Original Paper

Psychopathology 2001;34:179–186

Melancholia as a Desynchronization:Towards a Psychopathology ofInterpersonal Time

Thomas Fuchs

Psychiatric Clinic, University of Heidelberg, Germany

Thomas Fuchs, MD, PhDPsychiatric Department, Vossstrasse 4D–69115 Heidelberg (Germany)Fax +49 6221 565477, E-Mail thomas_fuchs@med-uni-heidelberg.de

ABCFax + 41 61 306 12 34E-Mail karger@karger.chwww.karger.com

© 2001 S. Karger AG, Basel0254–4962/01/0344–0179$17.50/0

Accessible online at:www.karger.com/journals/psp

Key WordsMelancholia W Guilt feelings W Synchronization W

Desynchronization W Interpersonal time

AbstractStarting from psychopathological analyses of lived timein melancholia, the paper first examines the continuousprocesses of synchronization effective in biological aswell as social life. These processes enable the individualto compensate for states of shortage, to adapt tochanged circumstances, finish with past events and re-connect with the present. Examples of such resynchro-nizing processes are regeneration, sleep, dreaming, for-getting, remorse or grief. Melancholia is then interpretedas the result of a desynchronization, i.e. an uncoupling inthe temporal relation of organism and environment, orof individual and society. With the processes of resyn-chronization failing, the person falls out of common envi-ronmental time. This conception allows a parallel to bedrawn between chronobiological and psychosocial re-sults of research. Moreover, it offers the possibility tounderstand not only the psychopathology, but also thetriggering of melancholic episodes on the basis of a dis-turbance of time. Consequences for a ‘resynchronizingtherapy’ are outlined.

Copyright © 2001 S. Karger AG, Basel

Introduction

Piet Kuiper, a renowned Dutch psychiatrist, fell illfrom severe melancholic depression at the age of 60. In hisaccount of it he wrote:

‘What has happened can never be undone again. Not only thethings go by, but also possibilities pass by unused. If one does notaccomplish something in time, it is never done any more ... The realessence of time is indelible guilt.’ – ‘The deepest abyss I fall into is thethought that even God cannot help me, for He cannot undo any-thing.’ [1, p. 58, 162]

Guilt feelings as a prominent sign of melancholicdepression have been interpreted by psychopathology indifferent ways. Kaestner [2] and Janzarik [3] stressed theinability of the depressed person to feel and realize values,while at the same time being tormented by these values’claim to be fulfilled. Tellenbach [4] coined the term ‘re-manence’, i.e. falling short of rigid demands on oneself ofduty and orderliness, which he regarded as the risk inher-ent in the ‘melancholic type’.

Finally, the guilt feelings may also be derived from themelancholic disturbance of Zeitigung or lived time whichhas been described, mainly by Straus [5] and von Gebsat-tel [6], as an ‘inhibition of vital becoming’. FollowingStraus, in melancholia the ‘immanent’ or ‘ego-time’ of the

180 Psychopathology 2001;34:179–186 Fuchs

movement of life gets stuck, whereas the ‘transient’ or‘world-time’ goes on and passes by. The depressed person,so to speak, ‘lives time’ no longer as his own; instead, itcomes upon him from in front and overrides him. Theinhibition of inner time does not allow him to progresstoward the future, nor is he able to close and leave behindhis past experiences. ‘The more the inhibition increasesand the speed of inner time slows down, the more thedetermining power of the past is experienced’ [5]. Whathas happened remains conscious as a fault or failure, asever-growing guilt. In melancholia, time is continuouslytransformed, as it were, into guilt which cannot be dis-charged.

Such analyses are still fundamental for a psychopathol-ogy of time, and of melancholia especially. From today’sperspective, however, they suffer from the drawbacks of apsychopathology based on life philosophy, postulating thebasically metaphysical principle of the élan vital, a vital‘principle of becoming’ inherent in the individual. As aresult, lived time is considered as primarily monadic,without reference to intersubjective or social time. Thus,the depressive pathology of time seems to be comprehen-sible as an individual disturbance or inhibition of ‘becom-ing’, which only afterwards lags behind the transient orworld-time.

