THE PARADOXICAL POWER OF THE DEPRESSED PATIENT: A PROBLEM FOR
THE RANKING THEORY OF DEPRESSION
John Price, D.M., M.R.C.P., F.R.C.Psych.
Senior Lecturer in Psychological Medicine
Russell Gardner, Jr, M.D.
Professor of Psychiatry and Behavioral Science
Submitted to the British Journal of Medical Psychology,
January 1994. Resubmitted August 1994.
Address for correspondence:
Plumpton,
THE PARADOXICAL POWER OF THE DEPRESSED PATIENT: A PROBLEM FOR
THE RANKING THEORY OF DEPRESSION
Summary
The social ranking (or social competition) theory of depression
suggests that the capacity for episodes of depressed mood evolved
as a mechanism for inhibiting challenge. Depressed mood induces
the sufferer to accommodate to low social rank, or to losing in
social competition, or to adopting the one-down position in a
complementary relationship (Price, 1991; Price et al., 1994;
Sloman et al., 1994). Thus depressed patients should be observed
to forego the privileges of high rank and of winning, such as
exercising social power and getting their own way. However,
several commentators have noted that depressed patients often
seem to be very powerful, and even appear to use their depression
to manipulate others. This paper attempts to reconcile the
theory to such observations.
Introduction
Many theorists have suggested that depressive episodes, of a
severity to be classified as illness, occur in the context of
conflictual interpersonal relations. The importance of
interpersonal stress, at least for women, has been confirmed in
a large scale sophisticated twin study (Cloninger, 1993). Freud
(1917) was probably the first to suggest that depression serves
the function of accommodation to loss of a loved object. Bowlby
(1973) elaborated this hypothesis and examined it from an
ethological perspective. Others have seen depression as a
reaction to the frustration of interpersonal needs for
relatedness (e.g., Birtchnell, 1990, 1993). Beck (1987) proposed
that in "sociotropic" people depression occurs when affiliative
needs are unsatisfied, and in "autonomous" people it occurs when
there is failure of personal achievement.
Those who look at depression from an evolutionary or
adaptationist point of view tend to see the function of
depression as concerning the regulation of the investment of
resources. Nesse (1991) suggested that the trigger for
depression is the appreciation of unpropitiousness, following
which investment of resources is reduced for a certain period of
time. A specific variant of this hypothesis states that mood
serves to regulate investment in social competition (Price et
al., 1994); the trigger for depression is an appreciation of the
impossibility of winning, and the function of the depression is
to facilitate losing, and accommodation to the results of losing
such as low social rank and/or the one-down position in a dyadic
relationship. It may be that different depressive episodes serve
different functions, and certainly there are many depressions
which in the individual case appear to serve no function at all.
On the other hand, it may be that mood changes evolved in the
context of intrasexual selection (social competition), and that
endogenous depressions and "separation" depressions are secondary
to that basic function.
These evolutionary hypotheses, although basically untestable,
are important for our conceptualisation of depression and for the
generation of testable hypotheses about proximate mechanisms;
and also for practical matters such as the choice of animal
models. Therefore it is important to explore any apparent
disparity between an evolutionary hypothesis and the data. Our
hypothesis predicts that depressed patients should behave in a
submissive manner, and the following observations appear to
flout that prediction:
1. Some depressives are successful in manipulating others.
2. Depressives may express more hostility to others than
controls.
3. Some high ranking people are depressed and many low ranking
people are happy.
We will address these issues, but first we outline in more detail
how depressed mood may relate functionally to ranking behaviour.
Social hierarchy (ranking)
Social ranking is the process by which individuals become
allocated to ranks in a social hierarchy. Ranking is one of
those complex behaviours in which the relatively simple
manifestation in animals serves to clarify the extremely complex
situation found in humans. Most animal hierarchies are
determined by fighting or the threat of fighting. The threats
of the dominant animals induce submissive behaviour in other
group members; and sometimes the submissive behaviour is so
prominent that it appears to pre-empt the threats; consequently,
primatologists have been tempted to talk about subordinacy
hierarchies rather than dominance hierarchies. In human social
life, we still retain this primitive animal type of hierarchy
formation, but we have added many others. Most human cultures
disapprove of direct dyadic fighting, unless it is highly
ritualised in the form of sport. However, fighting still occurs
in situations over which society has little control, such as the
school playground, the prison cell and the marital bedroom. This
fighting has little influence on the kind of ranking that is
important for society as a whole. In human society we have
ranking according to birth, a process which we share with many
species of macaque; we also have ranking based on prestige,
which to a small extent the chimpanzee shares with us; we have
ranking by capital assets, and we have formal allocated ranks as
in most work situations. These different sources of ranking are
usually highly correlated, although this is not the place to
discuss the status incongruence which occurs if they are not.
