TheValorizationSadnessAlienationMelancholicTemperament

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The Valorization of Sadness Alienation and the Melancholic Temperament

Author(s): Peter D. KramerSource: The Hastings Center Report, Vol. 30, No. 2 (Mar. - Apr., 2000), pp. 13-18Published by: The Hastings CenterStable URL: http://www.jstor.org/stable/3528307 .

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T h e Valorizationf Sadness

Alienation a n d t h e MelancholicTemperament

by PETER D. KRAMER

In the Western aesthetic of melancholy, alienation and authenticitywalk hand in hand, and therapies

that change affective states-especially drugs like Prozac-are philosophicallyuspect. This is not a necessary

state of affairs.What would be the centralphilosophicalquestions

ina culture whose aesthetic values rose from

the well-springsof optimism?

A t the heart of Listening o Prozac s a thought ex-

periment:Imaginethat we have to hand a med-

ication that can move a person from a normal

psychological tate to another normalpsychological tate

that is moredesiredor bettersociallyrewarded.1What are

the moralconsequencesof that potential,the one I called

"cosmeticpsychopharmacology"?

The questionwould be overgeneral xcept that it oc-curs n the context of a discussionof psychicconsequencesof technologies.Peoplenow experience he selfin the lightof psychotherapeuticmedications as lately they experi-enced it through psychoanalysis. n the thought experi-ment, the medication we are to imagine is rather like

Prozac,and the less desiredstate is somethinglike melan-

choly,when that term refers o a personalitystyle rather

than an illness.Melancholicsarewell described n litera-

ture thatstretchesback for centuries.They arepessimistic,

self-doubting,moralistic,and obsessive.They have low

energybut use that energyproductively.They are creative

in the arts.They areproneto depression,especially n re-sponseto socialdisappointments.

Listening o Prozacargues hat the importantaction of

new medications may be on the melancholic tempera-ment as much as on depression,althoughthe two arepre-sumed to be related.The book'sassessmentof cosmetic

psychopharmacology eginswith the observation hat for

decades,psychotherapyhas been the technologyappliedto melancholy.In this account, psychotherapy ncludes

PeterD. Kramer, TheValorization f Sadness:Alienationand the Melan-cholicTemperament," astingsCenterReport0, no. 2 (2000):13-18.

approaches, uch as supportiveor strategictherapies, n

which self-understandingis not the means or end of

cure-where the goal is change in affectivestate merely.

Asking why cosmetic psychopharmacologymakes us so

uneasy,I did not neglectto considerthe targetsof treat-

ment-in particular, laims that suffering s an indicator

of the humancondition;thatpsychicpainservesan adap-

tive function; and that melancholyis an element of au-thentic self. But since the premiseof "cosmesis"s move-

ment from normal to normal,the post-treatment tate as

much as the pretreatmenthould meet the criteriaof Dar-

winian fitness and human completeness.And those who

hope psychotherapy ucceeds must be comfortablewith

the diminution of melancholy.For these reasons,I came

to believe that a criticalelementin a principledobjectionto cosmetic psychopharmacology must involve the

method of change, namely,medication, more than the

goalsof intervention.

To my delight, moralphilosophershave takenup this

thoughtexperiment,particularlyhe medical ethicist CarlElliott, in a seriesof essaysdistinguishedby theirliterary

appeal.These discussionsarea continuationof Listeningo

Prozac,but they arealso a form of backtracking, ecause

the element that interestsElliott is cosmesis'sgoal. Elliott

is worriedabout the diminutionof alienation.

I hope here to use Elliott'sessays o ask,as rule-keeperfor a certainsort of game, whether the concept of alien-

ation successfully dentifiesgrounds on which cosmetic

psychopharmacologymight be morally suspect. At the

sametime, I will want to reopen he issueof the legitimate

goals of treatment.To previewmy conclusion-my im-

HASTINGS CENTER REPORT 13arch-April 2000



pression is that the concern over

Prozac,and with imagined medica-

tions extrapolated from experiencewith Prozac, urnsalmostentirelyon

an aestheticvaluationof melancholy.

* * *

E lliott's central claim is that ad-

dressing alienation as a psychi-atric issue is like treatingholy com-

munion as a dietary ssue-a catego-

ry mistake. Includedin this claim is

the understandinghat alienationhas

a particularmoral worth. Neither of

theseassertions trikesme asobvious.