Modifying this approach, it is proposed to consider theprimary melancholic pathology of time not as an individ-ual inhibition but as a disturbance of a synchronized rela-tion, or a desynchronization. My thesis is that melancho-lia is the result of a desynchronization, i.e. an uncouplingin the temporal relation of organism and environment, orof individual and society. I will attempt to demonstratethat this concept (1) allows a parallel to be drawn betweenchronobiological and psychosocial results of research;(2) offers the possibility to comprehend not only the psy-chopathology, but also the triggering of melancholic epi-sodes on the basis of a disturbance of time; (3) extendsand shifts the focus from the individual to the relation ofindividual and social time. This is particularly importantconsidering the increasing acceleration and permanentrevolution of the life world in western society. After all,this development raises the question of whether thepathology lies in the individual who is not equal to thisspeed any more, or rather in a sort of collective mania. Inany case, epidemiological research points to an increase indepressive conditions – reactive or endogenous – in west-ern societies due to social changes accompanying indus-trialization [7–9].

Of course, the concept of synchronization/desynchro-nization is derived from chronobiology, referring to the

order or disturbance of rhythms such as the sleep-wakecycle or the diurnal period of hormone levels. In order tointroduce these terms into phenomenological psychiatryand stimulate an interdisciplinary approach to depres-sion, it will be necessary to extend the meaning of thoseterms over different levels (e.g. biology, sociology). Thereader may examine to what extent this semantic restruc-turing is successful and fruitful.

The first part of my paper outlines the processes of syn-chronization which characterize our life on a biological aswell as psychosocial level. These processes imply mecha-nisms of elimination and regeneration which help to workup residues and to make up for temporary desynchroniza-tions. The second part describes melancholic depressionas a failure of synchronization resulting in a completeuncoupling of internal and external time.

Life as a Process of Synchronization

Physiological LevelBiological systems change over time, not in a linear

manner, however, but cyclically. There is a continuousattunement between endogenous and exogenous rhythmsor timekeepers, a synchronization of organismic with cos-mic rhythms, such as daily, lunar and solar periods. Thus,for example, the sleep-wake rhythm of 24 h is known to bethe result of a synchronization between endogenous andexogenous time-keepers or oscillators.

Rhythm is the way the organism maintains its innerorder against the decaying processes of anorganic nature.Homoeostasis is not a ‘static’ state, but is marked by aperiodical alternation of intake and excretion, exhaustionand regeneration, wake and sleep, ergotropic and tropho-tropic phases; marked also by disturbances, shortages andcorresponding counterregulations. These periodical dis-crepancies or imbalances become apparent in subjectiveexperiences of urge or unpleasant feelings; as drive needsin hunger or sexuality; as sleepiness, exhaustion, pain orillness – states which all press for their own abolition by asuitable behaviour towards the environment. Shortageand need, labour and pain are the price life pays for itsinner order to be maintained against the physical world.

This is connected with the primordial experience oftime which is always directed towards the future. Plantslive in immediate exchange with their environment, with-out temporal discrepancies. Animals, however, experi-ence time lags, i.e. feel shortages as ‘not yet’. Animals suf-fer the separation of drive needs and satisfaction. Withthis discrepancy arises an appetitive tension, a ‘being after

Melancholia as a Desynchronization Psychopathology 2001;34:179–186 181

something’ (e.g. the prey not yet grasped, the sexual part-ner not yet met). The drive tension establishes a primor-dial time differential or ‘time span’. Janzarik [10] hascoined the term of ‘protensivity’ for this primary tempo-ral orientation. Lived time thus results from periodicalasynchronies or discrepancies. It is characterized by thecyclical repetition of drive needs or interests and theirorientation toward a compensation in the future. Timeexperience arises with want and suffering.