High human rank gives the privileges which are enjoyed by
animals of high rank, such as taking precedence and getting their
own way if conflict arises. It also gives uniquely human
privileges, such as giving other people orders, being "right" if
there is a disagreement as to fact, and being "in the right"
rather than to blame when something goes wrong. Territorial
animals have the convention that the owners of territories get
their own way, while intruders have to accommodate themselves to
the owners or leave. In social groups which share a group
territory there is no differentiation into owner and non-owner,
so there is no obvious criterion on which to base a convention
for taking precedence. It is generally agreed that ranking
systems (social hierarchies) have evolved because they provided
an alternative convention for deciding who gets their own way.
It follows that in hierarchical species there are two styles
of social relating, one for relations with higher ranking members
and one for relations with lower ranking members (Footnote 1).
These styles of relating are two of the vertebrate "basic plans"
for intra-specific communication (Gardner, 1982); other basic
plans regulate attachment, co-operation, pair-bonding and
reciprocal exchange. Basic plans are integrative genetic
blueprints that coordinate perceptual, cognitive, emotional and
executive processes in the service of an adaptive function.
Since hierarchies are very widespread among vertebrate species,
it is likely that the common vertebrate ancestor had early forms
of these hierarchical basic plans, and that they have become
firmly embedded in the human genome over the last 300 million
years. Together with the basic plans for relations between the
sexes, they antedated and perhaps helped to fashion the basic
plans for parent/child bonding.
In humans there are two forms of these hierarchical basic
plans, depending on whether the hierarchy is accepted or
contested (Price, 1992). If the two parties in a relationship
are both accepting of the rank difference and any differences in
payoffs that go with it, then they are likely to be affiliative
and cooperative. The mental representation of the dominant
member in the mind of the subordinate member is characterised by
respect and the expectation of protection, nurturance or reward.
The subordinate basic plan for this relationship does not require
a depressive component (although depression may occur if the
relationship is broken by separation, rejection or death). But
when the asymmetry in the relationship is contested, and the
subordinate thinks him/herself to be better than the other, or
is dissatisfied with the dominant, then the representation of the
other is characterised by envy and resentment. In order to
prevent challenge, the basic plan may require a depressive
component.
(Table 1 about here)
It has been our thesis that depressive states evolved to
promote acceptance of relationships which would be otherwise
unacceptable and might be challenged. In the depressed state,
the rewards of high rank lose their attractiveness; the self is
seen as too inferior to compete for them; and the personal
resources to compete for higher rank are prejudiced by tiredness,
various forms of subjective physical incapacity and the apparent
unfriendliness of former allies and supporters.
In addition to the basic plans for organising stable
hierarchical relationships, it is likely that basic plans have
evolved for changing rank; and these "second-order" basic plans
enable the individual to switch the management of an important
relationship from one first-order hierarchical basic plan to
another. The second order subordinate basic plan requires not
only the inhibition of challenge which characterises the first
order subordinate basic plan, but also the giving up of those
behaviours such as social dominance and the enjoyment of rewards
which were associated with the rank that was lost (Price et al.,
1994).
According to the ranking theory of depression, mild
depression and dysthymic personality are related to the first
order subordinate basic plan, activated when there is incomplete
acceptance of whatever rank the individual has been able to
achieve. Severe or psychotic depression is related to the second
order subordinate basic plan, activated when there is unwanted
loss of rank or the threat of loss of rank; the delusional
denial of former rank and achievement in psychotic depression may
help in adjustment to reduced rank. Hypomanic states are
conceptualised as related to the dominant basic plan,
particularly to the second order form which mediates rise of
rank. The increased confidence and energy of elevated mood
facilitate the challenges and social lobbying characteristic of
up-hierarchy behaviour, and help the individual to adopt the more
dominant communicational style appropriate to high rank (Gardner,
1982).
Social rank gives inter-personal power, and there can be no
escaping the fact that loss of rank involves loss of power.
