In a departure from conventional medical and psychological models, a new article by Domonkos Sik of the University of Eötvös Loránd in Budapest argues that depression is more than a medical condition affecting the mind or body.
Instead, Sik identifies depression as a social phenomenon deeply rooted in the complexities of modern life, where acceleration, system colonization, and biopolitics are altering our sense of time, agency, and relationships.
“Many of those paradoxes and distortions, which are partly responsible for the disrupted socialization processes resulting in a depressed chiasm, are not changeable in any therapeutic intervention (e.g., the ones located on the level of economic structures of global capitalism, the information technologies of mass communication, or the political institutions of representative democracies). Such structures can only be transformed gradually, by relying on long-term, wide social mobilization. While at first, it might seem that psychotherapy has nothing to do with such emancipatory movements, there are counter-examples,” Sik writes.
He extends his argument to show its implications for expanding phenomenological understandings of depression and its potential for impacting the clinical space.
“Such self-reflective critical and therapeutic praxis monitors the dominant discourses, structural hierarchies, the latent value judgments, and the broader ideological context, the unintended structural consequences of the intervention and the space of opportunity of the clients at the same time. While constraining the actors, social structures are far from being unchangeable: they are constantly reproduced as the unintended consequences of social interaction. By reshaping the actors’ involvement in these reproductive processes, the structures might be reconfigured as well: their gradual emancipatory transformation might begin with the help of not only psychotherapeutically but also sociologically reflective subjects.”
Sik’s study presents a compelling framework that connects social theory with phenomenological psychopathology, calling for a reorientation in how we perceive and address depression. He contends that societal forces like rapid technological change, economic instability, and network capitalism profoundly impact an individual’s ability to find hope, meaning, and authentic connections. Depression emerges from this context not merely as a biological or psychological issue but as a societal one, shaped by disrupted experiences of time, agency, and relationships. Sik’s analysis urges clinicians and policymakers to expand their understanding of depression, emphasizing the need for therapeutic approaches that recognize the social dimensions of mental health.
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Sik reimagines the psychopathology of depression through a phenomenological lens rooted in the work of philosopher Maurice Merleau-Ponty. Sik introduces the concept of “disruption of chiasm,” which sees depression as an interwoven distortion of time consciousness, agency, and interaffectivity. He links this disruption to social and cultural phenomena like globalization, biopolitics, and capitalist acceleration, arguing that current models overly medicalize depression and neglect the societal context in which individuals live.
“Within this framework, depression can be reinterpreted as a disruption of chiasm: it is not merely the illness of the body, the disorder of the mind, or a specific form of social suffering (as explained by various disciplines), but the distorted reconfiguration of the flesh (i.e., the pathology of existential structure). Such distortions affect the totality of the world: time consciousness loses its plasticity and linearity; agency is hindered by a horizon consisting of obstacles instead of potentials; and interaffectivity is blocked as the other is reframed as an object-body instead of a living one.”
From the perspective of “chiasm,” there are no concrete divisions between the internal and external. Instead, individuals are made up of “interrelated bodily, intentional, and intersubjective components.” Instead of viewing individuals as distinct entities, they are seen as continuous with their environments. Human existence is an intertwining of the subjective, material, and social components.
From this perspective, Sik expands and reconfigures the etiology of suffering and depression by calling for supplementing the existing and dominant biological and psychopathological perspectives with the sociological gaze, which “refers to the intersubjective component of the flesh.” Suffering does not simply concern the body and the mind but the “entirety of chiasm.” In other words, causal models of depression should not be understood as only dysfunctions of the body and mind but inherently involve the disruption of intersubjectivity.
Thus, Sik uses this framework and offers a paradigm for reinterpreting depression as a “disruption of chiasm” with distortions of time, agency, and intersubjectivity. Disruptions of these three categories contribute to depression by creating a distorted perception of the past and future, suspended agency and loss of hope, and disconnection from oneself and others. He explores these categories in relation to phenomenological descriptions of depression and dysfunctions of modernization.
Dysfunction of Time Consciousness
Sik explains the dysfunction of time consciousness through experiences of unpredictability and change. Since the economy is constantly accelerating due to the logic of capitalism and a focus on novelty, the pace of life is also equally accelerating. However, political and societal structures move at more traditional speeds, resulting in different accelerations, causing disintegration and individual suffering.
This is further aggravated by “information society,” the endless intake of information and stimuli without adequate narrative processing, with no security nor predictability.
Dysfunction of Agency
Despite the promise of individualization in modern society, increasing autonomy, and individual agency, Sik demonstrates how that is not possible within the framework of a capitalist market. In reality, the individual embedded in the constraints of network capitalism is disconnected from the objectified other, a process further exacerbated by globalization, governmentality, and the emergence of the ‘cult of performance’ and the ‘project-self.”
Sik writes:
“Actors became dependent on structures, which cannot be checked anymore by institutional means; they naturalize and internalize the principles of a highly performing, hyper-flexible self as the basis of self-identity while being exposed to surveillance technologies monitoring and controlling the remnants of their autonomous activity.”
Dysfunction of Interaffectivity
Due to globalization and the need for efficient ways to integrate larger and more distant social units, the space for community interactions based on shared meanings and mutual understanding is greatly reduced. Structural transformations have significantly impacted the basic need to give sense to the world and the self, affecting the ability to communicatively build a mutual lifeworld. Examples of these transformations are the role of biomedicine and the psy-disciplines in defining what is considered “normal intimacy” and capitalist logic, which embeds intimacy in a way that supports production and consumption.
In sum, colonization has forced social interactions and emotional connections that adjust to concepts of normalcy and efficiency, as dictated by the structures of political and economic systems, and individuals are not enabled to engage freely with one another.
Sik extends his analysis to explore how globalization, biopolitics, and system colonization shape socialization processes, resulting in the previously mentioned distortions, ultimately leading to depression.
Sik interprets socialization in a way that is relatable to chiasm as “a co-adjustment that is the mutual adaptation of biological, psychic, and social systems.” He writes:
“Socialization is not simply intertwining with the interactive, institutional, and cultural realms, but also includes a bodily and mental adjustment.”
According to this definition, “time consciousness, agency, and interaffectivity are shaped by those socializing interactions, which are responsible for the coordination of social action, the adaptation to the environment (constituted of social, bodily, and psychic systems), and the redistribution of social positions.”
When a combination of these societal mechanisms consistently disrupts an individual’s time consciousness, agency, and interaffectivity, their worldview becomes one of uncertainty, overburdening responsibilities, political polarization, distrust, career anxiety, unsupportive intimacy, among more, which has a high chance of an individual meeting the clinical definition of depression.
The presence of these negative societal distortions within one’s social network increases the likelihood of socially induced depression, thus understanding the distortions, alongside the biological and psychological factors, are crucial.
The article concludes with multiple potential consequences of using a social theoretical perspective to expand the phenomenological understanding of depression.
First, one’s mental state would be seen not solely as an individual’s mood or biology but as influenced by a person’s structural and cultural context. This can offer new tools for clinicians to understand clients and their lifeworlds.
Additionally, it can be used to expand the focus of therapy beyond the internal to the external and map and classify the distortions as laid out in the article.
Lastly, it encourages clinicians and clients alike to reflect on their experiences and mobilize to transform political and economic structures contributing to mental health challenges, further demonstrating the psy-disciplines’ role in promoting social change.
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Sik, D. (2024). Socialized into depression – toward a social phenomenological psychopathology. Philosophical Psychology, 1–26. https://doi.org/10.1080/09515089.2024.2331011 (Link)
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