptoms at a later age.
 Has more severe symptoms. Instead of having fatigue, the person may have no
energy at all . Instead of having a dampened mood, they may be unable to feel
any happiness.
 Is more likely to have psychomotor symptoms.
 Is more likely to have anxiety or suicidal thoughts .
Melancholic depression can also occur alongside other specifiers. For example,
someone with melancholia may have a seasonal pattern to their symptoms. Research
shows melancholia is more prevalent when sunlight and temperature levels are low.
Melancholia might also co-occur with postpartum depression and depression
with psychotic features .
WHAT CAUSES MELANCHOLIA?
Melancholia is sometimes called “endogenous depression,” meaning “depression that
comes from within. The condition is highly heritable. People with melancholia are likely
to have a family history of mood issues or suicide. Social and psychological factors
rarely contribute to melancholia the way they might with other depression subtypes.
Research suggests differences in the brain may be responsible for melancholia.
Someone with melancholia may have less neurons connecting to their insula (the part
of the brain responsible for attention). They may also have an altered hypothalamus ,
pituitary gland, or adrenal glands . These changes may affect a person’s appetite,
stress levels, and more.
EFFECTS OF MELANCHOLIA
Melancholia can prompt various biological changes in the body. People with
melancholic depression spend more time in the REM phase and less time in the deep
sleep phase. Thus, they may get less quality rest.
People with melancholia often have elevated cortisol levels , which increase
one’s stress . They may also experience weight loss and chronic inflammation.
The condition can also affect cognitive processing and performance. Research
suggests it impedes working memory, visual learning, verbal learning, and problem
solving. These symptoms are specific to the melancholic subtype of depression.
Overall, melancholia can impact a person’s relationships, occupation, and health. In
severe cases, it may prompt an individual to attempt suicide. Melancholia tends to
cause longer periods of suicidal thinking than other types of depression.
If you or a loved one has melancholia, know that there is hope. A licensed therapist
can help you on the journey to recovery. You can find a therapist here .
References:
1. Brown, W. A. (2007, January 15). Treatment response in melancholia. Acta
Psychiatrica Scandinavica, 115(s433), 125-129. Retrieved from
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0447.2007.00970.x/full
2. Carroll, B. J., Feinberg, M., Greden, J. F., Tarika, J., Albala, A. A., Haskett, R.
F., … & Young, E.. (1981). A specific laboratory test for the diagnosis of
melancholia: Standardization, validation, and clinical utility. Archives of General
Psychiatry, 38(1), 15-22. Retrieved from
http://jamanetwork.com/journals/jamapsychiatry/article-abstract/492458
3. Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013).
Washington, D.C.: American Psychiatric Association.
4. Freud, S. (1917). On murder, mourning and melancholia. London: Penguin Group.
5. Jackson S.W. (2008) History of psychiatry and medical psychology. Boston:
Springer.
6. Javier, H. (2014). The four humors theory. ESSAI, 12(1). Retrieved from
http://dc.cod.edu/cgi/viewcontent.cgi?article=1497&context=essai
7. Lamers, F., Beekman, A. T. F., van Hemert, A. M., Schoevers, R. A., &
Penninx, B. W. J. H. (2016). Six-year longitudinal course and outcomes of
subtypes of depression. The British Journal of Psychiatry, 208(1), 62-68. Retrieved
from https://www.cambridge.org/core/journals/the-british-journal-of-
psychiatry/article/sixyear-longitudinal-course-and-outcomes-of-subtypes-of-
depression/3F3CC68201884E067284379B05F49697
8. Melancholic depression: Symptoms, treatment, tests, and more. (2016, March
10). HealthLine. Retrieved from
https://www.healthline.com/health/depression/melancholic-depression#Overview1
9. Parker, G., Fink, M., Shorter, E., Taylor, M. A., Akiskal, H., Berrios, G., … &
Swartz, C. (2010. January 1). Issues for DSM-5: Whither melancholia? The case
for its classification as a distinct mood disorder. The American Journal of Psychiatry.
Retrieved from
http://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2010.09101525
10. Parker, G., Roy, K. Hadzi-Pavlovic, D., Wilhelm, K., & Mitchell, P. (2001). The
differential impact of age on the phenomenology of melancholia. Psychological
Medicine, 31(7), 1231-1236. Retrieved from
https://www.cambridge.org/core/journals/psychological-
medicine/article/differential-impact-of-age-on-the-phenomenology-of-
melancholia/296E27B2F54AD6B3C03A963CCDB7E975
11. Radua, J., Pertusa, A., & Cardoner, N. (2010, February 28). Climatic
relationships with specific clinical subtypes of depression. Psychiatry Research,
175(3), 217-220. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0165178108003946
12. Rush, G., O’Donovan, A., Nagle, L., Conway, C., McCrohan, A., O’Farrelly,
C., ... & Malone, K. M. (2016, November 15). Alteration of immune markers in a
group of melancholic depressed patients and their response to electroconvulsive
therapy. Journal of Affective Disorders, 205(1), 60-68. Retrieved from
13. Taylor, M.A. & Fink, M. (2006). Melancholia: The diagnosis, pathophysiology, and
treatment of depressive illness. New York: Cambridge University Press.

14. Zaninotto, L., Solmi, M., Veronese, N., Guglielmo, R., Ioime, L., Camardese,
G., & Serretti, A. (2016, September 1). A meta-analysis of cognitive performance
in melancholic versus non-melancholic unipolar depression. Journal of Affective
Disorders, 201(1), 15-24. Retrieved from
Non c’è il blu senza il giallo e senza l’arancione. L’artigiano, la libertà

negata. Una malinconia che investe tutto. Ritratto di Van Gogh
Van Gogh, Terrazza del Caffè la sera (1888), particolare
Esistono analisi, mano a mano più dettagliate, che documentano lo scarto

tra il recepimento di Vincent Van Gogh (1853-1890) presso i
contemporanei e la sua fortuna attraverso i posteri. Questi pur
interessanti volumi monografici hanno il pregio di rimarcare le difficoltà
di una condizione di vita, ma l’ineliminabile sensazione conclusiva è che
la restituiscano con un senso di pietismo pettegolo, di inarginabile
desolazione individuale e morale. Quasi come il Sisifo di Camus è bene da
vedere felice, così il Van Gogh di Van Gogh è ogni tanto giusto vederlo
trionfante. Il pittore è innanzitutto un valentissimo esercitatore di se
stesso, forse più tirannico che metodico. Chi lascia oltre novecento dipinti
e più di mille disegni non è un signore strambo che si è svagato, ma un
rigido conquistatore del suo spazio di autonomia e creatività. Lo dimostra
che muovesse da una concezione fondamentalmente olistica del colore.
Ricordiamo il suo monito, che lungi dall’essere severo, è inno timido alla
pastosità: non c’è il blu senza il giallo e senza l’arancione.
C’è in Vincent un doppio morso incrociato al fondo della sua anima prima
ancora che della sua bocca: il senso del dovere (l’artigiano apprendista del
suo stesso opus inceptum) e il senso dell’impossibilità (la libertà negata
come costrizione in re ipsa, non come potenzialità inespressa). Eppure,
nella malinconia sgorgantene, Van Gogh è tutto fuorché un presule della
mala sorte. È un sincero partigiano del lato fascinoso della debolezza. Più
che un cristiano anonimo, per usare la definizione di Rahner, è un fedele
militante aristotelico della natura relazionale dell’umanità. Così
relazionale, addirittura, che non tutto di quella relazionalità riesce a farsi
comunicare.
Ed ecco allora l’irredimibile promessa malinconica dell’arte: portare a
galla esattamente quel frammento nascosto. Come scriveva nel 1888: si
può bere il proprio goccio e fumare la propria pipa. Disegnare un
universale di enormi moti d’anima in piccoli spazi. Lo prova la “Terrazza
del Caffè la sera”: un ritrovo di Arles che ci si restituisce tale e quale alla
chiusura dei tavolini al rinomato pub Le Consulat a Montmartre. Ce lo
dice “La notte stellata sul Rodano”, con tutte le sue corpose stelle
inespresse di angoli luccicanti e sfere di fuoco.
Studioso, Van Gogh, che non lo si dice abbastanza. Studioso senza sconti
per sé: nel tardo Ottocento europeo in cui orientalismo è troppo spesso
apologia del colonialismo, ecco il “Ramo di mandorlo fiorito”, così
meravigliosamente suo e così grandemente erudito da essere più
giapponese dei giapponesi. E quanta malinconica sobrietà nel
semicontemporaneo “Autoritratto con l’orecchio bendato”? Non vediamo
il furioso orecchio reciso o l’estremamente dolente volto deformato: Van
Gogh ci mostra il compianto del danno fatto(si). Non c’è nessun
d’Annunzio buttatosi dal balcone qualche decennio dopo. Lo sguardo
della malinconia è una pentecoste laica: sgrana d’immenso
l’infinitesimale, riduce a contatto vicino l’eterno (basti pensare alle
pagode del ricordo che proustianamente emergono nella piccola chiesa di
Auvers, dove Dio e il ricordo sono facce della stessa medaglia).
Profeta vero questo piccolo genio dei baci dati, degli schiaffi presi e dei
baci da dare. Il suo “Caffè di Notte”, con le sedie da asciugare e gli
avventori che etimologicamente non sanno andarsene, è quanto di più
simile ai nottambuli di Edward Hopper del secolo successivo; senza “La
ronda dei carcerati” il pessimismo di Mario Mafai non si sarebbe mai fatto
tela. Il “Frutteto in fiore” è una memorabile antologia di perfezione
tecnica.
Sulle orme del sentire spinoziano, Van Gogh sembra dirci che se Dio è
amore e la natura è Dio, ancor più è vero che la natura è amore. E l’amore
che si genera dalla tempra melanconica non è solo l’anello di fuoco
cantato da Cash: è una fiaccola sempre accesa. I fiumi tra Francia e Belgio
possono esondarci di sopra, ma intanto lei torna a raccontarci che blu non
è blu senza l’arancione ed il giallo.
Melancholy Philosophy: Freud and Benjamin