In particular, want to say that both

are thrown into doubt by a premiseof our discussion,namelythat med-

icationcan lessen alienation.The na-

ture of the technologymay cause usto reassess he category,and the sig-nificance,of the target.

To beginwith the questionof cat-

egory: Clearlysome alienation is an

aspectof mentalillness,indeedalien-

ation is an element in schizophrenia.It is not absurd o imaginethatalien-

ation might be "psychiatric."Often

Elliottequatesalienationwith depres-sion, as when he paraphrasesWalker

Percy to this effect: "Take a look

aroundyou; it would take a moronnot to be depressed."2he argumentsElliott makes regardingdepressionand alienation,as worrisometargetsfor pharmacology, re identical.It is

not alwaysclear whether the depres-sion referred o is a stance or a syn-drome.

As regards category, then, the

question is, alienation of what sort?

Elliott recognizes that alienation

comes in many forms, and he de-

scribes personal, cultural, and exis-tential alienation.But from a psychi-atricpoint of view,the people Elliott

suggestsas candidates or antidepres-sant use are homogeneous.They are

not primarilymistrustful, in a waythat might make us think of a para-noid alienation;nor are they sociallyunawareand distanced rom their fel-

lows in way that might suggest an

autistic alienation. Elliott's subjectsaresad, obsessive,andquesting.They

worry.Their alienationis of a singlesort,the sort that is an element of the

melancholicpersonality.When I say that the premise

"medication diminishes alienation"

casts its shadowon questionsof cate-

gory, I mean that our likely beliefs

about category are susceptible to

being altered by our beliefs abouthow that diminution occurs.We do

not expect medication to work di-

rectlyon the cognitive componentof

alienation, ust as we do not imaginethere is a pill for, say, atheism or

chauvinism-that sort of imaginingwould violate the rule that the drugwe have in mind is a good deal like

Prozac. Presumably,our hypotheticmedicationtones down obsessionali-

ty, pessimism,and social anxiety,so

that, secondarily,a person feels less

impelled to resist the ambient cul-

ture. It altersaffectiveaspectsof per-

sonality,where affectextendsto such

phenomenaas sense of status n social

groups.That is to say,our premisebrings

into play the basis of personality. f

we werecertain,as many mid-centu-

rypsychoanalystswere,thatpersonal-

ity is the detailedpsychicencodingof

a person'sexperience in the world,

relatively ixed but responsive o in-

sight, then the parameters or a dis-

cussion of the pharmacologic en-

hancement of alienation would be

clearer.Equally, f we wereto discov-

er thateven minordepressions in all

instances caused by a virus that de-

forms brain anatomy,the discussion

would be stableat a differentpoint of

equilibrium.The rangeof philosoph-ical arguments might remain simi-

lar-one can approach character

armoras a medicalcondition and onecan definelivingwith microbesas an

expectablestate of human life-but

in each instance we would be more

inclinedto entertainparticular nes.

To clarifythe interplayof targetand technology:SettingasideProzac,let us imagine that it is discovered

that moderatedoses of vitaminC de-

crease a person'ssense of isolation.

Would the taking of vitamins seem

worrisome?The answerdepends on

how we "listen" o the medication.

We might decide that alienationof

that sortwas in all probability ome-

thing like a vitamin deficiency.We

might even decide in retrospect hat

our objectionto cosmesis had result-

ed from an aesthetic assessmentof

the technology employed to achieve

it. That is, previously when it was amatter of using Prozac,ratherthan

vitamins, to the same end) we had

objectedbecausethe technologywas

artificial,scientificallycomplex, and

manufactured and advertised by a

large corporation-partaking of the

veryqualitieswe believeoughtto lead

to alienation,on, say,a politicalbasis.

Once vitamin C's effect was discov-

ered,we might come to believe that

Prozachad, after all, been repairingmedical damageto the self. Startingwith the premise hat medicationcan

mitigatealienation,it is not hard to

imagine evidence in light of which

alienation would be most parsimo-

niouslyunderstoodas at leastin parta psychiatricssue.

I should add that as a clinician,I

find the argumentby categorymis-

takesuspectbecausegenerally atego-

ry mistakesarein the oppositedirec-

tion from the one that perturbsEl-

liott. Mental illness has too oftenbeen too narrowlyunderstood-mis-

understood-as a principledresponseto socialconditions;this error s one

R. D. Laing made with regard to

schizophreniawhen he claimed that

psychosis s a response o the absurd

pressures f bourgeois amily ife. Myown belief is that the conundrum

necessarilys playedout at a historical

moment, ours, when the categoriza-tion of alienation remains ambigu-ous.