Psychosocial LevelIf we now turn to the relation of man to his social envi-

ronment, we find many forms of synchronization here aswell. The everyday contact with others already implies acontinuous fine tuning of emotional and bodily commu-nication, an exchange of ‘vibrations’, or a ‘resonance’. InEnglish, this is also pointed out by the expression ‘to be insynch’. Process research in psychotherapy has contributedto the elucidation of the subtle mechanisms effective inthis synchronization [11]. Moreover, infant research hasshown how the sympathetic contact essentially deter-mines our primary experience: The communication be-tween mother and baby is characterized by rhythmic andmelodic interaction, mutual resonance, or by what Stern[12] has called ‘affect attunement’. Thus, from the begin-ning, the microdynamics of everyday contact imply ahabitual synchronization. They bring about a basic feelingof being in accord with the time of the others, and to livewith them in the same, intersubjective time.

Usually, we are not consciously aware of this basic syn-chrony. However, the processes of social synchronizationbecome more noticeable in the manifold ways of timing,of day- and week-time regulation, date scheduling, punc-tuality, etc. In a wider sense, synchronization manifestsitself in all mutual commitments, agreements and ar-rangements which are kept up by individual self-con-straint and standardization. This coupling of individualtimes has been increasingly institutionalized and internal-ized in the modern age, leading to the nearly perfect syn-chronization of all members and sequences in industrialsociety, without which it would, for all its complexity, fallinto a functional chaos. The social synchronization has animpact on the organism and its daily periods as well: Sincebirth, the rhythms of the organism (eating, sleeping, excre-tion times, etc.) are shaped by socialization. Bunkerexperiments have shown that in spite of the loss of exter-nal time-keepers, a new, common day rhythm graduallydeveloped among test subjects [13]. Biological and socialtime may therefore not be separated.

Finally, our biographical development is strongly in-fluenced by synchronizations as well. The age of majortransitions and role changes such as starting school orwork, marrying, steps of carreer, retirement etc. is more orless standardized. Fixed minimum or maximum agesmark the entering in, or leaving from, a social ‘space oftime’. In his decisions on the course of life, the individualgets his bearings from his contemporaries (‘what is myposition compared to my age-group?’). Even here, thesocial time-keepers have an impact on the biological level,as is shown by the phenomenon of acceleration, i.e. theearlier onset of sexual maturation in western societies.Finally, we may think of the cultural synchronization thatconnects people of the same age-group by common atti-tudes, fashions, styles, values and memories, leading thusto a basic ‘contemporariness’. Its importance is painfullyfelt by people in old age when they gradually lose the fel-lows from their generation and, with them, their ‘remi-niscing community’.

In the life world, then, simultaneity and contemporari-ness are continuously produced. As on the biological level,however, these synchronizations are not at all constant.Periodically, we experience asynchronies, i.e. situationsthat require us to adapt to external changes, to compen-sate for disturbances and backlogs, or to advance in ourdevelopment along the biographical steps preset by lifeand society. Uncompleted tasks, unresolved conflicts,strain and distress accumulate, thus inhibiting or preclud-ing our progress toward the future. Traumatic events andserious experiences of guilt, loss or separation persistentlyaffect the experience of time. They entangle the person inhis/her past, and he/she temporarily loses the lived syn-chrony with others.

Hence, in loss or guilt, a new time experience arises: Itis not the time of ‘not yet’, the time of desires and wishesdirected toward the future, but the time of ‘no more’, thetime of the irrevocable past. It corresponds to a falling-outof the common time which runs on, while the individualcannot get rid of something experienced or done. It ismainly by separations from others to whom our lived timeis primarily related, that we experience the irreversibilityand the rule of time. Such discrepancies and deviationsfrom the present, or the periodical accumulation of themissed, the lost, or the unfinished, require specific pro-cesses of coping and resynchronization. With these, theindividual regains connection to the common, intersub-jective time. I will name only a few of such processes:

Forgetting and Repression. Remembering binds us tothe past. Field psychology discovered the ‘Zeigarnik ef-fect’, which means that uncompleted and unfinished tasks

182 Psychopathology 2001;34:179–186 Fuchs

are more easily remembered than completed ones [14].The faults, the guilt, the missed goals are inscribed intomemory for good, as static engramms; a glance into thepast is enough to revive them again. Nietzsche stressedthe strong connection of conscience and memory, andwrote pointedly: ‘Only what does not stop hurting re-mains in memory’ [15, p. 311]. He was one of the first tolook upon forgetting not as a loss, but as a positive capa-bility of inhibition, and remarked that ‘there could be nopresent without forgetfulness’ [15, p. 292].