Ilit FERBER
https://doi.org/10.4000/erea.413
Plan | Texte | Bibliographie | Notes | Citation | Cité par | Auteur
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Loss
Loyalty and Commitment
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1In his 1917 essay “Mourning and Melancholy”, Freud recognizes two mutually exclusive
responses to loss — mourning [Trauer] and melancholia [Melancholie]. This sharp distinction
between the two responses has long since become almost synonymous with the
understanding of a normal versus a pathological reaction to loss, and the clear demarcation
between them. At the outset of Freud’s article the two responses would seem closely related,
but the question of the acceptance and acknowledgement of the loss complicates the picture
and draws them apart (244). Both Freud’s mourner and melancholic begin with a basic denial
of their loss and an unwillingness to recognize it. But soon enough, the mourner, who is
reacting in a non-pathological manner, recognizes and responds to the call of reality, to let
go of the lost-loved object and liberate libidinal desire. This is the point of divergence with
the melancholic who remains sunken in his loss, unable to acknowledge and accept the need
to cleave and in a self-destructive loyalty to the lost object, internalizes it into his ego, thus
furthermore circumscribing the conflict related to the loss. The lost object continues to exist,
but as part of the dejected subject, who can no longer clearly define the borders between his
own subjectivity and the existence of the lost object within it. The structure of this
melancholic response is conceived by Freud as an antithesis to the basic well-being of the
ego, the survival of which is put at risk.
2Benjamin’s understanding of loss and its affect provides a challenge for the Freudian fixed
distinction between mourning and melancholy. Benjamin’s challenge is not direct, namely he
does not explicitly criticize Freud’s texts, but nevertheless alludes to them in a different
manner that has been described in terms such as a “constellation” (Nägele), a “long-distance
love affair” (Rickels), dependence (Hanssen) and “intertextuality” (Ley-Roff), hence stressing
the indirect character of this relation. I understand the affinity between Benjamin and Freud
as that which does not lie in such types of relation, but rather in a certain concern with the
name “melancholy” and with Benjamin’s desire to unfold it. As he claims in the prologue to
his book on the Trauerspiel (The Origin of German Tragic Drama): “[…] philosophy is — and
rightly so — a struggle for the presentation [Darstellung] of a limited number of words which
always remain the same — a struggle for the presentation of ideas.” (37, translation
altered): to this, the idea of melancholy seems to be a perfect exemplar, as it is a concept
that can almost be conceived as collapsing under the weight of its own history. This
historically-laden idea attracts Benjamin so much because of the special way in which the
encumbrance of different meanings, opposing implications and astounding similarities has
filled it up to its rims. Unfolding and disclosing the “name” melancholy, or as Benjamin would
choose to designate it in other contexts, the “idea” of melancholy, is the crux of his
exploration of the term. In that sense, it is important for Benjamin to unfold an existing Idea
rather than inventing a new one, since he sees the struggle for presentation of the already
existing, as what stands in the midst of the philosophical enterprise.
 1 Clewell suggests that the distinction between mourning and melancholia which is presented so
secur (...)
3The division between mourning and melancholy is completely absent from Benjamin’s book
on Trauerspiel, in which he uses the terms Trauer and Melancholie interchangeably, not
surrendering to the distinction between normality and pathology which psychoanalysis has
made commonplace. Benjamin summons melancholy at the end of the second part of
the Trauerspiel book in order to reinforce and enrich his discussion of the special type of
sadness and mourning expressed in the Trauerspiel. In this, he employs melancholy in order
to understand mourning and does not use any form of differentiation between them. It is my
claim that Benjamin poses a challenge to Freud’s overly secure distinction, by providing an
alternative located between the two facets of the Freudian division, drawing from both,
without being identical with any of them. Benjamin does not view melancholy as an illness to
be overcome or cured, but rather as a mood or disposition towards the world. Feeling is
transformed into mood, thus overcoming the philosophically problematic libidinal relation to
the object in Freud, translating it into an attitude towards the world, rather than a
pathology.1 In this essay, I shall examine three intersection points between the two thinkers,
showing in what way Benjamin transforms Freud’s psychoanalytic and subjective approach to
a philosophical attitude or mood. Benjamin’s understanding of melancholy can be examined
on two levels — one is his treatment of the baroque Trauer and allegory, and the second, is
the application of the term to his own work. I will address both these levels by presenting
three points in which Benjamin encounters Freud: (1) loss; (2) loyalty and commitment to
the object; and (3) work.
Loss
 2 Agamben pushes this further to claim that the melancholic actually lost what was never hers to
hav (...)
4In “Mourning and Melancholy” Freud writes that “Mourning is regularly the reaction to the
loss of a loved person, or to the loss of some abstraction which has taken the place of one,
such as one’s country, liberty, an ideal, and so on” (234). Whereas in melancholy “the object
has not perhaps actually died, but has been lost as an object of love […] In yet other cases
one feels justified in maintaining the belief that a loss of this kind has occurred, but one
cannot see clearly what it is that has been lost […] This would suggest that melancholia is in
some way related to an object-loss which is withdrawn from consciousness, in contradiction
to mourning, in which there is nothing about the loss that is unconscious” (245). In other
words, loss stands in the midst of the two diverse reactions, but in the first it is a conscious
and locatable one, while in the second the deep feeling and sorrow for the loss, becomes
unconscious. A loss has occurred, but it is unclear who or what was in fact lost. 2 Needless to
say, this is not to undermine the painful dejection and sorrow of the melancholic — it might
even be said that his affliction is even greater, inasmuch as he cannot locate the ground for
the pain. Following this analysis, Freud claims that if “in mourning it is the world which has
become poor and empty; in melancholia it is the ego itself” (246), thus locating loss in the
midst of both mourning and melancholia, albeit on different levels. The mourner’s loss seems
to have drained out the world itself, stretching out the site of loss to contain everything but
the dejected subject. The melancholic on the other hand, experiences a different kind of loss,
that of the ego. The loss of the ego that Freud inscribes to the melancholic is the aftermath
of the loss of love. It comes about when the lost object is internalized into the pain-stricken
ego, consequently splitting it apart, dividing it from the inside and rendering the ego itself
lost. The internalization of the loss, presents an interior absence within the ego, turning the
latter into the battlefield of separation, which at the end of the process is emptied out. The
schizophrenic divide within the ego, creates a space in which the ambivalence and hatred
originally produced with regard to the loss, is turned towards the self. The pathological
identification with the lost object is thus the ground upon which the ego attacks itself.
5Several portrayals of loss can be identified in Benjamin’s Trauerspiel book. The book as a