Weber (1947) defined power as "the probability that one actor
within a social relationship will be in a position to carry out
his own will despite resistance" (p. 247). Power is a state of
"my will be done" and of "getting one's own way". Lack of power,
and even more so loss of power, as occurs in the second order
subordinate basic plan, requires a state of "not getting one's
own way".
Unlike animals, humans have many and complex strategies for
getting their own way (Buss et al., 1987), and it would be
overoptimistic to expect the relation between mood and the
deployment of these strategies to be simple.
Do depressed patients get their own way?
The usual clinical experience of depressed patients is that they
feel very inferior and are put upon by other people. Gilbert
(1992) has called this state of mind "involuntary subordinate
self-perception." It is characterised by thoughts of "giving in
and giving up", and Coyne (1991) points out that the Automatic
Thoughts Questionnaire (Hollon & Kendall, 1990), which is
designed to tap the cognitive processes of depression, includes
items such as, "I'm a loser". Gilbert et al. (1994) have
produced evidence of increased submissiveness and unfavourable
social comparisons in depressed patients.
Aaron Beck (1976) described the state of mind of the depressed
patient thus:
"The term "loser" captures the flavor of the depressive's
appraisal of himself and his experience. He agonises over
the notion that he has experienced significant losses, such
as his friends, his health, his prized possessions. He
also regards himself as a "loser" in the colloquial sense:
He is a misfit - an inferior and an inadequate being who is
unable to meet his responsibilities and attain his goals.
If he undertakes a project or seeks some gratification, he
expects to be defeated or disappointed. He finds no
respite during sleep. He has repetitive dreams in which he
is a misfit, a failure." (p 106).
This description seems appropriate to someone falling in social
rank. However, other experienced observers have taken a
different view, and have pointed out that depressed patients
wield considerable power, if possibly in an indirect way.
Freud (1917), in his classic paper Mourning and Melancholia,
wrote of his depressed patients:
"They are far from evincing towards those around them the
attitude of humility and submission that alone would befit
such worthless persons; on the contrary, they give a great
deal of trouble, perpetually taking offence and behaving as
if they had been treated with great injustice."
Fenichel (1983) wrote:
"The depressed patient, who seemingly is so extremely
submissive, is actually often successful in dominating his
entire environment." (p 116).
Mendelson (1974), reviewing the extensive and still unresolved
debate within psychoanalysis on the relation of depression to
aggression, quotes Nacht and Recamier (1960) as saying:
"the depressed person - except no doubt the stuporous
melancholic - is always truly aggressive towards others
through the very medium of the manifestations of his
depression."
Hooper et al. (1978), commenting on their intensive study of
depression in the context of marital interaction, wrote that:
"....it is possible to see the whole depressive stance as
a massive attempt to exercise control over the marital
relationship".
Taking a strategical systems perspective, Coyne (1990)
observed that:
"Rather than being resigned, depressed persons are often
characterised by a stubborn refusal to accept the status
quo........Despite the psychodynamic conception of
depressed persons as those who turn their anger inward,
overt hostility and anger are key features in their close
relationships with others." (p. 164).
These observations point to the exercise of power by depressed
patients, possibly to an even greater extent than before the
depressive episode started.
The question of whether the onset of depression is associated
with an increase or a decrease in the exercise of power is, of
course, an empirical matter, which must be determined by
observational studies. But before that is done, it might be
useful to explore the theory in greater depth, in order to
determine the conditions under which we might expect the exercise
or otherwise of power by the depressed patient to manifest
itself. We can identify relationships in which the depressed
person might appear to be unduly powerful, which are consistent
with our hypothesis that depression is a facilitator of loss of
rank. First, we must consider separately those who rank above
the depressed person, including any who have overtaken them, and
those who still rank below them: the subordinate basic plan is
consistent with the exercise of power, even the increased
exercise of power, over those who still rank below. Second, it
is necessary to divide the social environment of the individual
into those with whom they are in competition, and those from whom
they obtain social support and/or with whom they are in a loving
relationship: there are circumstances in which the subordinate
basic plan may require the exercise of power over supporters and
loved ones in order to facilitate the withdrawal of power over
competitors. We will explore these areas of hierarchical
function, in the hope of clarifying the issues before research
in the field is undertaken.
1. The depressed person is your parent or boss
Sometimes when an individual falls in rank, he or she falls to
the bottom of whatever ranking system they are members of. This
has commonly been observed in monkeys. But often there are
people too junior for a rank change to be possible.
