ABSTRACT

Depression raises many questions. Why, for example, is it cyclical? It is well known that this psychopathology tends to resolve itself on its own and reoccur after a period of full or partial remission, when it becomes chronic. Drugs, at best, accelerate a remission that occurs in the natural course of the illness. 1 If we exclude dysthymia (to which the hypotheses developed in this chapter do not apply 2 ), the other forms are characterized by an on-off pattern. Depression is either there or it isn't. Patients often describe entering or emerging from the “illness” as sudden, sometimes unexpected events. This is the peculiarity of depression. When other psychopathologies become chronic, they tend to remain over time without much variation. If a psychic disorder is not rapidly overcome, irrespective of its aetiology, it reorganizes the interpersonal relationships around it, creating new positionings, roles and relational configurations that inevitably contribute towards stabilizing it (Sluzki, 1981). As family therapists are well aware, attempts by families to find a solution often increase the problem (Watzlawick, Weakland, & Fisch, 1974) and the self same ability of a nucleus to deal with the difficulties of one member generally becomes an obstacle to change when the problem persists. Depression, however, with its cyclical nature, does not seem to follow this rule.