How Loss Creates Depression And Growth
The Creative Destruction of Loss:
Can We Grow More Than We Wither?
11. The capacity to tolerate distress and efficiently develop greater internal resources creates the greatest possibility for posttraumatic growth. Posttraumatic growth and posttraumatic diminishment can co-exist.
Height is a trait: the taller the man, the greater the (evolutionary) fitness, at least to a certain point. The average height of a population closely approximates the optimal height. There is a distribution around this optimal norm: some are taller and some are shorter. Neuroticism,1 like height, is also a trait.
Language is an adaptation - an innate capacity baked into our DNA. Language skill is a trait, influenced by genetics but not uniform across the gene pool. Depressive behavior, like language, is an adaptation, and neuroticism is the equivalent to language skill or height.
The setting for depressive behavior is a low mood state.
Daniel Nettle:2
Low mood describes a temporary emotional and physiological state in humans, typically characterised by fatigue, loss of motivation and interest, anhedonia (loss of pleasure in previously pleasurable activities), pessimism about future actions, locomotor retardation, and other symptoms such as crying...3
Since the generic trigger of low mood is loss of or lack of access to some important resource, low mood may usefully be seen as an evolved suite of responses to unfavourable or adverse situations... Note that this does not mean that clinical depression itself represents adaptive behaviour... Low mood probably has multiple adaptive functions in unpropitious circumstances, subserved by its various different symptoms. [Italics mine]
Loss is one of the principal triggers of depressive behavior. In this analytical framework, what is loss? It is the loss of the abilities and resources necessary to live an optimal life. It is the loss of life fitness. The more we have lost, the greater our peril (we are more likely to die and less likely to have children). The loss of social status, for example, is a significant loss because it can imperil access to resources (e.g. food) and the ability to attract a suitable mate.
When we experience expected or readily manageable loss (of fitness), it is appropriate for our mood state to reflect the increased peril. With fewer resources, we have a more limited ability to risk fitness for possible reward. We must be cautious and the low mood state appropriately evokes congruent behaviors.
Daniel Nettle, again:
When the individual’s state is poor, a risky venture going wrong could push state down further into the danger area, and so behaviours with a small variance in payoff are preferred. When state is better, the individual can absorb potential failures and so is in a position to try out risky options that might just lead to a big payoff. Thus, to a very considerable extent, the model [for behavior responses to peril] supports existing views for the adaptive functions of low mood symptoms, and of positive emotions in general: when things are going quite badly, it is not the time to take risks, but as things improve, greater experimentation is warranted. [Economics would indicate such behavior is highly rational.]
One category of loss/limitation is the readily manageable, usually expected loss. During winter, for example, we lose access to new food. Because winter is expected, our contextual understanding accommodates our sensory-based experience. These sets of memories (contextual and sensory-based) are aligned and integrated. The event of loss - winter - matches our anticipation of loss. The level of distress is appropriate to the loss, and the salience of both is minimized because of the strength of the context. Put simply, the actual experience was as it was supposed to be.
Chris Brewin:4
According to dual representation theory, perception of a moderately stressful or emotionally salient event results in the creation of more enduring contextual memories [C-reps] and sensory-based memories [S-reps]...
In healthy individuals, the S-rep [sensory-based memory] for an extreme event is associated to a corresponding C-rep [contextual memory]. The association to the corresponding C-rep has two consequences: (a) allowing the event to be correctly integrated with its semantic and autobiographical context... and (b) allowing for increased top-down control.
What is context? Context is a set of beliefs, unchallenged assumptions, values, scripts, schemas, internal working models, biases, etc. Context is nothing less than the model of the world and how we most effectively and efficiently respond to it. We architect memories from a limited, biased sampling of new information and from the narrative and structural elements of already accepted ‘context.’
When the contextual and sensory-based memories of a loss have a strong correspondence (i.e. they are congruent), the consequent depressive behavior occurs without associated dissonance and the related neuroticism. However, if the winter were more severe than usual, we would not build contextual memories as efficiently. The surplus of sensory-base memories would cause dissonance - the sensation that something was not as it was supposed to be. Literally, we would have experience we could not account for: too much experience, too little understanding, an unnerving combination.
Neuroticism is our sensitivity to dissonance and the associated low mood state. If the winter was unexplainably severe, we would become neurotic - more focused on identifying behaviors to limit the loss of fitness, on developing improved understanding of the reasons for the severe winter.