Those who remain subordinate to a depressed person do not
benefit from the inhibition of confident self-assertion which,
we have suggested, is the main functional feature of the
condition. This inhibition only affects assertion expressed
towards competitors and higher-ranking people. The early
psychoanalysts (Mendelson, 1974) suggested that the aggression
of the depressed person is turned against himself, and this
remains true in many cases, but we could also add the ethological
view that the aggression may also be redirected down the
hierarchy. Whereas a boss may see a depressed person as quiet
and withdrawn (any unexpressed resentment being invisible), the
depressed person's children are likely to see them as irritable
and bad-tempered. The examination of a depressed person must be
situation specific (Clarkin & Haas, 1988) and requires a separate
evaluation of behaviour to superiors and subordinates. The fact
that a depressed patient may see some medical and paramedical
staff as superior and others as inferior is one possible cause
of disagreement among staff as to the true level of depression
of the patient.
The effect of rank on the expression of hostility may explain
why the results of studies into the expression of hostility in
depression are so confusing (Riley et al., 1989), and why
depressives are found to be more angry than controls (Fava et
al., 1993). These studies of hostility and anger have not taken
into account the relative rank of the object of the hostility.
We would predict that overtly expressed hostility to higher
ranking people would be reduced, whereas hostility to lower-
ranking people may be increased (see Table 2). And concerning
anger, we would predict that the anger which is felt to higher
ranking people is not expressed.
Coyne et al. (1992) point out that depressed people direct
hostility to their children:
Despite traditional psychoanalytic views of depression as
representing anger turned inward, depression is not
incompatible with being overtly hostile. Overt anger,
criticism and irritability are characteristic of the
interactions between depressed parents and their children,
especially when the children are older. (p. 216).
And they review evidence for this statement. Since parents are
usually higher ranking than their children, this supports our
view that the down-hierarchy expression of hostility is not
inhibited in depression, but may even be increased (see Table 2).
(Table 2 about here)
Unfortunately for this argument, the expression of hostility is
not a good guide to human ranking, as it is in animals, in whom
the main inhibition of hostile expression is fear of a dominant
other. In humans hostility may be inhibited by internalised
standards, or as part of a deliberate strategy to appear
attractive to others. Moreover, the partly inhibited expression
of hostility, such as hitting the furniture, may be an ambiguous
signal, as we discuss in a later section.
2. The depressed person loves you
We can divide your social relations into those who love you and
those with whom you are in competition (ignoring, for the moment,
that you may also be in competition with those who love you).
Your life is divided between the arena of competition and the
training ground of recuperation and preparation, where those who
love you prepare you for the struggle, raise your morale, and
push you into the arena to compete on their behalf. You may be
a child being pushed into the school arena by your parents to
compete in examinations or sport; you may be one of a group of
peers who are all competing and mutually supporting one another;
you may be a husband who on returning from work is dispatched by
his wife to deal with quarrelsome neighbours; or you may be a
"champion" such as a political candidate pushed into the arena
by family, friends and other constituents.
It is important to distinguish between the signals such a
competitor sends to adversaries and the signals they send to
supporters, both during the phase of active competition and the
phase of becoming defeated. Some signals are the same to the two
types of recipient, but some are different.
Signals emitted by the active competitor
a) to everyone (both adversaries and supporters)
While you are still competing, you send out signals of confidence
and the expectation of victory, and these signals go to everyone,
adversaries and supporters alike. We are familiar with this
phenomenon as spectators of those in conflict; when we watch the
television appearances of politicians fighting elections or
boxers training for a big fight, we observe that they all express
confidence and the expectation of victory to a degree which often
seems irrational. It seems that this irrational optimism is
generated by a reflexive process of mutual boosting between
competitors and their supporters, and sustains the effort
necessary to win, and that any competitors who lack it are likely
to be beaten. These signals go to a universal audience.
If you are competing for prestige and status, as well as for
dominance, you also send out signals which make you attractive
to whoever might confer status (Gilbert, 1992).
b) to adversaries only
To adversaries, the competitor sends signals of threat and
intimidation: what we have called catathetic (putting down)
signals. These are signals of favourable relative power, and are
elaborations of three basic propositions: "I am stronger than
you", "You are weak" and "I am strong" (Price, 1988). These
signals, which consist of physical or verbal aggression, have the
effect of "putting down" the adversary and lowering his
confidence.
b) to supporters only
The catathetic (putting-down) signals aimed at rivals are not
directed at your supporters, with whom you are, of course, not
in conflict. You do not want to put them down, but rather to
boost them up. So you send them signals of affiliation and of
praise. You may also send them signals requesting agonistic
support. Table 3 summarises this proposition that adversaries
receive signals of threat, while supporters receive boosting
signals and requests for agonistic support; and that these
signals change dramatically when you switch from a winning to a
losing strategy.