whole deals with Trauer and is therefore at its outset always-already a discussion of loss and
the response to it. However, more closely related to melancholia than to mourning, this loss
is not clearly accounted for in the book, or at least not specifically located. Nevertheless
allusions to it are scattered everywhere and its symptoms — such as the melancholic’s
distaste for life, his detachment from the world, etc. — are all the more present in the plays
and their configuration. Loss, as I read it, is in fact, the condition of the possibility
of Trauerspiel, which is structured as abounding responses to this loss in its subject matter.
Thus, as in Freud, loss occupies both the condition and the arena of its effect.
 3 The question of legibility and loss as its condition remains central to Benjamin throughout his
wo (...)
6Loss as a condition of possibility is present quite strongly in the actual subject matter of the
book. Benjamin discusses the conditions under which a work of art can be criticized or
matter can be the material of philosophical work, under terms of loss. He writes of
the Trauerspiel plays that “from the very beginning... [they] are set up for that erosion
[Zersetzung] by criticism which befell them in the course of time…. Criticism means the
mortification of works… the settlement [Ansiedlung] of knowledge in dead… [works]” (181-
2). The discussion of death and loss here becomes the condition of legibility of the works in
this case the Trauerspiel. Terms like erosion, death of Schein and ruins, all allude to the
extinction of the material aspect of the work. In order to approach it critically, something in
the work must be lost. This loss can be understood in sundry meanings, to all of which
Benjamin’s use of the term “mortification” is crucial. The activity of criticism as mortification
positions it first and foremost in the material. In states of erosion, ruin or degradation,
something is exposed in the material, opening it up for the critical gaze. Mortification locates
truth in the material, and furthermore — in dead material, that is, in the material that has
lost life and has become mere material. The work must be lost as a pre-condition to reading
it. “Mortification” should be understood here as what befalls the work or as what the critic is
bringing upon it. Following that, the “body” of the work, should be understood literally: the
work has a living body, and when it dies and life flows out of it, it remains a corpse, devoid
of life, ready for its autopsy. Benjamin also alludes to the special position of
the Trauerspiel specifically, which is not only a corpse but a corpse from the moment of its
birth. In other words, what is so exemplary about the Trauerspiel for Benjamin is its constant
state of death, or put differently — its constant internal reference to being lost. From their
very beginning, these plays are already in a state of decomposition and putrescence. It is as
if the Trauerspiel was a genre stillborn. This points to the fact that Benjamin’s choice of
the Trauerspiel is not accidental but exemplifies his interest in this extreme case of a living-
corpse or living-dead.3
7Understanding loss as a condition of possibility appears in the Trauerspiel book in another

image, that of emptiness. Freud’s claim that the mourner sees the world as empty after
experiencing the loss of his loved-object is echoed in Benjamin’s discussion of the baroque
religious ambient as well as in the Trauerspiel itself. Benjamin notes that the great baroque
playwrights were Lutherans and were thus located in the midst of an antinomic relation to
the everyday — a relation which reverberates in the plays they write. Lutheranism denies
“good works” since those cannot be dependant upon for redemption. Only external grace
which would come about only through faith and not deeds, could bear redemption with it
(Trauerspiel 138). This creed empties-out the everyday life and deeds, since they become
meaningless in terms of redemption. Conceiving the everyday as futile and trifling has
produced melancholy in great men, writes Benjamin, mentioning even Luther himself as
having suffered from melancholy and a “heaviness of soul”. Hamlet as the exemplary figure
of Lutheranism also contains a strong protest against it in his melancholy. Benjamin writes of
Hamlet that his words “contain both the philosophy of Wittenberg and a protest against it.
[…] Human actions were deprived of all value. Something new arose: an empty world […]
For those who looked deeper saw the scene of their existence as a rubbish heap of partial,
inauthentic actions” (Trauerspiel 138-9). Here Benjamin combines the empty world Freud
ascribes to the mourner, with a melancholic reaction. The meaninglessness of the world
empties it out, causing baroque men, playwrights and Hamlet as a paradigm — to sink into
melancholy. In this combination between mourning and melancholy, one can say the empty
world of the mourner, has been internalized into the ego, causing it to empty out as well.
The empty world stands as a ruin of meaning inhabited by nothing significant or redemptive;
it is lost.
8The issue of the abstract nature of the melancholic loss and specifically its non-intentional
character is crucial in Benjamin and arises in various contexts. First and foremost it appears
in the prologue to the Trauerspiel book where Benjamin writes that “truth is the death of
intention” (36). This statement is a complex and obscure one and it embodies one of the
most essential attributes of Benjamin’s special object-relations. Elsewhere Benjamin explains
the relationship between sadness and intention as follows: “sadness […] would be boundless,
were it not for the presence of that intentionality which Goethe deems an essential
component of every work of art, and which manifests itself with an assertiveness that fends
off mourning. A mourning-game [Trauer-Spiel], in short” (Selected Writings, Vol. 2, 373).
Here, sadness and mourning stand as opposites to intention, and intention has the capability
to fend them off. This citation parallels the characterization of the melancholic — the fact
that there is no object to which one can direct his sorrow, turns the melancholic’s eyes
inward in a Nietzschean gesture, only to find his own lost conscious. It seems that being
intentional is what blocks and produces a border for otherwise infinite and boundless
sadness. Intentionality has the power to encapsulate sorrow, to set it within the threshold of
the intended object, thus stopping it from expanding boundlessly and curelessly. Benjamin’s
notion of non-intentionality presents a certain type of object relations which should be
maintained with the critical object — the object of truth.
Loyalty and Commitment

