What causes depression and anxiety? I have been a practicing psychologist and psychoanalyst for almost 40 years and have seen hundreds of patients suffering from both. In my experience, some factors are obvious. People who suffer from depression and anxiety have experienced stresses and traumas in their development that predispose them to mood disorders. Garden-variety psychodynamic theory teaches us that issues involving loss, neglect, guilt, and rejection usually figure prominently in the backgrounds of people who present with significant symptoms of depression and anxiety.
Among the weirdest peccadilloes to emerge in the recent flood of stories of sexual harassment are those situations in which a man invites or coerces a woman to watch him masturbate. Analyzing the psychology of such a man can potentially help us understand the various forms of toxic masculinity currently filling the headlines. As a therapist, I’ve seen a few men who have done this kind of thing and most are driven by intolerable anxiety. The exhibitionistic fantasy—that’s what this is—originates in the man’s need to reassure himself that his penis, his manhood, is not bad, defective, or insignificant. A key part of the imagined scenario is that the woman is fascinated and excited by the display, which affirms the man’s positive sense of masculinity and momentarily relieves his anxiety. This dynamic is usually unconscious.
Everybody knows that Donald Trump is mentally disturbed. His mental illness is hiding in plain sight. Someone who can never admit a mistake or show remorse or guilt is unbalanced. Someone who frequently brags and demeans others is emotionally insecure and volatile. And someone who appears to lack empathy invariably has something missing inside. No one has to go out on a limb to know that these things are true.
In 1978, developmental psychologist Edward Tronick and his colleagues published a paper in the Journal of the American Academy of Child Psychiatry that demonstrated the psychological importance of the earliest interactions between mothers and babies. The interactions of interest involved the playful, animated and reciprocal mirroring of each other’s facial expressions. Tronick’s experimental design was simple: A mother was asked to play naturally with her 6-month-old infant. The mother was instructed to suddenly make her facial expression flat and neutral; to remain completely still, for three minutes, regardless of her baby’s activity. Mothers were then told to resume normal play. The design came to be called the “still face paradigm.”