(Table 2 about here)
Signals emitted by the losing competitor
a) to the adversary
There comes a point in any conflict when one of the adversaries
begins to lose. At this point you may be said to switch from a
winning strategy to a losing strategy.
The object of the losing strategy is one of damage limitation.
You must bring the contest to a close, and stop the winner from
inflicting more punishment on you. However the decision is
made, the change from a winning to a losing strategy entails a
reversal in signalling to the opponent. In order to convince the
opponent that you are no longer a threat, you signal not strength
but weakness. This may be signalled by running away, but if the
contestant remains in proximity to the winner, there are two main
forms of no-threat or submissive signal to be seen in vertebrate
contests.
One type of submissive signal was described by Darwin (1872)
as the Principle of Antithesis, which entails giving the opposite
signals to those which convey threat. If, in threat, the ears
are thrust forward, in defeat they are laid back; the tail,
which was confidently raised, is lowered and held between the
legs; the exaggeration of size and height is replaced by
shrinking, crouching and prostration.
The other main category of submission signal is the use of
metaphor. If any relationship is characterised by asymmetry of
power, the loser may adopt the behaviour of the less powerful
role, in order to express in metaphorical form that he or she is
less powerful that the recipient of the message. Thus, wolves
and other canids use the asymmetry in power between parent and
child. The defeated wolf rolls over and presents its perineal
area to the winner, in the way that a puppy presents itself to
its mother for cleaning, and this metaphor expresses the message,
"I am like a weak puppy to your strong parent". In species in
which there is sexual dimorphism and the male is larger and
stronger than the female, such as in rhesus monkeys, the loser
presents its hindquarters to the winner in the way that a female
presents herself sexually to the male, and this metaphor carries
the message, "I am like a weak female to your strong male."
Another asymmetry of power is between healthy people and sick
people. The loser could adopt the behaviour characteristic of
a sick person, and express his no-threat message in the metaphor,
"I am like a weak sick person to your strong healthy person."
This metaphor does not appear to be used in animals, even in
those species such as the hyena, in whom there is nurturing of,
rather than rejection of, sick group members. But in the human
lineage, the roles of both sick person and carer have become very
firmly established (Pilowsky, 1987; Lipowski, 1988), and it is
not unlikely that this asymmetry has been borrowed for use in
agonistic behaviour, and the metaphor of sickness has become a
human metaphor of submission, in the way that immaturity has in
wolves and femaleness in monkeys.
A related metaphor is that of old age, so that the loser might
adopt a geriatric posture and express the metaphor, "I am like
a weak old person to your strong healthy adult." Another
metaphor is the difference between fresh people and tired people,
saying, "I am like a weak, tired person to your strong, fresh
person." Therefore, according to the social competition
hypothesis of depression, we should not be surprised to find
depressed people appearing sicker, older and more exhausted than
would be justified by their physical state.
In summary, the losing competitor signals submission to the
winner in various ways, one of them being a metaphorical
expression of the message, "I am too sick to represent a threat
to you."
b) to your supporters
When, as a competitor, you decide to switch from a winning to a
losing strategy, it is important that you "take your supporters
with you". You do not want them to continue to boast on your
behalf and emit warlike signals, and to keep pushing you out into
the arena. Such behaviour would contradict and might well
jeopardise your own signals of submission. Possibly you have
made your supporters privy to the mental processes which led you
to switch to a losing strategy, in which case the supporters are
likely to change their behaviour in accord with yours. But it
is also possible that the decision to submit has been made
without the knowledge of supporters, possibly based on knowledge
not available to supporters, such as how painful are the buffets
received in the arena. In this latter case you have the job of
persuading your supporters to change their behaviour from active
support to acceptance of defeat. This may be a difficult task
requiring considerable forcefulness and the exercise of power.
In this context, signals of threat, which you have stopped
sending to your rival, you may now start to send to your
supporters. Even in total defeat, you need to retain this power.