 4 The destructiveness is come upon by Freud through his analysis of the extreme self-reproach of
the (...)
 5 For a compelling discussion of the ethical dimensions of melancholy, see Comay.
 6 Freud writes in a letter to Binswanger who has just lost a son, about his own loss of his
daughter (...)
9The second point of intersection with Freud’s text is that of the deep loyalty and
commitment the melancholic confers on his loss. The melancholic is establishing
identification with the lost object, by allowing it into the confines of the ego and turning it
into an integral part of him. As Laplanche writes with such insight, “Far from being my
kernel, it is the other implanted in me, the metabolized product of the other in me: forever
an “internal foreign body” (256). This laden state of destructive internalization, I argue, is an
embodiment of the endless commitment and responsibility the melancholic feels towards his
object. For the melancholic, the only way to keep the object is to destroy it. 4 It seems thus
that the model of loyalty Freud is suggesting is that of extreme destructiveness. Not only
does the melancholic patient not acknowledge the loss up to a pathological level, but he also
destroys the lost object in the attempt to keep it. The devouring of the object into the self is
the means by which the subject tries to keep the object from being lost. 5 The loved object
takes flight into the sanctuary of the ego, in order not to be extinguished. No mourning is
possible here, the work of parting is blocked in melancholia, writes Freud, since there is a
basis of ambivalence that wishes to hold the object and to let go of it at the same
time.6 Freud advocates killing off the traces of attachment to the other, as a means to
reestablishing mental health and returning to life. This demonstrates that Freud professes
that a subject can in fact exist without traces of what he has lost, or in other words, the
healthy subject for him is capable of repudiating attachments to lost others (Clewell 60). This
avowal would turn extremely problematic in Benjamin who, I argue, understands the work
undertaken in mourning not as an overcoming and effacement of loss, but rather as the
deepest articulation of its everlasting traces.
10The work of mourning can be seen not as a healthy response, but rather as an egotistic
one. The selfish aspect in mourning introduces a narcissistic self-love that is related to
extreme subjectivity. Freud’s text suggests, therefore, that the event of loss is an
opportunity for understanding that “the people we love are imminently replaceable and that
we necessarily fail to appreciate exactly how other they are […] in this model […] the loss of
a love object is understood as a temporary disruption of the mourner’s narcissism”
(Clewell 45-6). At the other end of mourning, stands melancholia, with its overwhelming
commitment to loss, which takes over the psyche at the price of giving up the well-being of
the self and the ego. The melancholic act of internalization circumscribes the loss and
sacrifices the self for its sake. The economy of the self becomes marginal in relation to the
responsibility towards that which was lost. The absence cannot be replaced by anything since
no symbolic mediation will ever be sufficient, not even memory. The melancholic thus gives
up the external world as a source for the construction of the self, and is destructively
satisfied by his own split tormented interiority, that becomes an expression for his endless
loyalty.
11Benjamin discusses the dialectics of loyalty when he describes the figure of the courtier in
the Trauerspiel. The courtier betrays the prince, and instead maintains loyalty to the objects
of kingship: “His unfaithfulness to man is matched by a loyalty to these things to the point of
being absorbed in contemplative devotion to them… Loyalty is completely appropriate only to
the relationship of man to the world of things. The latter knows no higher law, and loyalty
knows no object to which it might belong more exclusively than the world of things”
(Trauerspiel 156-7). The courtier betrays the prince at the moment of crisis, when “the
parasites abandon the ruler, without any pause for reflection, and go over to the other side.”
The courtier reveals an almost inconceivable unscrupulousness which indicates a dismal and
melancholic submission to an order of material constellations rather than that of human
morals (Trauerspiel 156), thus choosing material objects upon the prince. The example of
the courtier functions here to illuminate the distinct position of loyalty in relation to the
ethical realm. Loyalty cannot function as the highest law in the realm of human relationships,
insofar as it cannot encompass an ethical relation. In this realm, loyalty cannot encompass
and embody an ethical relation; it can only become possible when turned upon
something lifeless: only in the world of things can human devotion function as the highest
possible law — it is only then that responsibility loses its ethical nature and turns into blind
devotion. But the choice to be invested in non-living things immerses the courtier in and
subjects him to the earthly and material, thus detaching him from the human world. These
two mutually exclusive options, the material and the human, present the faithlessness to the
prince as the obverse of the faithfulness to things. The latter being a dead realm, a realm of
despair and immobility, but nevertheless, the only one which can contain meaning (even
subjective arbitrary meaning). In opposition to meaning which is fleeting and elusive, the
presence of objects is irrefutable and dependable. However, this deep tenacity also has a flip
side in which utter loyalty becomes entangled with betrayal (Trauerspiel 157). There is a
dialectics inherent in loyalty: the deepest devotion is always saturated with a secret wish to
take over the thing, to take over meaning. In that sense it is very similar to the destructive
loyalty of the melancholic that, filled with commitment and devotion, destroys the object
within the confines of the melancholic consciousness. The objects are also an eternal
reminder of the emptiness that remains after all meaning and faith is gone. The power of this
emptiness lies in its capacity to be filled with meaning again. The image of the world of
things is an image of loss, but a loss which has a potential, albeit partial, for recuperation.
 7 These two extremes can be seen in two of the figures Benjamin is occupied with elsewhere: the
coll (...)
 8 This can be found especially in the early “On Language as Such and on the Language of Man”
(Select (...)
12Understanding loyalty means understanding a feeling towards the object, be it any one
two extremes: complete love and devotion, or the secret wish to take over. In both cases,
the object does not remain what it was, and is transformed into something completely
different which is couched in the intense feeling towards it, which in one case empties it out,
and in the other tears it away from everything that is not complete and total love. 7 The place
from which Benjamin is approaching his objects of philosophical work, is from within such
commitment which stands between love and destruction, devotion and a take-over. The
melancholic commitment to the loss, including its problematic sides, receives echo in
Benjamin’s philosophical and historical enterprise. 8
Work
 9 It is interesting that in his 1917 “Mourning and Melancholia,” Freud is stressing the element of
w (...)
13The third and last intersection I want to construct between Benjamin and Freud is that of
the concept of work [in the sense of Arbeit and not Werk]. This might be the most important
element in my discussion, since it illuminates the way in which Freud’s argument for
pathology may turn to be philosophically and critically productive in Benjamin. If the notion
of commitment was derived from the melancholic stance, Benjamin draws the concept of
work from the mourner. The Trauerarbeit [work of mourning] is what Freud defines as the
servitude that the mourner performs in the long and intense process of detachment from the
lost object (note here the interesting relation that can be constructed between Trauer-
arbeit and Trauer-spiel, work and play).9 After the call of reality has been accepted, there is
work to be done. This is the point in which the reality-principle takes over and directs the
mourner to the important work of detachment which is aimed at living once again, freed
from mourning. The long and arduous process of the work of mourning maintains the lost
object within the psyche, gradually accepting the fact that it is indeed lost and working a way
out of the attachment to it. The work is composed of a slow and painful working through of
each of the memories and strands attaching the dejected subject to the object, which Freud
defines as a thousand links (256). The detachment from the loss is done thereupon, through
an extremely meticulous work of untangling the attachment, which is largely composed of
memories.
14However difficult and even unbearable this work may be, it nevertheless ends with a
complete loosening of all points of attachment to free the subject so that “the ego becomes
free and inhibited again” (245). In other words, the cutting of the strands of attachment is
dictated by the voice of reality, so that the work of mourning is directed towards life and life-
energy. This is the point in which the principle of life takes over and directs the mourner to
focus himself on the important work of detachment and uninhibited life. The aim of the
process of detachment has thus, nothing to do with the object itself, but with the subject
which has to be freed from it. The object here is only a problem that we should push aside in
order for reality to prevail. “Mourning impels the ego,” Freud writes, “to give up the object by
declaring the object to be dead and offering the ego the inducement of continuing to
live” (256). Evidently, this is a point from which the melancholic is as far as can be. Not only
does he not detach himself from the object, but he internalizes it — consequently preventing
the possibility to detach. When the object becomes part of him, such work of mourning is no
longer feasible. Lacking the necessary distance and blurring its borders with the subject —
the lost object is left to decay within the melancholic, without the possibility of disposal.
Freud indeed mentions the possibility of work in melancholy but neglects it immediately,
since being incorporated in the melancholic and divested of its independent and external
status, the object is rendered un-workable (257). Whether it is because the loss is un-
identifiable or because the lost object was already incorporated into the melancholic subject
himself — no work can be executed, since the loss is itself lost.
 10 “On Language as Such and on the Language of Man” can provide a good place to explain what
such an (...)
 11 Note the curious relationship between the “Trauerarbeit” and “Trauerspiel”: work of mourning and
p (...)
15I argue that Benjamin combines melancholy and its deep acknowledgement and
responsibility towards loss, together with work — and more specifically with philosophical
work. Thereupon, Benjamin does not view work as what should be directed towards a
detachment from the object, aimed at rendering it absent, so that the subject will be become
free again. Rather, work is aimed at presenting the object, giving it a voice and consequently
redeeming it. Lagache’s definition of the work of mourning as “killing death,” (486) will not
suit us here. It is not Life that is inaugurated, but rather lifelessness. Benjamin is
transferring the concept of work from the realm of mourning to that of meaning, thus the
work of expression will be a deepening of the loss, an extended deadening of the object. The
object will not be disposed of but presented and given a voice, 10 and thus saved. Philosophy
is not waiting to return to life after detaching itself from the lost object. Rather, it comes to
its fullness from within this deadening. In other words, the work Benjamin is proposing is
that of rendering the object present, and not absent (as the mourner does). It is a work that
lacks neither the pathology of melancholia, nor the normality of mourning — it is a sad
work,11 in that it is still, almost heavy, lacking the libidinal-life energy, which makes
melancholy so destructive, and mourning so easily parting.
16I have now reached the crux of my talk. I will now present the other end of loss in
Benjamin — not the one standing as a pre-condition to the work of loyalty and responsibility,
but that which lies at the completion of this work: a loss which is not an effect of work, but
of rest.
17In contrast to Freud’s concept of work, which effaces all traces of loss, Benjamin work
very distinctly harbors and intimates such evocations. Benjamin conception of work in the
preface to the Trauerspiel book, is clearly not concerned with the eradication of the traces of
loss and destruction, on the contrary — it emphasizes them. In his description of the mosaic
as an image of the philosophical idea, Benjamin writes that the latter’s particles are always
glued together in a manifest manner. “And the brilliance of presentation depends as much
on… [the] value [of the fragments of thought] as the brilliance of the mosaic does on the
quality of the glass paste” (TS 29). Not only is the puissance of the picture not affected by its
fragmentation and ruin-like quality, but it is intensified by just that. The glue becomes a
condition for the forcefulness of the picture. It is this “failure” in the picture, which harbors
its strength, and it is the traces of that which was destructed and lost, which present
themselves in the truth. There is never a complete closure or concealment of the loss, but
the philosophical work and its result, constantly bear it within them. The product of the
philosophical work, the idea, which is produced from the condition of loss, will always bear its
traces (Butler 468). This strengthens my claim for the work of presentation and expression
instead of that of detachment. Benjamin is therefore not overcoming loss as he does not
mourn, but works through it and is engaged with the loss itself, and the presentation of this
loss.
 12 I am indebted to Friedlander’s book for numerous ideas that profoundly concern Benjamin’s
writings (...)
18One of the most captivating implications Freud offers in his text is the illuminating
insinuation that the melancholic’s lost object is half-alive. It is an object already lost and
thereby not living, but is not yet completely dead since it still exists in one way or another,
within the melancholic consciousness. It is thus half-alive, one buried-alive. The pathology of
the melancholic state is that it cannot let go, unable or unwilling to part and bring itself to
rest. However, rest is also absent from the object itself, which hovers between life and
death, powerless in the face of the destructive melancholic energy clinging to it. Relocating
Freud’s account in the realm of meaning under Benjamin’s transformation of the pathology of
the lost object, the terminology of stillness or rest might gain auxiliary meaning. Not only
does stillness arrest the destructive agitation, but it also brings the object to rest.12 The
philosophical work of expression, the work that presents the object in its fullness while being
devoid of intention, is also that which brings it to rest. However, bringing to rest is not
meant here in the sense of burial that would conceal the object from sight in order to mollify
the detachment — rather, it is bringing to rest in the sense of deadening or deepening death,
and bringing to a complete rest. A complete philosophical expression would mean exhausting
and draining from life, thus removing the object from the sphere of being half-alive, and
deadening it. In other words, presenting meaning does not imply endowing the object with
life or rebuilding its ruins, but rather bringing to rest in completing the process of its
extinction. Bringing to rest therefore, is closely related to actualizing and securing meaning,
which are both based on the cessation of life or its draining into congealed significance. This
significance is attainted by retaining the loss, rather than by overcoming it.
19Bringing to rest moreover requires detaching, but in a very different sense than the
detachment of mourning. The work of mourning entails cautiously reviewing every memory
and point of attachment to the object. There is something very personal about this type of
work. The subject is working through his ownstrands of attachment to the loss. This goes
hand in hand with the subjectivity that stands in the midst of the psychoanalytic project. The
aim of the process of detachment has nothing to do with the object itself, but with
the subject which has to be freed from it. The object here is only a problem that we should
push aside in order for reality to prevail. The Benjaminian project takes a different direction
altogether. The detachment which occupies an important place in the process of expression
is intended towards freeing the object itself, bringing it to rest, and not freeing a subject
from it. The mourner is detaching in order to make the object absent, whereas Benjamin
detaches through the process of expression in order to make the object present.
Consequently, detachment here means presentation and not concealment or suppression.
Benjamin work has a strong commitment to knowledge and articulation of the object — and
in that way is putting it to rest and comes to terms with it.
20In that sense, loss stands at both ends. It is a condition to the work of expression, since it
functions as the condition to making the object legible in the first place. At the second end
stands loss as a state in which the object is fully expressed and drained of life (in Benjamin’s
words). Bringing to a rest, deadening or burying, are also forms of loss. All potential of life
and potentiality in the object are lost at the end of the process, but this is the only way to
completely express it “at a standstill”. Benjamin situates his philosophical work at the core of
loss, and calls for the understanding and the acknowledgement of that loss, together with a
strong commitment and work it requires. Hence, loss which was the precondition to
philosophical legibility and work is likewise present as the outcome of this work. “All
purposeful manifestation of life… have their end not in life but in the expression of its nature,
in the representation of its significance” (Benjamin, Selected Writings, Vol. 1, 255, my
emphasis). That said, the work of philosophical expression takes place at the end of the
object’s life, at the point of its utmost loss. There, philosophical work imparts rest.
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Bibliographie
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Notes
1 Clewell suggests that the distinction between mourning and melancholia which is presented so
securely by Freud, is also questioned by him. She claims that in order to part, we first need to
identify, and in that sense mourning becomes the condition for melancholia. This claim does not
cancel out the distinction, but rather positions the two responses or structures as working
together (61).
2 Agamben pushes this further to claim that the melancholic actually lost what was never hers to
have (thus maintaining a relationship with the imaginary). In this claim, we are confronted with a
situation in which not only the object is lost, but the loss itself is lost as well. The difficulty to
overcome such a loss stands exactly in its being without locus, in the inability to direct any “work”
whatsoever to anything.
3 The question of legibility and loss as its condition remains central to Benjamin throughout his
work and reaches its most lucid formulation in his last texts on history and the Arcades Project
(Specifically in convolute N).
4 The destructiveness is come upon by Freud through his analysis of the extreme self-reproach of
the melancholic. Freud understands it as something that is actually not directed towards the self,
but towards the lost object. However, since this object was internalized and became part of the
self – the criticism and aggressiveness is now turned towards the patient himself. The attempt to
murder or annihilate the other, actually becomes self-murder, or suicide – since that other is now
part of the self. Consequently, self killing is only possible when the subject turns itself into an
object, otherwise it would oppose the most basic will to life in Freud (252).
5 For a compelling discussion of the ethical dimensions of melancholy, see Comay.
6 Freud writes in a letter to Binswanger who has just lost a son, about his own loss of his
daughter Sophie: “We know that acute mourning resulting from such a loss will come to an end
but that we shall remain inconsolable and shall never find a substitute. Whatever occupies this
place, even if it does so completely, will always remain something else. And, to tell the truth, it is
right that it should be so. It is the only way we have of perpetuating a love we do not wish to give
up” (Cited in Lussier, 671, my emphasis).
7 These two extremes can be seen in two of the figures Benjamin is occupied with elsewhere: the
collector and the allegorist. Each presents one of these options of understanding loyalty. See
Pensky (240-6).
8 This can be found especially in the early “On Language as Such and on the Language of Man”
(Selected Writings, Vol. 1, 62-74); The Arcades Project; and “On the Concept of History” (Selected
Writings, Vol. 4, 389-400).
9 It is interesting that in his 1917 “Mourning and Melancholia,” Freud is stressing the element of
work in the process of mourning, whereas in his “Draft G [Melancholia]” (Standard Edition, Vol. 1,
Extracts from the Fliess papers, 200-206), written probably in 1895, he emphasizes the element
of longing over that of work (200). It seems that in this earlier essay, the escape from such
longing was not yet evident to Freud, thus situating mourning and melancholia as much closer to
one another than in the later essay.
10 “On Language as Such and on the Language of Man” can provide a good place to explain what
such an expression would mean, specifically in what sense Benjamin is aiming at expression of the
object itself, or giving it a voice by man, in the phase before the fall, after which this expression is
transformed into empty chatter (Selected Writings, Vol. 1, 62-74).
11 Note the curious relationship between the “Trauerarbeit” and “Trauerspiel”: work of mourning
and play of mourning.
12 I am indebted to Friedlander’s book for numerous ideas that profoundly concern Benjamin’s
writings as well as Rousseau’s, especially that of bringing meaning to a “rest”.
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Pour citer cet article
Référence électronique
Ilit FERBER, « Melancholy Philosophy: Freud and Benjamin », E-rea [En ligne], 4.1 | 2006,
document 10, mis en ligne le 15 juin 2006, consulté le 23 juillet 2020. URL :
http://journals.openedition.org/erea/413 ; DOI : https://doi.org/10.4000/erea.413
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Cet article est cité par
 Ferber, Ilit. (2011) Contributions To Phenomenology Philosophy's Moods: The