Fresh insights allow us to create more viable contextual memories - better explanations - of the distressing loss. We come to associate the contextual memories with the sensory-based memories alleviating the distress and dissonance. In other words, as long as we are ill-at-ease, we seek better understanding. Similarly, understanding is relief.
We might conclude, ”The winter was severe because we did not pay tribute to the harvest god.” The accuracy of the belief is not relevant, rather the strength of the explanation is.
The losses which are associated with the greatest mental anguish are unexpected losses. The losses are inexplicable. They also destroy prior context, causing trauma.
Brewin et al.:5
Trauma generally involves a violation of basic assumptions connected with survival as a member of a social group. These include assumptions (not necessarily conscious ones) about personal invulnerability from death or disease, status in a social hierarchy, the ability to meet internal moral standards and achieve major life goals, the continued availability and reliability of attachment figures, and the existence of an orderly relation between actions and outcomes.
Trauma’s epistemic wounds are the means of destroying context. In the aftermath of these events, we have a limited array of contextual memories to match the many powerful, affect-laden, overwhelming sensory-based memories. In other words, without context, the sensory-based memories become intrusive imagery. We relive the trauma experiences rather than contextually re-experience them.
Chris Brewin (2010) again:
Normal encoding involves the creation of contextual memories [C-reps] and sensory-based memories [S-reps] with connections between the two. Pathological encoding involves relatively stronger S-reps [sensory-based memories], relatively weaker C-reps [contextual memories], and impaired connections between them.
Trauma causes Brewin’s “pathological encoding.” We failed, we were overwhelmed, we didn’t know what to do. We lost significant life fitness and don’t understand why. As a result, we continue to experience significant, persistent dissonance. We relive the associated images repeatedly and intrusively.
Given the heightened peril cause by the loss of life fitness, our mood drops and our behaviors change. We become neurotic. In other words, we are distressed by the loss, and we experience our depressive behaviors as the mental experience of depression.
Neuroticism is a major trait of our affect systems.
Daniel Nettle:6
Though the design features of affect systems are adaptations that are common to all human beings, individuals vary in the reactivity of their affect control mechanisms. That is, the same interpersonal events cause a larger and longer perturbation of affect in some individuals than others. This variation in lability of negative affect systems is captured by personality dimensions such as neuroticism or negative emotionality.
What does neuroticism do?
Edward Watkins:7
The self-absorption paradox could be explained if there was a neurotically motivated, threat-avoidant form of chronic self-focus, labeled rumination, which contributes to psychopathology, as well as a contrasting form of chronic self-focus, motivated by epistemic curiosity, labeled reflection, which would be associated with increased self-knowledge. The Rumination–Reflection Questionnaire distinguishes between reflection (e.g., “I love analyzing why I do things”) and rumination, defined as repetitive thinking about the self prompted by threats, losses, or injustices to the self. [all italics mine]
If a loss signals a significant deterioration in the environment, then greater neuroticism will provide the greater chance for survival and recovery of fitness. If a loss does not signal significant deterioration in the environment, then less neuroticism will provide a faster recovery of fitness.
An unexpected loss is unexpected. From the point of view of our schemas, beliefs and internal working models, it is inexplicable.
When I date, I know I might break up sometimes, but when I love someone so much, how is it possible she ended the relationship? How is it possible for attachment figures to leave my life so abruptly?
Without specific explanation or a strong contextual setting, our experience of the trauma is more global and general.
We worry than anything might be to blame for the loss:
- I am unable.
- I am unworthy.
- I am ignorant.
The evaluation of our self-regard diminishes even if we didn’t actually lose ability. Our self-regulation diminishes even if we didn’t lose inter- and intra-personal resources. Finally, our regard for our sense making diminishes, and we might resign the search for meaning (“people you love just leave”) rather than try to make sense of the unexpected loss (“she was scared of marriage”).
These three domains - self-regard, self-regulation and sense-making, collectively ‘our resources’ - are highly correlated with depression and personal development. The more a loss impairs our decision or capability to act in these three domains, the more we are at risk of depression and posttraumatic diminishment. The greater our post-lost resources, the more we are resilient to the loss.
Exposure to depression is the greatest predictor of the future incidence and severity of depression. Although the magnitude of damage to our resources might relate to the level of loss and emotional distress, the process of regaining (or even improving) resources is different from relieving distress.
If distress is alleviated before resources are regained, each exposure to significant loss could continue to impair resilience and increase probability and severity of depression.
