Yvette Durham

“Depression” is a problematic word. We all believe we know what it means because we toss it off so easily: “Oh, I’m depressed; I got a run in my stocking.” At the same time, when we are describing severe psychopathology, we presume that because the word is descriptive, it offers a definition as well. We move to the next step and presume that because we can take a picture of the brain and “see” depression, it therefore is real. It has been occurring to me more and more, not just from these conversations, but also from my work, that when the brain is in clearly different states—and the Diagnostic and Statistical Manual of Mental Disorders80 says they are the same pathology—maybe our definition of the psychopathology is too broad. We need to redefine the nature of suffering to understand how it may be a condition more like dukkha, instead of a disease with a physiological cause as specific as something like a brain lesion. That is not to deny that true psychopathology exists, or that the patients I take care of do not suffer from a brain disease. I believe very strongly that they do. But I also see patients who, with focused attention and by acquiring new skill sets, can bring themselves out of it in the same way that William James did when he decided to focus his attention from inside to outside. The ability to focus attention means your brain is in a different state. Maybe we ought to understand those as different definitions of illness. What I’ve learned from all of you is that maybe we have to start making those distinctions more strongly. That will allow us to focus attention on how to handle ourselves in a world with natural levels of suffering, and help us not stigmatize people who don’t have the brain capacity to even start. Those are two separate items.”
― Jon Kabat-Zinn, The Mind's Own Physician: A Scientific Dialogue with the Dalai Lama on the Healing Power of Meditation