Affective Grounds of Thinking. DOI: 10.1007/978-94-007-1503-5_5
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Auteur
Ilit FERBER
Tel-Aviv University
Ilit Ferber is a doctoral candidate at the philosophy department, Tel-Aviv University, and a 2004-
05 Fulbright recipient in Princeton's German department, where she is currently conducting her
research. She is finishing her dissertation, “The structure of melancholy and the way it is
expressed in Walter Benjamin's writings,” which examines Benjamin's early texts and their relation
to melancholy and mourning. She has presented papers on Kant, Benjamin and Brecht, and is a
2006-07 “Dan-David” post-doctoral recipient at Tel-Aviv University.
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Accueil>Numéros>4.1>Melancholy Philosophy: Freud and ...
4.1 | 2006 : Discourses of Melancholy
Competing Melancholies: (En-)Gendering Discourses

of Selfhood in Early Modern English Literature
Rainer EMIG
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1When the shepherdess Urania in Lady Mary Wroth’s The Countess of Montgomery’s

Urania (1621) enters a cave where she hopes to be alone with her sorrows, she is in for a
nasty surprise: there is already another occupant. A man who calls himself Perissus, the lost
one, has stretched himself out on a bed of leaves and is waiting for death. What then ensues
is a near-comical quarrel for the right to the cave with each candidate trying to come up with
the most convincing claim to suffer the most:
“O God,” cried Perissus, “what devilish spirit art thou, that thou thus dost come to torture me? But
now I see you are a woman; and therefore not much to be marked, and less resisted: but if you
know charity, I pray now practice it, and leave me who am afflicted sufficiently without your
company; or if you will stay, discourse not to me.”
“Neither of these will I do,” said she.

“If you be then,” said he, “some fury of purpose sent to vex me, use your force to the uttermost in
martyring me; for never was there a fitter subject, then the heart of poor Perissus is.”
“I am no fury,” replied the divine Urania, “nor hither come to trouble you, but by accident lighted
on this place; my cruel hap being such, as only the like can give me content, while the solitariness
of this like cave might give me quiet, though not ease. Seeking for such a one, I happened hither;
and this is the true cause of my being here, though now I would use it to a better end if I might:
Wherefore favour me with the knowledge of your grief; which heard, it may be I shall give you
some counsel, and comfort in your sorrow.”
“Cursed may I be,” cried he, “if ever I take comfort, having such cause of mourning: but because
you are, or seem to be afflicted, I will not refuse to satisfy your demand, but tell you the saddest
story that ever was rehearsed by dying man to living woman, and such a one, as I fear will fasten
too much sadness in you; yet should I deny it, I were to blame, being so well known to these
senseless places; as were they sensible to sorrow, they would condole, or else amazed at such
cruelty stand dumb as they do, to find that man should be so inhuman.” (1426-7)
2What is debated and challenged by the protagonists of Wroth’s tale is access to, and thus
the claim to possession of, one of the crucial cultural concepts of the seventeenth century:
melancholy. I will try to show in this essay how melancholy forms one of the means with
which eccentricity is established as a cultural force. Moreover, I will try to demonstrate how
melancholy is instrumental in creating that which is considered a benchmark of Modernity, a
notion of the individual subject.
3Melancholy is no completely new phenomenon in the Renaissance. It derives from classical