One source of relief is creative sense making: For example, “I deserve to be beaten by my father.” Another way might be to regain access to an attachment figure: “She changed her mind, and we’re back together.” In either case, the relief would reduce the drive to rebuild the resources needed for the next loss.
We might grow in one area and suffer diminishment in others. Posttraumatic diminishment and posttraumatic growth can, and frequently do, co-exist. Did we lose self-regard? Is our capacity for self-regulation diminished? Do we distrust our creative sense-making?
Additionally, were we able to rationalize the loss and alleviate distress, while losing other resources, we might be more likely to adopt the same process after the next loss. At first, we might have a net gain in resources from such a one-sided process. But if over time the marginal value of improvement in one specific dimension declines and the cost of neglect in the two other dimensions increases, the initially adaptive process becomes defensive which in turn can become maladaptive, and then pathological.
Distress is the consequence of too many sensory-based memories without corresponding contextual memories. It limits our capacity to inhibit rudimentary behavior and take action based on higher-order cognitive reasoning. The greater the pain, the more we just react and the more our behavior responds to the demands of fight/flight (sympathetic) or freeze (parasympathetic) systems. As we lose access to higher-order cognitive functioning, our internal sense of self diminishes.
Distress tolerance is also a trait. Often it is best to promptly flee a looming threat. However, the ability to regard and evaluate the looming challenge particularly after the fact, is valuable to engage the drive to develop internal resources.
The tolerance of distress enables the cognitive resources necessary to identify, test, optimize, plan and practice, and finally implement actions designed to gain needed external resources (e.g. food) and to enhance self-regard, self-regulation and efficiency-creating insight.
Here again, neuroticism, especially in the context of repetitive thinking can be highly adaptive.
Daniel Nettle:8
There may also be other kinds of benefits to neuroticism. Neuroticism is positively correlated with competitiveness. McKenzie has shown that, among university students, academic success is strongly positively correlated with neuroticism among those who are resilient enough to cope with its effects (McKenzie, 1989; McKenzie, Taghavi-Knosary, & Tindell, 2000). Thus negative affect can be channeled into striving to better one’s position.
It is quite possible that very low neuroticism has fitness disadvantages in terms of lack of striving or hazard avoidance. Although very high neuroticism has evident drawbacks, it may also serve as a motivator to achievement in competitive fields among those equipped to succeed.
The combination of neuroticism and distress tolerance generates new, updated or improved beliefs, assumptions, values, scripts, internal working models, biases, etc. It strengthens context. These epistemic developments, the opposite of trauma’s destruction, would show as gains to self-regard, self-regulation and insight, as gains to fitness. Strengthened context, when associated with the sensory-based memories of loss, would dispel dissonance, reduce the event’s inappropriate saliency and allow the event to be processes as part of a coherent autobiography.
Loss, Depression and Growth
I have sketched examples of several broad concepts in order to assemble the following loose framework to describe a sense of logic to the some of the consequences of loss, including depression and rumination - two issues which have provided some controversy recently.
The need for maintain optimal life fitness is a dominant drive and motivation. We consume resources to live. The success of replenishing resources is unpredictable. We pursue goals and take actions to replenish resources needed for optimal life fitness.
We sense peril when our current level of fitness is below our optimal level. The greater our peril, the fewer resource we can risk without creating significant probability of death. The less we can afford to lose, the less risk we will take. The greater to reward for risk taking, the more risk we will take.
Our mood states intermediate this process. A sense of peril evokes depressive behaviors. A sense of opportunity evokes active, approach behaviors.
When we seek fitness, we seek actual resources (e.g. food), and also seek internal resources - the capacity to redress fitness deficiencies, the capacity to regulate the attendant distress, and accurate working models to direct our goal seeking efforts efficiently.
Seeking of new resources requires diagnosing, searching, optimizing, planning and practice, and action - sophisticate cognitive processes each. This development is an embodied cognitive process.
Unexpected, significant loss causes significantly greater sensory-based memories than contextual memories. This dissonance is a major drive to develop stronger context, align this understanding with the surplus sensory-based memories, and integrate the related memories so the dissonance and salience diminishes.
Repetitive thinking is a significant means to create new contexts and translate the cognitive outcomes into new capabilities, expanded capacities for self-regulation and more efficient beliefs and models about the self and the world around.
