Juliette Vazard (CUNY Graduate Center), "Losing the light at the end of the tunnel: Depression, future thinking, and hope"
Forthcoming, Mind and Language
Patients with clinical depression experience a significant decrease in their ability to entertain thoughts of positive events that could happen as part of their lives (MacLeod et al., 1996; Bjärehed et al., 2010; Thimm et al., 2013; Anderson & Evans, 2015). Understanding the mechanisms which sustain this change in prospective cognition is of major clinical import, since developing a perspective on the future is key in the recovery of these patients (Cooper, Darmody, & Dolan, 2003).
Although the connection between lack of hope and depression is well established in the literature (Beck et al., 1979; Cheavens, 2000; Ritschel and Sheppard, 2017), much empirical research is focused on the idea that the hopelessness of depressed patients is the result of their inability to imagine and plan towards desirable futures. Instead, in this article I take seriously the hypothesis that a loss of the affective experience of hope is causally responsible for the change in the prospective cognition of patients. This hypothesis rests on the more general idea that our ability to engage with desirable hypothetical futures might depend in large part on our affective disposition to experience anticipatory emotions such as hope.
I thus propose, using a viable concept of “hope” as developed by philosophers of emotion (Milona and Stockdale, 2018; Miceli & Castelfranchi, 2010; Rioux, 2021; D’Arms & Jacobson, 2000; Roberts, 2003), that a reduction in the affective disposition towards hope might be a direct cause of the reduced ability of depressive patients to generate rich mental representations of desirable futures. In the philosophy of emotion, hope is viewed as an evaluative state which immediately apprehends a given possibility p as a genuinely possible and desirable state of affairs. As a positively valenced emotion, hope takes the phenomenological shape of a longing towards its target state of affairs, and involves a motivation to pursue and promote it. Because hope is an “anticipatory emotion”, this motivated pursuit includes attempts to practically promote p, but also the recruiting of imagination and counterfactual reasoning to create a rich (conceptual and sensory) mental representation of p that one can entertain and manipulate in thought. And so, while imagining a given possibility might elicit hope, hope is also a major source of motivation for us to intentionally deploy our powers of imagination to construct rich representations of desired realities.
According to this conception of hope, hope is an evaluative and motivational mental state which functions to direct our attention and our motivation to identify and pursue hypothetical futures that we desire for ourselves. In short, feeling hope towards p acts as a motivating reason to deploy certain possible futures (the ones that we view as both desirable and genuinely attainable) in thought so as to explore them, learn about them, and promote them. Accordingly, subjects who lose the disposition to affectively engage with their future(s) in this manner lose an important source of motivation to generate positive episodic future thinking.
This idea implies a reversion of the assumptions and methods of future‐directed therapies (FDT) for major depressive disorder (MDD) (Vilhauer et al. 2012). Rather than focusing on developing goal-setting and planning skills in patients, eliciting genuine hope could be a useful, primary goal of future-directed therapy.
References
Anderson, R. J., & Evans, G. L. (2015). Mental time travel in dysphoria: Differences in the content and subjective experience of past and future episodes. Consciousness and Cognition, 37, 237–248.
Beck, A. T., Rush, A., Shaw, B., & Emery, G. (1979). Cognitive Therapy of Depression. New York: The Guilford Press.
Bjärehed, J., Sarkohi, A., & Andersson, G. (2010). Less positive or more negative? Future-directed thinking in mild to moderate depression. Cognitive Behaviour Therapy, 39(1), 37–45.
Cheavens, J. (2000). Hope and depression: Light through the shadows. In Snyder, C. R., (Ed.), Handbook of hope: Theory, measures, and applications (pp. 321–340). New York: cademic Press.
Cooper, S., Darmody, M., & Dolan, Y. (2003). Impressions of hope and its influence in the process of change: An international e-mail Trialogue. Journal of Systemic Therapies, 22(3), 67–78.
D'arms, J., & Jacobson, D. (2000). Sentiment and Value. Ethics, 110(4), 722–748.
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Roberts, R. C. (2003). Emotions: An Essay in Aid of Moral Psychology. Cambridge: Cambridge University Press.
Ritschel, L. A., & Sheppard, C. S. (2017). Hope and Depression. In: Gallagher, M, & Lopez, S. The Oxford Handbook of Hope (pp. 209-220). New York, NY: Oxford University Press
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Vilhauer, J. S., Young, S., Kealoha, C., Borrmann, J., IsHak, W. W., Rapaport, M. H., & Mirocha, J. (2012). Treating major depression by creating positive expectations for the future: A pilot study for the effectiveness of future‐directed therapy (FDT) on symptom severity and quality of life. CNS Neuroscience & Therapeutics, 18(2), 102–109.
Thank you for your thoughtful article. Eliciting hope is indeed and always has been from the time it was first conceived, the primary goal of Future directed Therapy. This has been born out in the research which demonstrates that it does improve hope as measured by the data in the studies. People don't feel hopeful because they don't believe thier desired future is possible. When people start to experience change in their behavior they change thier perception and their beliefs, which is what changes the emotion.
'Eliciting genuine hope could be a useful, primary goal of future-directed therapy.' Alternatively, if eliciting hope isn't a justifiable psychological intervention then it might be harmful. For example, it might raise false hope in a patient.