and Medieval models of the balance of bodily fluids. The earliest ones are attributed to a
follower of Aristotle, probably Theophrast, and to the famous physician to the Roman
emperor Marcus Aurelius, Galen of Pergamon. With Cassian melancholy was appropriated by
Christian thinkers in the second half of the fourth century. It also became of interest to Arab
thinkers, including the famous Ibn Sina, around the turn of the tenth into the eleventh
century — whose ideas the Christian part of Europe reappropriated under the name
Avicenna. Among the most elaborate Medieval treatises on melancholy are those by
Hildegard of Bingen. With Marsilio Ficino the concept entered the Italian Renaissance in the
fifteenth century (Radden The Nature of Melancholy).
4Already Aristotle (or his follower, very likely Theophrast) accepts for his ideas on
melancholy the theory of bodily fluids outlined by the fifth-century BC physician Hippocrates,
according to whom the most important of these fluids — which were also called “humours” —
were blood, phlegm, yellow and black bile. Their harmony created healthy and balanced
individuals. Yet much more interesting (and frequent) were thought to be the cases in which
their imbalance produced certain character types, but also illnesses. These character types
are still familiar to us today: the sanguine person supposedly full of energy, enjoying life, but
also prone to passion and lust; the phlegmatic type, thought to be passive and slow, often
subject to laziness and bouts of inactivity; the choleric type, jealous and envious, easily
enraged and aggressive. Lastly, the melancholic type, suffering from an excess of black bile
thought to be produced by the gall bladder. This type was believed to be susceptible to what
we would nowadays call depression, withdrawn, seeking isolation, and finding his or her (it
was usually his) preferred realm of (in-)activity in meditation, reading, and study.
5Yet already Aristotle (or Theophrast) was unsure about the borderline when melancholy
ceased to create exceptional persons and instead produced madness and even suicide. He
boldly asks “Why is it that all men who have become outstanding in philosophy,
statesmanship, poetry or the arts are melancholic, and some to such an extent that they are
infected by the diseases arising from black bile [...]?” (Radden 57). He continues, a little
below, after confusingly claiming that melancholy exists in forms of excessive heat or cold of
the brain: “But those with whom the excessive heat has sunk to a moderate amount are
melancholic, though more intelligent and less eccentric, but they are superior to the rest of
the world in many ways, some in education, some in the arts and others again in
statesmanship” (58). Already in the classical age, the discourse of melancholy meets that of
eccentricity, and both work by shading over normality or norm into the exceptional, with
positive of negative consequences. Even more fascinating is the repeated connection that
this Aristotelian treatise makes between melancholic eccentrics and power, its examples
being drawn not merely from what we would nowadays call the cultural sphere, but from that
of politics and the military. Thus it lists, besides Empedocles, Plato, and Socrates, also
Lysander the Spartan, Ajax, and Bellerophontes (57).
6The discourse of such “humours” from Antiquity to the Renaissance offers a primitive
means of negotiating individuality. It is primitive because of its strong schematism, yet
eventually permits a massive step away from Medieval binary notions of good and bad —
according to conformity with God’s plan for mankind and the supposed roles this plan
contained. At the same time, the particular humour of the melancholic brings with it
important privileges: it contains the greatest amount of self-determination (even the lusty
sanguine type is ultimately dominated by his passions); it brings with it an attraction to
activities appreciated by an age that placed increasing value on individual reflection, study,
and learning. At the same time it freed such reflection and study from the conventions of its
traditional authority: the church. The melancholic meditates, but he does not always pray;
he studies and reads, often indiscriminately, and not always the Bible and other religious
tracts. Despite the associations of suffering and illness, melancholy therefore proved an
attractive state, and it is no coincidence that women also lay claim to it once it has been
established — if they do not indeed participate in its construction.
7Shakespeare’s character Hamlet is frequently taken to embody the emergence of this

concept. His dress and behaviour, but most importantly his reflections, which are shared with
the audience in several monologues, clearly point towards this identification. His character
also shows the status of melancholy vis-à-vis established cultural norms: in order to become
a minimal subject through melancholy, one has to distance oneself from the norm, make
oneself eccentric that is (Gardiner 380-1). Hamlet, no lesser person than the son of the
deceased king with a strong claim to the throne, is an outsider at his own court of Denmark.
He is even more of an outsider since he is a student currently at leave from the university at
Wittenberg (the explicit hints towards the Reformation are important here, too).
8What is frequently called his characteristic indecision and hesitation, though, often too
quickly identified as his variant of a traditional tragic flaw, the prerequisite of a classical
tragic hero, is in fact his reluctance to leave his eccentric status behind and exchange it for a
centric one. If his aim was a simple reversal of power, he would stage a revolt and replace
the supposed usurper on the throne, his uncle and now step-father Claudius, with himself.
Yet this is evidently not Hamlet’s goal. None of his actions, not even the ones related to his
plan to avenge the death of his father, explicitly have this end in mind. It is as if Hamlet
cherishes his eccentric status, a fact supported by his vacillation concerning another
“normalising” aspect of his life at court, his tortuous courtship of Ophelia. Despite their
status differences, there is no real reason why Hamlet should not marry her. Not even his
plan of revenge is a real obstacle. Yet he not only thwarts any hope of eventual marriage he
or Ophelia might have; he also divulges his reasons for abstaining in terms that can once
again be called melancholic. This opens up the interesting possibility of reading the ghost of
Hamlet’s father as the equivalent of Wroth’s temptress Urania: here, the ghost tempts
Hamlet to integrate himself into the pattern of the avenger, while the court tempts him to
integrate himself as the heir apparent to the throne. Both voices are equally devilish — as
those of the ruling ideology.
9At this point it is helpful to bring in an anachronistic, but very influential view on
melancholy, since it offers some explanation towards its functioning even at a time when one
cannot seriously talk about a developed concept of the human psyche. Sigmund Freud’s
psychoanalytic theories distinguish carefully between mourning and melancholy. In an
eponymous essay, Freud describes mourning as the process of letting go a lost object.
Melancholy, on the other hand, is a trickier affair: it actually refuses to give up its lost object
and keeps it in a vacillating state where the subject on the one hand refuses to acknowledge
that it is gone, and on the other keeps on killing it symbolically — paradoxically to thereby
ensure its continuing presence (Freud 245-68). In the case of Hamlet, as has been pointed
out by several critics, this object is his dead father, whose death is once more made manifest
to him in the narrative of the ghost, while this very ghost represents Hamlet’s attempt to
keep his father even after his loss (Garber 124-37).
10More than just a family or individual matter, Hamlet’s melancholy contains important
elements for a discussion of eccentricity. The melancholic does not know what he or she is
sad about and strongly refuses to identify any object of his misery. This often leads to the
impression that misery itself is the object of the melancholic, something that one finds
confirmed with some important modifications in Robert Burton’s seminal The Anatomy of
Melancholy, which was published in the same year that Wroth’s Urania appeared, 1621.
Sustaining his or her state of being without a motivation and justification normally required
by the world, however, is the secret behind, the raison d’être of the melancholic as an
individual. The self-imposed and unjustifiable distance from the norm enables him or her to
be — as an eccentric.
11Wroth’s Urania is in exactly such as position of self-legitimation through keeping the secret
of her sorrow hidden — even from herself. She mourns that she does not know her parents.
Tough luck for a shepherdess, one feels compelled to comment. For someone suffering no
other pain or deprivation, entrusted with a simple task that enables her to take as much time
off for private musings, she is hardly entitled to sadness. Perissus thus seems to have the
upper hand. His loss is real, that of his beloved wife. Yet rather than being a mourner who
eventually lets go, he, too, becomes engaged in a melancholy cycle whereby he keeps his
supposedly lost object alive by staging an elaborate theatre of suffering — for himself.
Urania, not very pleased with such a lesser form of melancholy (lesser, because it knows its
object), consequently offers him a conventional piece of advice, one that employs the
strategies of contemporaneous revenge tragedies. She tells him that it is his duty to avenge
his wife’s death. This would integrate him in a regular pattern of loss again, i.e.
conventionalise him. Male fool that he is, he falls for this ruse and leaves the privileged
realm of melancholy to Urania.
12Revenge tragedy and melancholy indeed have a lot in common. In both, issues of loss and
the proper or improper attitude to it are debated. In both of them one sees the self carving
out a niche for him- or herself at the expense of the emerging individual’s role in — or rather
versus — society. In keeping with the characteristics of eccentricity, both revenge tragedy
and melancholy contain a strong element of observation and visibility linked with established
power hierarchies. In revenge tragedies, the avengers observe their future victims, while
these often watch their presumed enemies or have them watched (Hamlet again is a great,
though by no means the only example). The melancholic appears to watch him- or herself
mainly. Yet his or her privileged segregated state depends on a careful and often implicit
observation of his or her surroundings in order to make sure that the separation is
successful. It contains a continual awareness that the melancholic also feels watched, and
needs to control this observation by others closely. A space is thus created for an early form
of individuality through mechanisms that can be called eccentric. They are mechanisms,
however, that do not establish a modern individual once and for all and place it an
uncontested realm. Whatever is thus positioned in an eccentric realm of its own remains in a
relation with the power against which it is erected — a power that jealously watches its
orbital dissenters and tries to pull them back under its mastery.
13This becomes comically evident in Wroth’s Urania — who can only be sad on her own and
not in company. It is more implicit, but no less pronounced, in traditional descriptions of
melancholy which place melancholics in isolated places, such as remote rooms, even the
“ivory towers” of learning. This negotiation of eccentric spaces and regimes of observation
can be shown to dominate even the superficially opposed embodiments of eccentricity as the
descriptions of melancholy and the often hilarious goings-on in Restoration Comedies.
14A confirmation of my claims can also be found in the most famous English text on spleen,
another label for melancholia, Anne Finch’s eponymous poem, first published in
her Miscellany of Poems Written by a Lady in 1701. Finch was the daughter of a Baronet who
rose even further in rank by marrying the “gentleman of the bedchamber” to the Duke of
York during the reign of James II, who was later promoted to fourth earl of Winchilsea. After
the Glorious Revolution, Finch and her husband fled to their country estate, where they
remained for the rest of their days. Contemporaries claim that Finch wrote “The Spleen” out
of her frequent personal experience of depression, which could apparently only be lifted by
being in nature or engaged in artistic activity (an interesting alternative) or in the company
of her husband. It is arguable, though, that the depressions she depicts also arose from
frustrated ambition and enforced isolation.
15Yet, child of a time that would gain for itself the label Enlightenment, she also tried many
alternative remedies, such as the new luxuries tea and coffee, and the waters of then
fashionable Tunbridge Wells (Radden 168). For, ultimately, and this makes Finch an
“enlightened” thinker rather than an eclectic one like Burton, she at least partly believed in a
natural cause of this eccentric state of mind — in the same way that “spleen” was considered
to be related to a real bodily organ.
16Finch’s spleen poem, however, is not a purely rational treatise on the subject (Rogers 17-
27). The genre itself, and the choice of the Pindaric ode, a loose form traditionally employed
for passionate and enthusiastic verses, already partly subverts any systematic inquiry that it
contains. Similar to Burton, spleen for Finch can be everything, or rather, it can imitate
everything:
What art thou, Spleen, which ev’ry thing dost ape?