Edward Watkins:9
Repetitive thinking [RT] produces constructive consequences if it helps to resolve the discrepancy between the intended goal and actual current state, whether by aiding progress toward the goal or by helping to modify or abandon the goal. In contrast, RT becomes unconstructive if a person experiences an inability to progress toward reducing the discrepancy and at the same time is unable to give up on the reference value or goal. In such a case, RT would serve only to focus attention on the discrepancy between the desired goal and the actual situation, making the unresolved discrepancy more salient, perpetuating the unresolved issue, and exacerbating negative affect. It is important to distinguish between disengaging from efforts at goal pursuit, whether mentally or physically, and disengaging from the underlying goal: The former combines a lack of goal progress with the ongoing maintenance of the desired but unattained goal, further highlighting the unresolved discrepancy, whereas the latter constructively reduces the goal discrepancy.
- Repetitive thinking is mood congruent. Low mood states orient the cognitive process to the abandonment of goals. Active mood states orient the cognitive process to the renewal of old goals or the creation of new goals.
Jonah Lehrer’s post Mood and Cognition expands on his controversial New York Time’s article - Depression’s Upside:
While negative moods might promote focused attention and rigorous analysis, there's good evidence that happiness promotes a more freewheeling kind of information processing, which leads to more creative insights.
And that's why relaxation and happiness are so helpful: these moods make us more likely to direct the spotlight of attention inwards, so that we become better able to eavesdrop on the quiet yet innovative thoughts we often overlook... In contrast, when people are diligently focused (and perhaps a little melancholy), their attention tends to be directed outwards, towards the details of the problem they're trying to solve. While this pattern of attention is necessary when solving problems analytically, it actually prevents us from detecting those unlikely connections that lead to insights and epiphanies. (William James referred to insights as emanating from the peripheral "fringe" of consciousness, which is why they're so easy to ignore when we're staring straight ahead.)
- The failure to rebuild self-regard, self-regulation or productive insight before the alleviation of distress diminishes future resources necessary to resolve future loss in fitness. In other words, the experience of depression can increase the likelihood and severity of future depression.
- Depression is only one possible, maladaptive or pathological outcome, as we try to maintain fitness in the context of a life given to random, unexpected loss. Many things do go wrong.
- The capacity to tolerate distress and efficiently develop greater internal resources creates the greatest possibility for posttraumatic growth. Posttraumatic growth and posttraumatic diminishment can co-exist.
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Personality is the composition of five traits: Openness to new experience, Conscientiousness, Extroversion/introversion, Agreeablness, and Neuroticism. The trait of neuroticism is most associated with depression. ↩
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NETTLE, D. (2004). Evolutionary origins of depression: a review and reformulation Journal of Affective Disorders, 81 (2), 91-102 DOI: 10.1016/j.jad.2003.08.009
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The description of a low mood state corresponds with significant elements from Damasio’s catalog of emotions:
Damasio A. Looking for Spinoza: Joy, Sorrow, and the Feeling Brain. Houghton Mifflin Harcourt; 2003. ↩
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Brewin, C., Gregory, J., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychological Review, 117 (1), 210-232 DOI: 10.1037/a0018113
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Brewin, C., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103 (4), 670-686 DOI: 10.1037/0033-295X.103.4.670
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Nettle, D. (2009). An evolutionary model of low mood states Journal of Theoretical Biology, 257 (1), 100-103 DOI: 10.1016/j.jtbi.2008.10.033
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Watkins, E. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134 (2), 163-206 DOI: 10.1037/0033-2909.134.2.163
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Nettle, D. (2006). The evolution of personality variation in humans and other animals. American Psychologist, 61 (6), 622-631 DOI: 10.1037/0003-066X.61.6.622
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Watkins (2008). ↩
Essays
Reader Comments (13)
Loss can also be imagined loss.. that is fear of loss and this in itself can somtimes be even more debilitating than actual loss. As with actual loss the person suffering it has a real rason for depression and low mood. When simply fear of loss is apparent, then less can be 'done about it' - somewhat like tilting at windmills!
Thanks so much for the comment! Depression is like tilting at windmills, with less and less energy every day.
Emotional trauma is a 'knowledge' wound. It's damage to our context - the way we understand ourselves and the world around. So all trauma is 'imagined' in this particular sense.
Thanks for the wonderful article and really love it. i can see how it relates to what i experience. thanks
I have found the use of learned optimism has really helped me with the loss of my father. L.O. has enabled me to live more in the present and has significantly helped me to reduce rheumination. As a result my depression has lifted, I don't get as stressed and anxious as I used to and I have also managed to stop smoking at the same time. As a result I'm feeling a whole lot more positive.