Elliott goes on to arguethat alien-

ation is circumstantiallyappro-

priateand morallyvaluable.Regard-

ing personal and cultural alien-

ation-the mismatchbetweenpartic-ular self and the particulars f the so-

cialsurround-Elliott writesthatyou

might feel ill at easeamong Milwau-

14 HASTINGS CENTER REPORT March-April000



kee Rotarians.Elliott would disfavor

your being offered Prozac n this in-

stance because "Some external cir-

cumstancescall for alienation."

Now I hope it is the case that no

one is dispensingmedicationas an al-

ternative o dropping membership n

the MilwaukeeRotary.But if Elliott

is at some distance from the clinicalmoment here, he is nonetheless suc-

cessful in depicting one sort of un-

ease,thatof the sensitivepersonstuck

in a group of philistines. Walker

Percy,in a passagecited by Elliott,works the same vein as regardsde-

pression:"Consider the only adults

who are never depressed: chuckle-

heads, Californiasurfers,and funda-

mentalistChristianswho believetheyhave had a personalencounter with

Jesusand aresaved once and for all.Would you tradeyour depression o

becomeany one of these?"3

Theseexamplesareamusing,but I

fear that because they are all of a

type, they prejudice he jury.Elliott's

and Percy'scomments succeed, on

first reading, not because we value

every nstanceof alienation-any sort

of fish out of any sort of water-but

because of a culturalpreferencefor

the melancholic over the sanguine.

Consider the alienationor depressionof a hockeyplayer(a potentialfuture

Rotarian) rooming with poets; we

may not want him to resistintegra-tion. Or consider the sort of movie,common in recent years, where a

straight-lacedman is thrown into the

company of a wild woman and her

friends; he audience'shope is that he

will overcome rather han sustainhis

alienation from the kooky subcul-

ture.

In Listening o Prozac,I addresseda similar issue-alienation from

what?-in regard o mourning ritu-

als. Those who consider the Ameri-

can grieving period too brief and

thereforealienating to the sensitive

have pointed with admiration to

ruralGreece, where widows mourn

predeceasinghusbandsfor five years.But enforcedmourning is restrictive

for resilient widows; they are the

alienatedin a traditionalculture. If

alienationmeans a sense of incom-

patibilitywith the environment, hen

peopleof differing emperamentswill

be alienated n differentsettings.Do

we honor both the sensitive and the

resilient? s it permissible or resilient

Greekwomen to move to a societywith shortergrievingperiods?More

to the point, if the sensitivemove toruralGreece,will the consequent oss

of alienationrob them of an aspectof

theirhumanity?This sortof example

might convince us that it is not per-sonal or cultural alienation that we

value, but the melancholictempera-ment or aspectsof it, such as loyaltyand sensitivity-and thatwe honor a

sufferern anysetting,evenone from

which she is not personallyor cultur-

allyalienated.

Effectively,Elliott conflates per-sonal andculturalalienation.The no-

tion of culturalalienation s invisiblybuttressedby what I might call the

WoodyAlleneffect.The prominently

onelTrillingandEdmundWilson de-

batedthe point-they are essappeal-

ing than the wounded Dionysianva-

riety.4The clusterof personality raits

arising from the melancholic tem-

perament (pessimism,perfectionism,

sensitivity,and the rest) overlapsso

stronglywith our imageof the intel-

lectual that we may have difficultycrediting hinkerswho aredifferentlyconstituted.The pervasivenessf this

valuation came home to me in the

courseof my writingan essayabout

the psychologistCarlRogers;Rogersmet all the criteria or intellectualitysave one, pessimism, and on that

grounds was dismissed as a light-

weight.5Thus concern over personal or

culturalalienationcomes to seem the

valuation of one sort of normalper-son (the melancholic) over another

(the sanguine). And just how far

would a moralistgo in thispreferencefor alienation?Are those 25 percent

The nature of the technology may cause us to reassess

the category, and the significance, of the target.

neurotictoday are often politicallib-

erals,andthis correlationhas more or

lessheld since the Romanticera.Soft

left, hardright.But even if this con-

junction is real and has an explana-tion (andwhat sort of explanationdo

we have in mind?), it is hardlyuni-

versal. A sanguine person may be

alarmedby apartheid, ustasa melan-

cholicmight attributehis disaffection

to the ending of apartheid. f Prozac

inducesconformity, t is to an ideal ofassertiveness; ut assertivenessan be

in the serviceof social reform of the

sort ordinarily understood as non-

conformityor rebellion.The politicaleffects of medicatingthe disaffected

will be various.