Thou Proteus to abused mankind,
Who never yet thy real cause could find,
Or fix thee to remain in one continued shape. (Finch 308)
17Possessing no substance, only surface, and irritating people in the same way as apes (also
a common term for fools and fops), spleen perfectly matches the contours of eccentricity.
The fact that the poem chooses spleen as the addressee of its ode and its equation with
Proteus, the classical god of shape-shifting, however, adds a dimension to it that is touched
on, though not yet properly elaborated, in Burton: creativity. The creative potential of spleen
might only reside in imitation. Yet its effect on “abused mankind” is both investigative and
creative: it provokes them to inquire into its causes (in the best Enlightenment tradition of
experiment) and it triggers attempts at its representation — such as Finch’s poem. At the
same time it also dulls this imagination again, thus acting as a stimulant as well as a
corrective to flights of fancy.
18Important for my argument is once again the obvious link between spleen and
individuality. Spleen does not only possess a Protean quality, it also lends it to those
possessed by it: “In ev’ry one thou dost possess, / New are thy motions, and thy dress’
(Finch 309). This is not very far from the play-acting of Restoration Comedy with its many
men and women of mode. Also in keeping with ostentation and surface, characteristics of
eccentricity since its emergence as a cultural concept in the seventeenth-century, is the
difficulty or impossibility of determining its genuineness. Finch’s poem makes the
complicated claim that fools often pretend to suffer from the spleen, because they know that
some great men are really affected by it (Hellegers 199-217). Yet these great men, in turn,
are also “inclined” towards the spleen as a reaction to their frequent frustrations — and thus
appear to use it rather than genuinely suffer from it:
The fool, to imitate the wits,

Complains of thy pretended fits,
And dullness, born with him, would lay
Upon thy accidental sway;
Because, sometimes, thou dost presume
Into the ablest heads to come:
That, often, men of thoughts refined,
Impatient of unequal sense,
Such slow returns, where they so much dispense,
Retiring from the crowd, are to thy shades inclined. (Finch 309-10)
19The last three lines of the excerpt once again reiterate the theme of culture as a complex
mechanism without simple equations. They also consciously use an economic metaphor of
investment and returns and thus show that culture (and melancholy and eccentricity within
it) are thoroughly tainted by notions of cultural and real capital. Thirdly, withdrawal from the
crowd is a common mechanism, and yet it remains a paradoxical one, since the crowd
retains an awareness of these marginal figures who have opted for temporary isolation —
and fulfil an important symbolic cultural function as a consequence.
20At the same time, the spleen, despite its prohibitive and destructive impact, also makes
the appreciation of art possible, a new form of cultural self-negotiation connected to the new
social mobility — which also found its expression in collecting and displaying objects,
paintings, and sculptures, together with practicing amateur art forms in middle-class homes,
such as drawing, playing musical instruments, and singing. Finch’s poem seems to indicate
that one can only appreciate art fully through the awareness that its enjoyment can be
spoiled by the spleen. Finch thus opens up the same paradox as Burton by making spleen
ubiquitous as illness and its cure. Like an echo of Burton’s Anatomy, Finch’s poem then lists
a number of possible cures, including alcohol, Indian leaf, or Eastern berry (311). Yet none
of these is really shown to remove spleen’s power — which affects the “Coquette” (310) as
much as the religious person, thus dangerously equating low and high forms of performance
and veneration again. What it does equally to them is something familiar to us: “To deserts
banished, or in cells reclused” (311), it turns them into eccentrics.
21It is no coincidence that Alexander Pope, an acute critic of the superficialities of his age,
took up the strategic and theatrical potential of spleen, in which the melancholic and
carnivalesque manifestations of eccentricity enter a strategic alliance. In his famous mock-
heroic poem The Rape of the Lock of 1712 there is a symbolic excursion to the Cave of
Spleen in canto IV modelled on Edmund Spenser’s more serious allegorical excursion to the
caves of Mammon, Despair and Night in The Faerie Queene (Pope 86-109). It is triggered by
the loss of the lock of hair that gives the poem its title, thus by a thoroughly trivial cause.
Yet the detailed description of the cave not only ironically belies the triviality behind it; it
shows how familiar Pope was with spleen and melancholy as dominant cultural discourses of
his day. In fact, his description reads like an ironic rejoinder to Finch’s often ambivalent, yet
more serious depiction. The cave as the symbolic space in which the emerging modern
individual manifests itself is here only seemingly returned to its earlier allegorical occupants.
 1 . “As late as 1815, if a report presented in the House of Commons is to be believed, the hospital
o (...)
22Spleen, now identified as specifically feminine, sighs there on a bed — just like any woman
of Pope’s time with sufficient leisure to do so (Quinsey 3-22). Plagued by “Megrim” (101)
(migraine) and the East wind, a commonly accepted cause of spleen and melancholy, she is
attended by two allegorical servants: Ill Nature and Affectation. Here Pope’s criticism is most
evident. Yet it is also instantly shown to be contradictory: if the affectation of melancholy
and spleen is exactly that, then it cannot simultaneously be someone’s nature. Or is the
affectation of spleen here the symptom of an even deeper individual degeneracy, perhaps
one that characterises the depravity of an entire culture? Pope’s biting irony somewhat loses
its grip here, when he calls the theatrical display of spleen “for sickness, and for
show” (101). At the same time, one should not forget that sickness as display was common
in the eighteenth century, as is attested by the frequent trips to hospitals and mental
asylums as part of genteel entertainment.1
23Luxury, and thus excess, is located at the heart of this (self-)deception, when “each new
night-dress gives a new disease” (101). Pope is moreover thoroughly aware of the proximity
of spleen and creativity when he writes of the afflicted that “some take physic, others
scribble plays” (102). The evident misogyny of the canto (which, however, also indicates
awareness that spleen, when affected, was also a specific feminine form of self-assertion) is
thus undercut to some extent, even when one assumes that the plays deriving from the
affliction are not meant to be regarded highly. That Pope is concerned with the ability and
licence to manifest oneself in language and signs, becomes clear when he uses an image
from Homer’s Odyssey, the god Aeolus’s gift of a bag filled with winds for Odysseus’ return
journey, and translates it into a bag filled with feminine utterances. The catalogue he gives is
derogatory: “Sighs, sobs, and passions, and the war of tongues” (102). Yet we have to see it
in line with the generally little respected manifestations of eccentric individuality, which are
also commonly reduced to triviality and superficiality. We should also notice that it is those
superficial “feminine” conceits, to which tears are soon added, that enable Belinda, the
protagonist of Pope’s poem, to protest against her treatment, albeit to little effect.
24Once again, hegemonic power (here represented by Belinda’s male attacker who believes
it his prerogative to “pluck” beauty) and dissidence do not see each other eye to eye. Yet the
oblique dissident gaze back towards hegemonic centrality can subtly uncover the latter’s
intentions — here even in the act of self-ridiculing, in which Belinda uncovers the charade as
what it is: sexual aggression.
25Pope himself is an interesting case in point here. At pains to inscribe himself into the
culture and literature of his time as a central figure, he was nonetheless perceived as
eccentric. Undersized and a hunchback, he even had to reside in the periphery of the cultural
centre of his day, inner London, due to his Catholicism. It is all the more telling that he
proved so insistent in pointing out the mechanisms of the society and culture of his day —
and that he chose the weapon of irony and sarcasm for doing so. The bosom of Ill Nature
who attends Spleen is filled with lampoons, with the ill-tempered satires or caricatures for
which none other than Pope was most famous. Like Burton, he thus describes himself at
least as a servant of melancholy or spleen. It is ironic, though perhaps only logical as far as
the centrality of eccentricity and melancholy in post-Renaissance Western culture are
concerned, that, despite the eccentricity of his writings and person, he has ultimately helped
to concoct the very centric myth of the eighteenth century as the Age of Enlightenment. In
this competition for canonical status, the masculine version of melancholy has won. In
another, that of the subversive power of ongoing cultural debates, things are not quite so
clear, and figures like Wroth and Finch might have more claim to what the twentieth-century
poet W. H. Auden once called “the cave of making” (Auden 691-4).
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Bibliographie
Des DOI (Digital Object Identifier) sont automatiquement ajoutés aux références par Bilbo,
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peuvent télécharger les références bibliographiques pour lesquelles Bilbo a trouvé un DOI.
Auden, Wystan Hugh. Collected Poems. Ed. Edward Mendelson. London and Boston: Faber &
Faber, 1976.
Finch, Anne. “The Spleen”. The Norton Anthology of Poetry, shorter fourth edition. Ed.
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Uncanny Causality. New York and London: Methuen, 1987.
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Melancholy”. Journal of the History of Ideas 38 (1977), 373-388.
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Spleen”. Mosaic: A Journal for the Interdisciplinary Study of Literature 22:1 (Winter 1989),
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1, 1423-1427.
Haut de page
Notes
1 . “As late as 1815, if a report presented in the House of Commons is to be believed, the hospital
of Bethlehem exhibited lunatics for a penny, every Sunday. Now the annual revenue from these
exhibitions amounted to almost four hundred pounds; which suggests the astonishingly high
number of 96,000 visits a year” (Foucault 68).
Haut de page
Pour citer cet article
Référence électronique
Rainer EMIG, « Competing Melancholies: (En-)Gendering Discourses of Selfhood in Early Modern
English Literature », E-rea [En ligne], 4.1 | 2006, document 9, mis en ligne le 15 juin 2006,
consulté le 23 juillet 2020. URL : http://journals.openedition.org/erea/412 ; DOI :
Haut de page
Auteur
Rainer EMIG
Regensburg University
Rainer Emig is Professor of British Literature at Regensburg University. His main areas of interest
are 19th- and 20th-century British literature and culture. Among his publications are the
monographs Modernism in Poetry (1995), W.H. Auden: Towards a Postmodern
Poetics (1999), Krieg als Metapher im zwanzigsten Jahrhundert (2001), and the edited
collections Stereotypes in Contemporary Anglo-German Relations (2000), Ulysses (New Casebooks
2003), and the forthcoming Hybrid Humour: Comedy in Transcultural Perspectives (with Graeme
Dunphy). A recently completed project takes him into the 17 th century, however, where he
identifies the emergence of eccentricity as a phenomenon that has been shaping British culture to
the present day. Its outcome should appear as Eccentricity: British Culture from the Margins in
2007. Further book-length projectsdeal with Literary Masculinities (from the Old English poem
“The Wanderer” all the way to postmodernity) and Literary Treasure Hunts (from Beowulf to Harry
Potter).
Articles du même auteur
 Jane Dowson & Alice Entwistle. A History of Twentieth-Century British Women’s