Thanks for a great blog btw, some great stuff here!
Sometime we see from working with children that depression is learned from a parent. The negative feelings from a mother or father can often become part of the 'norm' and the child just acts like that as he or she believes that to be the normal behaviour. A little like children hitting others can not see why they are being corrected as daddy hits mummy like that! It almost becomes a way of like and acceptable by the child.
Some believe that depression is only a state of mind and can be changed like changing your shoes or coat. This has become quite a popular opinion with a lot of people telling you to 'pull yourself together' or 'snap out of it'! They believe that depression is a sign of a weak body and unless you strengthen your body (a little like weight lifting) then they will always be depressed.
Trauma and coping with it leads us to another form of depression - loss. This can be the death of a loved one (human or animal) or an accident. People here often turn to a greater celestial being in times of trauma and it works for them.
Often people get depressed at perceived loss. This is short term and usually passes when the perceived loss has passed.
Thought I would add some comments and observations to the mix as I used to work in mental health as a psychiatric nurse, and also had personal expereince with post traumatic stress as a result of tragedy in my family.
I have written a book to describe my recovery and some of the processes that helped me. One thing that psychitary did not teach me was about the role of compassion and forgiveness in the healing process, qualities that are often deferred to religion.
Secondly from my nursing CBT was often the therapy of choice which I found to be limiting and lacked proper context. Often the release and acknowledgement of emotion needs room and space for expression before more resourceful thinking can take place.
Thirdly the comment made earlier on about areas of strong inner resources can coexist with less strong areas is so true. In psychiatry the application of force field analysis attempts top pick that up but often falls short in reality.
From my own experience the need to put down anchors to hold me through turbulence was important, and I believe the recognition of strong inner resources can help to this end.
The other area of importance for me was recontextualising my life so that the victim label and identity did not find prime definition of my life. Having significant others to hold that context and acknowledge my strengths and my humanity was an important part of my healing process.
Hope this adds value to the ongoing discussion
Best wishes
Anita
This is an extremely insightful article! Thank you so much for your thoughts. I have had many members of my extended family be lost to us these past few years and I am excited to share some of these thoughts with my family to help us grow.
That is a really deep post and, I'm afraid to say, somewhat over my head in parts. Are you saying that because the way language influences the way we view the world so much that the concept of "loss" can cause depression differently in the speakers of different languages? That is a pretty powerful concept, and the post was very well written, just difficult to wrap my head around.
When I write about language, it is usually as a metaphor. Maybe the article is clearer if the 'language' part is ignored.
The point I focused on is that depressive behavior is in our nature, part of our DNA. Evolution discovered this behavior was adaptive and built it into the machinery. Because depression causes so much pain and distress, it's unnatural to think depressive behavior creates benefit.
Some of our depressive behaviors attempt to generate personal growth from loss. If such grow is not attained these behaviors create depression.
...
At least I understood what I meant when I was writing about language, but I abused it as a metaphor. I hope both languages and the readers will accept my apology :)
I agree that loss can create both depression and growth. However if you look at Post Traumatic Stress Disorder, often depression can take s stronger hold than the growth component. I work with a method called EFT, Emotional Freedom Techniques, and much has been achieved in this field to bring loss into acceptance and strong personal growth.
Natural Depression Therapy EFT Brisbane and Sunshine Coast
It's an awesome post! I love the thoughts. Everyone have experienced depression and agreed that it is not good not even healthy. So the question how can we avoid depression? ;)
The word Loss should be the very definition of depression. Because no matter when, where, or how the word Loss is used, there's always depression close by. For example the loss of a loved one is a term that brings about immediate depression, even sometimes if it wasn't exactly your loved one that was loss. Because you feel sorrow for the person who just loss their loved one. But at the same time loss can bring about growth because once you get over the loss, it always makes you stronger in the end.
Thank you for such an incredibly insightful post!
My work in Meditation has found that it is also an incredible asset to treating the debilitating effects of self-defeating thoughts and rumination which deepens the depression.
Learned Optimisim as mentioned by another commenter above is at the root of Mindfulness Therapy - you simply learn how to be a in a state of no-judgment of your thoughts - seeing them simply as thoughts and not as facts.
Wishing all of you and your loved ones a speedy recovery and positive Mental Health.
Here's a few articles I wrote on how you can learn meditation for your own mental health please click here