Sleep and Dreaming. Sleep is not only a physiologicalregeneration but an essential instrument of resynchroni-zation, of forgetting and finishing. Therefore, we speak ofthe ‘sleep of the just’, i.e. of the person who has balancedher social debits and credits. On the other hand, a sleep-less night may call all worries and problems of the dayback into consciousness. Freud, in The Interpretation ofDreams [16], also stated that dream contents relate touncompleted issues which by dreaming shall be broughtto a solution and conclusion. Patients with posttraumaticstress disorder illustrate the failure of these processes ofresynchronization: They cannot find oblivion by sleeping,their dreams only repeat the experienced horrors againand again.

Remorse and Grief. Remorse is not only directedtowards a social compensation or atonement, it is also aninner process of coming to terms with one’s guilt. When itis successful, the culprit is reconnected to common timeand to the progress of life. In a similar way, the process ofgrief helps to untie emotional bonds that do not corre-spond to the present any more. The person, however, whocannot bear and live through periods of grief remains inconstant asynchrony.

Crises. Crises arise as serious reactions to a desyn-chronization: Former orientations, roles and attachmentshave become anachronistic. The necessary development,however, is dammed back. A new homoeostasis is not tobe attained without a break or ‘time-out’, a phase of dis-orientation and dying of the past. Different, mainly pain-ful processes, such as grief, renunciation, re-evaluationand re-interpretation may help a person to reconnect tothe present and leave the past behind. We can see herethat desynchronization may well be a necessary stimulusfor personal development.

SummaryLet us summarize the argument at this point: The rela-

tion of the individual and the environment is character-ized by a temporal coupling. On the biological level,endogenous and exogenous rhythms are attuned to each

other. On the emotional and social level, we are connectedto the others by processes of resonance and synchroniza-tion. These couplings are not static, but pass through peri-odical phases of balance and imbalance, of disturbanceand reconciliation, of desynchronization and resynchro-nization. Different biological and psychic processes serveto re-establish the present, or to bring the individual up todate. Among them are the periodicity of the vital func-tions, the compensation for shortage by satisfaction ofneeds, and the recurring processes of coping with theunfinished by forgetting, sleep, dream, remorse, grief orcrisis.

Mere coherence or lived synchronicity does not yetbring about time experience. This rather results from adesynchronization or discrepancy of coupled internal andexternal processes on the biological or on the psychosociallevel. The time of a living being is primarily directedtoward the future, as the ‘not yet’ of ‘being after some-thing’ or of protensivity. In social associations, however,the human being also experiences separations and losseswhich throw him out of common time. Time as passingby, the time of ‘no more’, comes to our consciousness ininterruptions of the stream of life, mainly in separationsfrom the others with whom our life is in synchrony. Whilenormally the movements and alterations of things or menare included in our own progressing, their direction is nowreversed. They advance towards us and pass on by, whilewe cannot take part in their sequence any more. Transientor fleeting time only appears for us when we lag behindthe changes of our environment.

Melancholia as a Complete Desynchronization

A complete desynchronization between individual andenvironment is characteristic of melancholic depression.It ensues when coping with major change fails, i.e. indi-vidual resynchronization mechanisms do not succeed, butbreak down. Moreover, depressive psychopathology itselfexpresses the uncoupling of the resonance and synchronyof individual and environment.