Poetry [Texte intégral]
Article 3
Paru dans E-rea, 5.1 | 2007
 Paul Cefalu. Revisionist Shakespeare: Transitional Ideologies in Texts and Contexts [Texte

intégral]
Article 1
Paru dans E-rea, 4.1 | 2006
Haut de page
Droits d’auteur
E-rea est mis à disposition selon les termes de la licence Creative Commons Attribution - Pas
d'Utilisation Commerciale - Pas de Modification 4.0 International.
https://journals.openedition.org/erea/67

Malinconia e Suicidio I

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Malinconia e suicidio I: considerazioni cliniche

Melancholy and suicide I: clinical

Clinica Psichiatrica, Università di Siena

Parole chiave: Suicidio • Malinconia • Depressione • Psicopatologia

Journal of Psychopathology | Official Journal of the Italian Society of Psychopathology

Melancholia is a subtype of depression . People with melancholic depression often feel

things happen in their lives.

Although melancholia can be difficult to treat, recovery is possible. A trained mental

depression was ever studied.

During the Renaissance, Europeans considered melancholia to be a sign of creative

century, the term returned to its clinical roots.

modernize the concept of melancholia into its current definition.

Today, melancholia is no longer listed as a standalone mental health issue. Instead,

the Diagnostic and Statistical Manual (DSM) lists it as a specifier for depressive

(Melancholia can also occur during the depressive phase of bipolar .)

To be diagnosed with melancholic depression, a person must present at least one of

1. Loss of enjoyment from all (or nearly all) activities.

2. Lack of positive response to objectively pleasurable events.

And at least three of the following:

1. Despair that is not linked to loss or grief .

2. Loss of appetite or significant weight loss.

3. Psychomotor changes: Either physical restlessness or slowed movement.

5. Waking at least two hours earlier than normal.

MELANCHOLIA AND OTHER TYPES OF DEPRESSION

Melancholia can look very different from non-melancholic depression. Compared to an

individual with another type of depression, someone with melancholia typically:

 Develops symptoms at a later age.

 Is more likely to have psychomotor symptoms.

 Is more likely to have anxiety or suicidal thoughts .

Melancholia might also co-occur with postpartum depression and depression

WHAT CAUSES MELANCHOLIA?

Melancholia is sometimes called “endogenous depression,” meaning “depression that

Research suggests differences in the brain may be responsible for melancholia.

stress levels, and more.

sleep phase. Thus, they may get less quality rest.

People with melancholia often have elevated cortisol levels , which increase

The condition can also affect cognitive processing and performance. Research

solving. These symptoms are specific to the melancholic subtype of depression.

Overall, melancholia can impact a person’s relationships, occupation, and health. In

severe cases, it may prompt an individual to attempt suicide. Melancholia tends to

cause longer periods of suicidal thinking than other types of depression.

1. Brown, W. A. (2007, January 15). Treatment response in melancholia. Acta

Psychiatrica Scandinavica, 115(s433), 125-129. Retrieved from

Psychiatry, 38(1), 15-22. Retrieved from

Washington, D.C.: American Psychiatric Association.

4. Freud, S. (1917). On murder, mourning and melancholia. London: Penguin Group.

5. Jackson S.W. (2008) History of psychiatry and medical psychology. Boston:

6. Javier, H. (2014). The four humors theory. ESSAI, 12(1). Retrieved from

Penninx, B. W. J. H. (2016). Six-year longitudinal course and outcomes of

subtypes of depression. The British Journal of Psychiatry, 208(1), 62-68. Retrieved

8. Melancholic depression: Symptoms, treatment, tests, and more. (2016, March

10). HealthLine. Retrieved from

for its classification as a distinct mood disorder. The American Journal of Psychiatry.

differential impact of age on the phenomenology of melancholia. Psychological

Medicine, 31(7), 1231-1236. Retrieved from

relationships with specific clinical subtypes of depression. Psychiatry Research,

175(3), 217-220. Retrieved from

therapy. Journal of Affective Disorders, 205(1), 60-68. Retrieved from

treatment of depressive illness. New York: Cambridge University Press.

G., & Serretti, A. (2016, September 1). A meta-analysis of cognitive performance

in melancholic versus non-melancholic unipolar depression. Journal of Affective

Disorders, 201(1), 15-24. Retrieved from

Non c’è il blu senza il giallo e senza l’arancione. L’artigiano, la libertà

Esistono analisi, mano a mano più dettagliate, che documentano lo scarto