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March is Women's History Month!

On Identity, Depression And Listening: Andrew Solomon Answers Your Questions

Writer Andrew Solomon speaking at TEDMED.
Courtesy of TEDMED
Writer Andrew Solomon speaking at TEDMED.

Writer Andrew Solomon delves deep into topics most wouldn't touch. His book Far From The Tree is a thoughtful look into parents raising children who are different from themselves: children with Down's syndrome, autism, or a complete loss of hearing and others. His TED Talk based on the book has been seen almost two million times.

Solomon was featured on the TED Radio Hour episode Identities and answered listener's questions about his work.

What part of you, if any, was the driving force behind writing Far From the Tree? Was it being a writer, being a psychologist, being an LGBT advocate, personal experiences?

All of those characteristics informed my writing of the book. I'd say the leading factor, however, was the revelation of how much I, as a gay person, had in common with others who are outside the mainstream in various way. People have asked me why I didn't include a chapter on gay people, and I have explained repeatedly that the whole book is informed by my experience as a gay person, and that everything in it is relevant to gay identity. I have always been drawn to outsiders, and that interest, predicated on my own sense of outsiderness, has determined much of my research. Though I didn't know it, even the work for my first book, which was on Soviet artists, was informed by my interest in how people find dignity in the face of adversity—how they forge meaning and build identity. And Far from the Tree is the epitome of that concern. And that concern originated for me in being gay.

How did you learn to be such an eloquent speaker, especially regarding difficult topics? Any tips?

I don't know that I have tips per se. For my TED talks, I came up with the ideas and spent a long time organizing them, then practiced talking about them with a broad range of people. I wasn't reading from a script, and I hadn't memorized what I said, but I did have the carefully considered structures of my talks in mind before I went out there. I think the best thing to do before a talk is to organize and practice. As for difficult topics: I have always been drawn to difficulty, and most of all to how people manage to find strength in difficulty. I sometimes find it easier to talk about difficult topics than about easy ones; I have a sense of merit in the difficulty that inspires me onwards.

How do explain how you became such a generous man willing to listen to and including everybody? What do you think it is that has enabled you to do that with such depth and integrity?

When I was growing up, my mother used to say, "A good listener is always more interesting than a good talker." She also used to say, when teaching social skills, "You should be able to make conversation with a brick wall." I think those two bits of guidance have informed both my personal and my professional life. Not that I don't talk; obviously, this question is asked in the context of my talks, and I can yammer on. But I learned to listen early, and I like doing it. I'm endlessly intrigued by stories, and I love helping someone to formulate his or her story. I can drift off when I'm reading pure abstraction, but the narratives of human lives hold my attention every time. And I've discovered, over time, how much people want their stories told and retold, and so my work as a writer has consisted in part of accommodating that desire.

How do you describe depression to those not afflicted?

I begin by explaining that the opposite of depression is not happiness, but vitality, and then I try to describe it much as I have in my TED talk—to explain the loss of interest in the world, the loss of the ability to function, the loss of interest in one's own life, the loss of ability to eat, take a shower, answer the phone. I talk about the feeling of deadness that takes over. And I describe the anxiety, that sense at every moment that doom lies just ahead; I speak of that constant fear with no particular object, that sense that it is too frightening to stay alive, and that death is the only release.

Sometimes I use metaphor. In my book, I wrote, "I returned, not long ago, to a wood in which I had played as a child, and saw an oak, a hundred years dignified, in whose shade I used to play with my brother. In twenty years, a huge vine had attached itself to this magnificent and confident tree and had nearly smothered it. It was hard to say where the tree left off and the vine began. The vine had twisted itself so entirely around the scaffolding of tree branches that its leaves seemed from a distance to be the leaves of the tree; only up close could you see how few living oak branches were left, and how a few desperate little budding sticks of oak stuck like a row of thumbs up the massive trunk, their leaves continuing to photosynthesize in the ignorant way of mechanical biology.