Triggering SituationThe typical constellation triggering melancholia has

been characterized by Tellenbach as a situation of rema-nence. The melancholic does not feel equal to the speed ofexternal changes or to necessary developments. He givesup in the face of painful processes of detachment or elimi-nation, he refrains from necessary role changes, and heshrinks back from confrontation with the basic facts of

Melancholia as a Desynchronization Psychopathology 2001;34:179–186 183

existence: isolation, finiteness, decision, guilt. The inabili-ty to enter a real grief process probably plays the maintriggering role. The required untying of bonds seems toothreatening and painful; the loss is not acknowledged, theprimary affect suppressed. Hence essential resynchroni-zation processes are missed.

This corresponds to the premorbid striving of themelancholic type to avoid discrepancies in relation to hisenvironment at any rate. The ‘hypernomia’ which Kraus[17] has worked out as the hallmark of the melancholic’ssocial identity, is a ‘hypersynchrony’ as well. Down to themicrodynamics of everyday behaviour, the melancholicseeks continuous resonance by compliance and friendli-ness, social attunement, punctuality and timely comple-tion of his tasks. He must not be indebted to somebodyjust because he feels he is not capable of achieving theinner processes of release: the forgetting of the unfinished,the freeing of debts, the development towards emancipa-tion and autonomy. This inability to cope with desyn-chronizations inhibits his personal maturation and ren-ders him all the more vulnerable toward inevitable bio-graphical breaks or role changes.

Physiological DesynchronizationThe capitulation before an inescapable task of coping

or development now leads exactly to what the melan-cholic fears most of all: to the break-down of coherenceand resonance with his environment in depressive illness.Once the resynchronizing mechanisms fail, apparently aphylogenetically older defense mechanism is released: Itconsists of a passive and submissive behaviour of humili-ty, and when intensified, in a blockade, paralysis or‘freeze’, thus reminiscent of a ‘playing dead reflex’. Thiscorresponds to a conversion from social to biologicaldesynchronization, leading to a reaction of the organismas a whole, namely a psychophysical slackening or stasis.The triggering of depression by overall exhaustion or seri-ous somatic illness shows that a vital desynchronizationmay play a primary causal role as well.

The physiological desynchronizations are well-knownas far as their manifestations are concerned, though theirunderlying mechanisms have not yet been explained. Letus think of the disturbances of neuro-endocrine and tem-perature periods, of the sleep-wake rhythm, of the femalecycle, then the loss of drive, appetite or sexuality, andfinally the seasonal depressions as desynchronizations inrelation to the annual period. The psychophysiologicalregeneration in sleep is also seriously disturbed. De-pressed persons awake early in the morning after a dis-rupted and shortened sleep and then start brooding over

their faults and fears. The dream phases as well as dreammemories are reduced, the contents mainly negative,which means that the ‘psychohygienic’ effect of sleep islost [18, 19]. On the other hand, therapeutic sleep depri-vation effects a temporary resynchronization with imme-diate impact on mood.

The uncoupling from the environment is also mani-fested in an unpleasant insistence of the body. A leadenheaviness, constant exhaustion, and a sense of restrictionand tightening make the patient feel the bare materialityof his body that is otherwise hidden in the movement andperformance of life. In addition, a loss of vitality in manysystems of the organism comes about. In serious cases, aliteral freezing and ‘reification’ of the body ensues whichis no longer capable of resonance with its environment[20].

Psychosocial DesynchronizationLet us now consider the desynchronization concerning

intersubjective time. First, it becomes manifest in aretreat from social obligations. Depressed patients avoidthe environment with its social or physical timekeepers.They do not get up on time, their tasks are taken over byothers, important family decisions are made withoutthem. Futile attempts to keep pace with events and tocatch up on tasks increase the feeling of remanence.

Moreover, the depressive suffers the loss of sympathet-ic resonance; he gets ‘out of synch’. While dialogues arenormally accompanied by a continuous synchronizationof bodily gestures and gazes [11], his expression sets andloses its modulation. The affect attunement with othersfails. This is connected to the inability to participate emo-tionally in other persons or things, to be attracted oraffected by them. Painfully, the patient experiences hisrigidity in contrast to the movements of life going on inhis environment.