The metaphor of sickness which signalled "no threat" to the
rival may also be useful in changing the behaviour of supporters.
The signal "I am sick" has two main effects: one is to excuse
the sick person from their normal social role, which in this case
is competing; so the supporters are likely to see their sick
champion as "out of action" or "off games" and therefore to
refrain from pushing you into the arena. The other effect is to
elicit nursing and medical care, which is likely to draw into
your entourage the doctor whose job it is not only to relieve
suffering but also to classify your condition according to some
diagnostic scheme. Since you are using the metaphor of physical
sickness, you are likely to be forceful in your demand for a
physical diagnosis, because an opinion that "there is nothing
wrong with you" or "it is just nerves" may invalidate your
communication of the sick role to your supporters. In such a
case you might well become angry with a doctor who refused to
confirm your physical incapacity.
To summarise, in attempting to explain the forcefulness of
some depressed patients, we have suggested that they need to be
forceful to the "home team" to get them to accept the change in
the competitor's role from fighting to submitting; and, in
considering the signals which might effect this change in the
supporters, we have been led to contemplate the possibility that
depressed patients are using the metaphor of physical incapacity
in order to achieve these aims. In order to get the home team
to change its behaviour, the patient may have to exercise power
in enforcing his or her sick role over supporters who have not
been privy to the decision to switch from an aggressive strategy
to a submissive strategy.
When the rival is also a loved one
When competition occurs between loved ones, such as parent and
child or marriage partners, the situation is infinitely more
complex. Then, assertive aggression may be inhibited not only
from fear of being destroyed by the rival's retaliation, but from
fear of destroying the other, or from fear that the exhibition
of aggression may destroy love and cause the other to break off
the relationship; or aggression may be vetoed by early training.
Conversely, if it is known that retaliation will be inhibited by
the loving relationship, aggression towards a more powerful loved
one may be unchecked by an appraisal of unfavourable relative
strength, as occurs frequently with the aggression of children
towards their parents. Temper tantrums, sulking and hitting the
furniture are ambiguous expressions of aggression, which may be
interpreted to mean, "this is a preview of what I will do to you
if you don't let me have my own way", which is a form of threat
behaviour, or "this is a demonstration of what I feel like doing
to you but can't because I am not powerful enough" which is a
signal of submission. Therefore, the literature on the
expression of hostility in depression would not be a good test
of the present hypothesis, even if those studies had recorded the
relative rank of the depressed person and the object of the
hostility. What needs to be measured is change in the expression
of hostility to equal or more powerful people which occurs at the
onset of a depressive episode; then the change in hostility due
to depression can be separated from long-term influences on
hostility such as moral scruples; but even in this case one must
be aware of the possibly ambiguous signalling function of
incompletely expressed hostility.
Are low-ranking people more depressed than high-ranking people?
Our hypothesis has also been criticised because there is an
imperfect correlation between mood and rank. For instance, Nesse
(1991) pointed out that "some events that profoundly influence
mood do not involve social position, some low-status people are
happy, and many high-status people are unhappy." Severe
depression may even affect a Head of state (Post & Robins, 1993).
In fact, the stress of low rank depends on three factors: 1) the
person ranking above you is a bully, 2) the person ranking below
you is ambitious and trying to usurp your place, and 3) you are
dissatisfied with your rank and do not respect those who rank
above you. These factors also apply to animal hierarchies, where
the number two is frequently under more stress than those at the
bottom of the hierarchy where competition is not so severe. And
human hierarchies are complicated by additional factors such as
social class, wealth and formal appointment which may lead to
status incongruence; also in man, the stress of low rank may be
ameliorated by the consolations of philosophy and religion. But
in unstructured situations such as the school playground and the
marital relationship we would predict that, on the whole, a
victim is likely to be more anxious than a bully, and a
subordinate spouse more depressed than the partner who "hen-
pecks" him or her.
Unlike animals, humans are members of more than one hierarchy
at the same time. If you are a high ranking member of one group
you may feel a member of a reference group consisting of the
leaders of other groups, and in this more high-powered group you
may be vulnerable to being put down. Or you may be put down by
a dominant spouse. Or you may fail to reach internalised
standards for your leadership role, and be put down by an
internalised dominant other. Or you may get into an agonistic
symmetrical relationship with God, from which it is difficult for
a human to emerge victorious.
Conclusion
There are advantages as well as dangers in modifying a theory to
accommodate data which do not appear at first glance to fit it.