"Fresh from a major depression in which I had hardly been able to take on board the idea of other people's problems, I empathized with that tree. My depression had grown on me as that vine had conquered the oak; it had been a sucking thing that wrapped itself around me, ugly and grotesque and more alive than I. It had had a life of its own that bit by bit asphyxiated all of my life out of me. At the worst stage of major depression, I had moods that I knew were not my moods: they belonged to the depression, as surely as the leaves on that tree's high branches belonged to the vine. When I tried to think clearly about this, I felt that my mind was immured, that it couldn't expand in any direction. I knew that the sun was rising and setting, but very little of its light reached me. I felt myself sagging under what was much stronger than I; first I could not use my ankles, and then I could not control my knees, and then my waist began to break under the strain, and then my shoulders turned in, and in the end I was compacted and fetal, depleted by this thing that was crushing me without holding me. Its tendrils threatened to pulverize my mind and my courage and my stomach, and crack my bones and desiccate my body. It went on glutting itself on me when there seemed nothing left to feed it."

I have suspected a dear friend of mine is suffering from fairly severe depression, but she is stubborn and believes it not so much a disease as it is a weakness of character. Whenever the topic is brought up she will dismiss it out of hand, practically as if it were an insult. Do you have any advice on how to approach the subject with a person like this?

It's important to say that depression has biological underpinnings, and that while medications do not seem to create irreversible changes in the brain, repeated depressive episodes do. So if she can control her mood states without medication, that's great; and if she needs medication, that's just fine; and if she neglects her psychic decay completely, that's a bad way to go. Untreated depression tends to get worse and worse. When it's at its apex, it can lead to suicide. So your friend is gambling with her life, and you should emphasize that to her. But even putting the potential for suicide aside, she is giving over time to depression when she could be well—and life is short, and she won't get the time back. Dealing with depression effectively is a mark not of weakness, but of strength.

In your opinion, since "The Noonday Demon" was published, what is the most radical breakthrough in treating depression? Any new pharmaceutical developments we, as depressives can be hopeful for? And would you consider writing another "Noonday Demon" more of a follow up with updated statistics?

The most radical breakthrough is deep brain stimulation, a field led by Helen Mayberg, a functional neuroimaging specialist who realized that Brodmann area 25 of the brain seemed to be implicated in depression, and who developed a process for implanting an electrode in the brain to provide constant stimulus to this area, so regularizing its activity. She's achieved absolutely astonishing results with people who have failed every other kind of treatment: failed psychotherapy, psychopharmaceutical interventions, transcranial magnetic stimulation, and electro-convulsive therapy. It's brilliant, inspiring work, and is the first hypothesis-driven treatment for depression. She doesn't tell her patients when she turns the device on, but one of them, at that moment, said, "What did you just do? All my life I've been locked in a room with a thousand screaming children, and they just left the building."

I wish I could say there had been huge breakthroughs in pharmaceutical therapies (which are obviously preferable to brain surgery for those for whom they work). There are some new drugs here and there, but nothing radical and worthy of notice.

As for an updated edition, I've got too many new books to write. But I am putting together a new introduction for the reissue of the book abroad and will look into using it in the English-language versions as well.

You recently received your Ph.D. — would you please explain what your thesis research topic, and why you chose it?

The title of my thesis was "Transition to Motherhood: The acquisition of maternal identity and its role in a mother's attachment." It is about the idea that a new mother has two new relationships in her life: one to her newborn child, and the other to a maternal identity. It is possible to be besotted with your child but uncomfortable in the role of motherhood; it is possible, equally, to find fulfillment in this new role and yet be curious unattached to your own child. For the work, I put together a cohort of 24 women each of whom I interviewed once just before the birth of her first child, once just afterwards, and then every six months until the children were four and a half.

Motherhood entails a radical break. The shift is often disorienting, and even women who are very proud of and thrilled about having produced children frequently find the initial disequilibrium very difficult. For most of the women in this protocol, becoming a mother seemed to me to entail trauma, which sometimes included but was not limited to postnatal depression. While these women were in general deeply committed to their children from the start, they also negotiated a recovery from their disturbance that went on for some time. This recovery was a component of maternal engagement, as it provided the mothers with a feeling of success in relation to their children. The earliest stages of maternal attachment entail the mother's bonding with a child simply because that child is her child; most of the child's particular qualities are not initially legible. Later attachment involves the active recognition of the child as a distinct other with his or her own personality and character. This is a connection based less on the generic situation of motherhood and more on interaction with a specific child. The mothers in the protocol and the people around them tended to value enthusiasm about their role as mothers and, separately, about their child; they tended to stigmatize any concomitant negativity. External and internal relationships were altered to accommodate a shift in priorities that ultimately constituted a shift in identity.

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NPR/TED Staff