The desynchronization also becomes manifest in a fail-ure to achieve forgetting and elimination. ‘Everythinggoes through my head again and again, and I always haveto wonder if I did things right. I can’t sleep at nightbecause my thoughts stay with the past day, and in themorning everything comes back to me in terror’. It is thetorture of not being able to forget, of being constantlyforced to remember and therefore not arriving at thepresent any more. The dominance of the past is only theother side of the slackening protensivity, of the lack ofdrive, needs and interests that otherwise direct us to thefuture.

With increasing inhibition, the basic movement of lifefinally comes to a standstill, as anthropological psycho-

184 Psychopathology 2001;34:179–186 Fuchs

pathology has described it. The depressive has fallen outof common time and has become, as it were, a livinganachronism. He literally lives in another, sluggish time.Nevertheless, the external, intersubjective time runs onfor him, i.e. it passes him by. Because of this uncoupling,it appears as an empty, only transient time that he cannotfill or shape any more, like a continuous call: ‘Gone!Over!’. These phenomenological analyses of time distur-bance can be experimentally verified, as Mundt et al. [21]have shown again recently. Depressive persons experi-ence a time dilation, i.e. they estimate given time intervalsto be longer than the actual objectively measured time.Even so, it seems important that this external or world-time is socially constituted, and not a mere physicaltime.

With the uncoupling of intersubjective time and theloss of protensivity the future is blocked, which meansthat the patient cannot transcend or leave behind the past.With this, however, the past is fixed once and for all; itmay no more be changed, evened out or abolished byfuture living. Now all guilt and all omissions are actual-ized at once. In a similar manner, the death of a close per-son may unexpectedly cause guilt feelings for which thereseems to be no comprehensible reason at first. But as longas that person lives, we implicitly count on the possibilityto make good in the future what we failed to do for him inthe past. This window of opportunity, however, vanisheswith his death. Our common time totally curdles intopast, unalterable through a common future.

The depressed person experiences just this situation,not with one person, however, but with everybody. Hehimself has already become past while still living. His lifeis fixed in all details irrevocably. Now, all the countlessfaults and omissions that we all become inevitably guiltyof push into his awareness. ‘One has said things that can-not be taken out of the world any more’, a patient com-plained. Or as Kuiper [1, p. 158] writes: ‘The deepestabyss I fall into is the thought that even God cannot helpme, for He cannot undo anything’. Not the intensity, butthe principal irrevocability is the characteristic sign ofmelancholic guilt. The confessions of the patient are notat all directed toward resynchronization with othersthrough remorse or compensation, for the premise, thecommon dimension of time, does not exist any more. Hisguilt is irreparable as such.

Complete desynchronization is marked by the transi-tion to melancholic delusion. Now the return to a com-mon intersubjective time has become unimaginable, thedetermination by the past total. In nihilistic delusion, theasynchrony reaches the extreme of a loss of reality, of a

juxtaposition of two worlds. A patient of mine was con-vinced that all her relatives had died; she was alone in theworld and had to live on for ever. A similar self-descrip-tion has been given by Kuiper:

‘Someone who resembled my wife, was walking beside me, andmy friends visited me ... Everything was as it would be normally. Thefigure representing my wife constantly reminded me of what I hadfailed to do for her ... What looks like normal life is not. I foundmyself on the other side. And now I realized what the cause of deathhad been ... I had died, but God had removed this event from myconsciousness ... A harsher punishment could hardly be imagined.Without being aware of having died, you are in a hell that resemblesin all details the world you had lived in, and thus God lets you see andfeel that you have made nothing of your life.’ [1, p. 136]

Apparently, the total uncoupling from intersubjectivetime may be described only by the expression of havingdied.

