Reviews: Lauren Slater – Welcome to My Country & Prozac Diary

I have written elsewhere about psychotherapy “insiders”, which refers to therapists and patients/clients who have written memoirs, or case studies/ case stories about their experiences with the therapy process and mental illness. One of the best insiders for providing an appreciation and understanding of the experiences of both a person suffering from mental illness and a therapist working with those who suffer from mental illness, is Lauren Slater, I reviewed her most recent book, “Blue Dreams” earlier. For this post I will refer to her books, “Welcome to My Country” (1997) and “Prozac Diary” (1999).

“Welcome to My Country” is both about Lauren’s own breakdowns and ongoing depression and the various issues and insights about her clients in her psychotherapy practice, while “Prozac Diary” is all about her own history with depression and her “relationship” with Prozac. This is the best account, among many, of an inside view of depression and reactions to psychiatric medicines. I have used Slater’s book, along with Andrew Solomon’s “The Noonday Demon” for my “insiders” material on depression, which also interrogates the relationship between bio-chemical treatments and psychotherapy. “Prozac Diary” and “The Noonday Demon” are best for discussing the “illness-treatment”relationship and identity issues. Also, the issues of creativity, productivity, and self-worth, which may include the illness (depressions) or at least the dynamic of dealing with the “edge” – pain is worth investigating. Once Prozac or other psychotropic drugs may have removed the pain, what happens to the self or an identity which was previously known and which may have required some “pain” for the creative “whole” person? Both Solomon and Slater discuss this. Does Prozac create a different person? When influenced on a regular basis by a psychotropic drug, will it affect the person as a self – the psychology of one who is in the world and relationships with other people?

Slater comments on people who said something like, “Prozac helped me become the person I was meant to be”. But Slater says, “And yet for me it was not that simple. My personality, yes, had always consisted of suppressed energies and curiosities, but also of depressions, echoing intensities, drivenness that tipped into pain, With the exception of the counting and touching obsessions, which I was only too happy to be rid of, I missed these things, or parts of them anyway, for they were familiar to me as dense fog and drizzle, which had its own sort of lonely beauty, as does a desert or the most mournful of music.”(p. 44).

I will post other material on depression later. There are quite a number of excellent accounts from other insiders, to include William Styron’s “Darkness Visible”, Anthony Storr’s “Churchill’s Black Dog”, Kathy Cronkite’s “On the Edge of Darkness”and several books by Kay Redfield Jamison.

In reflecting on both her being with depression and her role as a therapist, Slater, in “Welcome to My Country”, makes an observation which goes to the heart of the psychotherapy “enterprise”:

“What after all, is therapy, if not a story of progress? Such a story could be harmful to people who are bound to feel like failures in a ┬ámilieu where the expectation of improvement is so clearly etched. Perhaps the therapist’s job is not to help grow but to help shed, chipping away at the marbled mind until the original nubs and spurs emerge. Instead of thinking in terms of development, maybe we should be thinking in terms of sloughing, making the padded self thinner and thinner, until a true skeleton juts out.”(pgs 140-141)