The main advantage is likely to accrue from making the theory
more specific. We hope this is what has occurred in our attempt
to make the "yielding in social competition" theory of depression
fit in with some observations that depressed patients may at
times be far from yielding. This has led to the following
postulates:
1. Whereas expressed hostility up the hierarchy is inhibited in
depression, hostility down the hierarchy is not inhibited and may
be increased. This may explain some of the conflicting findings
concerning the expression of hostility in depression (Riley et
al., 1989).
2. Whereas self-assertion to adversaries in inhibited in
depression, self-assertion and various types of controlling
behaviours to supporters and loved ones may be increased. The
function of this is to switch the supporters' behaviour from
agonistic support to nurturant support.
It may well be a combination of these first two postulates
which accounts for the impression the early psychoanalysts, and
also later clinicians, got of the depressed person being
assertive. They were observing their patients in unusual
circumstances, either in a caring therapeutic relationship or
interacting with a loved one. Moreover, Freud was treating a
wealthy selection of the Viennese population who may have
regarded the whole medical profession including Freud as socially
inferior. The performance of these same patients out in the
social arena competing with their peers might have been very
different.
3. The message of capitulation may be expressed in the metaphor
of the sick role, both to adversaries, conveying the message, "I
am sick and therefore no threat to you", and to supporters,
conveying the message, "I am sick and therefore out of action;
stop pushing me into the arena to fight on your behalf." This
has implications for the physical symptomatology of depression
and for somatisation disorders, and supports the importance
attributed by Clarkin and Haas (1988) to the assessment of "the
illness-related perceptions, cognitions and behaviors of the
spouse and other family members."
4. In the "involuntary subordinate strategy" of depression,
passive forms of submissive behaviour are increased, but active
submission (flattery, ingratiation, etc.) is reduced. This is
because active submission is a form of social climbing. In a
hierarchy of three members X, Y and Z, flattery of X by Z is a
means of enlisting X's support against Y, and is therefore an
expression of up-hierarchy self-assertion. The absence of the
capacity for flattery is part of the "no threat" signal of
depression.
5. If self-assertive or leadership behaviour is divided into
aggressive dominance and social dominance (Kalma & Peeters, 1993)
we predict that social dominance towards all recipients is
reduced by depression, whereas aggressive dominance may be
reduced to equals and superiors but increased to inferiors and
supporters.
Footnote 1. Not many animal species can sustain equal
relationships between members of the same sex, and therefore the
human basic plan for relating hedonically to equals is probably
of relatively recent evolutionary origin.
Table 1. Some characteristics of the hypothesised basic
hierarchical plans.
Contested hierarchy Uncontested hierarchy
a) no change in hierarchy
dominant basic punitive protective
plan indignant caring
confident mood confident mood
egalitarian rivalrous sharing
basic plan mutual hatred friendship
subordinate fearful respectful
basic plan coerced into voluntary
obedience obedience
depressed mood normal mood
b) change in hierarchy (second order basic plans)
up-hierarchy plan elevated mood elevated mood
rebellion receipt of honours
down-hierarchy plan depressed mood philosophical
denial of former attitude
high rank devaluation of
former rank
Table 2. An active competitor's interpersonal signals classified
according to category of signal and the social role of the
recipient. In brackets are given the signals emitted by the same
competitor after the process of being defeated has begun.
Social role of recipient
Adversary Supporter
Agonistic behaviour
1. threat Yes (No) No (Yes)
2. submission No (Yes *) No (No)
3. solicit agonistic No (No) Yes (No *)
support
Nurturant behaviour
1. offer nurturance No (No) Yes (No)
2. solicit nurturance No (No) No (Yes *)
Legend: Yes = this is the kind of signal customarily given in
this situation in this relationship.
* = these signals may take the form of the metaphor of
sickness. In the case of agonistic support, the metaphor cancels
the previous signal.
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Reference note
The problem posed by the apparent non-submissiveness of depressed
people has been debated extensively in the pages of the monthly
Across Species Comparisons in Psychopathology (ASCAP) Newsletter
(the July, 1990 issue onwards), back copies of which may be
obtained from the editor (Professor Russell Gardner, Editor of
ASCAP, Department of Psychiatry and Behavioral Science,
University of Texas Medical Branch, Galveston, Texas 77555-0428).
This paper represents a summary and integration of those
discussions.