Conclusion

Zeitlichkeit or time-relatedness of man is not a solipsis-tic ‘existential’ as Heidegger puts it, nor a mere vital ‘timeof becoming’ that runs in the individual, but primarily alived synchronicity with the environment and with oth-ers. It is only from periodical desynchronizations, i.e.states of shortage, need, incoherence, insufficiency, guiltor separation, that the experienced time of the ‘not yet’ or‘no more’ results. This time experience stimulates, for itspart, processes of resynchronization, enabling the individ-ual to finish with past events, to adapt to changed circum-stances and to reconnect with the present. Examples ofsuch processes are sleeping, dreaming, forgetting, re-morse, grief or crisis.

Persons with a predisposition to melancholia have alimited capacity for such resynchronizations. They feel anecessity not to allow discrepancies to grow, not todeviate from the standardized course of life, nor to fallback from it. If this happens all the same, the completedesynchronization or temporal uncoupling of melan-cholic depression may ensue. With such depression, theintersubjective desynchronization is transformed to a bio-logical desynchronization and vice versa. Melancholicdelusion is the utter manifestation of this uncouplingfrom common time.

From this point of view, the treatment of depressionshould have the aim to restore and support the missingprocesses of synchronization. On the biological level, theinstruments for this available at present are pharmacolog-ical and electroconvulsive therapy, sleep deprivation or

Melancholia as a Desynchronization Psychopathology 2001;34:179–186 185

light exposure. A psychotherapeutic ‘resynchronizationtherapy’ should take into account the following guide-lines:

(1) The first requirement would be a spatial and tem-poral frame creating a definite and legitimate recoveryperiod for the patient, a ‘time-out’ so to speak, duringwhich he can gradually readapt to the common socialcourse of time with as few pressures as possible.

(2) Secondly, it is important to give rhythm to every-day life, i.e. to emphasize repetition and regularity in thecourse of the day and week, since it helps the patient togain a stand against fleeting time.

(3) The third principle should be the furthering of pro-tensivity, i.e. the orientation of the patient toward futuregoals, however modest, to be achieved within a shorttime. This may be stressful at first, since the patient’sactual, appetitive motivation is still missing and eachaction is in immediate danger of not satisfying his highdemands on quality. It is therefore most important toexplain to the patient that the intentional arc alone, thathe draws in plan and execution, is enough to create hisown ‘time arrow’ against passing time and to re-establishhis protensivity.

(4) From this follows the principle of ‘optimal resyn-chronization’: The patient should experience a degree ofactivation and stimulation appropriate to his presentstate, so that the idle time is filled again, without, how-ever, causing a relapse into uncoupled time by forcedrehabilitation. The image of a gear change suggests itselfhere, where different levels of synchronization are chosenaccording to the present speed.

(5) Finally, after the remission of acute depression, itbecomes important to further the psychological and socialresynchronizations whose failure has contributed to theonset of illness, above all, processes of grief and rolechange.

At the beginning, I mentioned the social processes ofacceleration to which we all are subjected. It can easily beforeseen that the permanent revolution of the life worldwill increasingly result in desynchronizations that de-mand too much adaptability of the individual. As psy-chiatrists, we are close to this development, for more andmore people are coming to our wards who cannot toleratethe accelerated modernizations and fall into the uncou-pling of depression. Their suffering shows that man’scapability of biological and social resynchronization can-not be increased at will, however variable his naturemay be.

The German philosopher Theunissen [22] has spokenof a ‘negative theology’, or a ‘dominion’ of time as anobjective process to which we are all exposed, but whichthe melancholic person has to suffer helplessly and de-fencelessly. I think that in this point Theunissen is subjectto a mystification. We ourselves are the ones who havecreated the dominion of time to which we are thenexposed as a seemingly independent process. The ‘socialconstruction of reality’ [23] essentially implies the con-struction of time, and with the ever growing socializationof individuals, this construct appears as an autonomous,godlike force that demands its sacrifices. It is this alien-ated and reified time that in melancholia falls back on thesubject from the outside. The depressive shows us vicar-iously that as individuals and as society, we are equallyconfronted with the task to reappropriate the time that wehave made our enemy, and to make it our friend again.

Acknowledgment

For aid in translating, I am indebted to Mrs. Aoife Hunt, Heidel-berg.

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