Politics aside, we may find we

have an aestheticpreference or neu-

rosis. The melancholictemperamentis the artistictemperament.Even if

hearty Apollonian artists exist-Li-

of humans who lack the purported

"WoodyAllen gene" morallydefec-

tive? If so, we might logicallyfavora

medicationthat makesthem more ill

at ease.It seems less a matter of mis-

trustingpharmacology han of valu-

ing melancholy.

* * *

I lliott's hirdcategory s existential

alienation-"questioning the

very terms on which a life is built,"an unease such as one might suffer

even on a desert sland, or, as Robert

Coles might put it, underany moon.Here we seem to be getting to the

heart of the matter, alienation that

hasnothingto do with distance rom

a particularocialsurround.

We could perhaps obviate this

considerationby arguingthat if exis-

tential alienationis neitherpersonal

HASTINGS CENTER REPORT 15arch-April000



nor cultural, it should be part of

being human, for all people in all

times. If normal ife is a project, hen

change qualifies as cosmetic onlywhen life remainsa project.Even for

"goodresponders"o medication,ex-

istence remains hedged round bydeath, chance, unfairness,and absur-

dity.But empirically, we know that

angst grabsdifferentpeopledifferent-

ly. Some people are more constantlyawareof the universal xis-

tential condition. But what

is it to be aware in this ':1.

sense? Even existential

alienation might be inter- . :i;twined with temperament. - 4Elliott leans toward that *-1`:

recognition when he 'L;"

writes, "Alienationof any -T"type might go togetherwith depression,of course,but I suspect that the two

'-..

don'tnecessarily o handin

hand."Butthat is the ques-tion at issue: o what extent

is affect,such as anxietyor

depression,constitutive of

existential alienation? To

put the matter differenty: j

If, medicated, one retains

an intellectual unease butwith diminishedemotional

discomfort, does being in

that state constitute exis-

tential alienation?

Imagine one of Walker

Percy's amously alienated

characters,aya commuter. AlbrechtHe might feel bad for two Philadelph

reasons,becauselife is im-

perfectand becausehe is predisposedto feel worse than others do in re-

sponseto that imperfection.If he ex-periences relief via medication, he

mightcome to understandwhich was

which, his dysthymia versus the

alienationcommon to all humans.As

a diagnostician,medicationis imper-fect, but neither s it simplydismissi-

ble. On a quest for authenticity,we

must be open to discoveriesof this

sort-that what seemedcarefullyde-

velopedself wasarbitrary, iologicallybasedidiosyncrasy.

Elliott resists his sort of reframingwhen he asserts hat "there s no dif-

ference between the commuter who

feels bad without knowing why and

the same commuterreadinga copyof

DSM-IV."6But that is becauseElliott

mistrusts the manual. Finding his

condition delineatedthere,the com-

muter might decide he had formerlymade a category mistake, just as,

finding himself in a Walker Percynovel, a diagnoseddepressivemight

tDurer,Melancolia,1514

ia Museumof Art:The LisaNorrisElkinsFund

draw a concusion in the reversedi-

rection. I once treated a dysthymic

patientwhose formerpsychiatrist adcommanded her to "Put away your

Sylvia Plath!" Whether poetry or

medication (or manual-reading)s a

better means to self-discovery s in

partan empiricalquestion;a combi-

nationmight proveoptimal.Another thought experiment:

Imaginewe have definedpossibleele-

ments of existential alienation:

spleen, anomie, angst, accedia,verti-

go, malaise,emptiness,and the like.

Now we givea medication ordepres-sion and find thatsome factorsdisap-

pearand othersremain,so that a hy-

potheticalsubject s no longer vertig-inous but remainsanomic. Wouldwe

have defined "core"alienation?Dis-

sected the existential?Well, perhapsnot. Not if alienation's onnection to

minor depression is especially inti-mate. The problem of melancholic

temperamentcannot be made to dis-

appear,not even by our framingthe

conundrum in terms of re-

spect for existential alien-

ation. Elliott'sworry is pre-

ciselythatif amedicationre-

li5:, places pessimismwith opti-mism, anxietywith assertive-

ness,diffidencewith gregari-ousness, it will have robbed

us of a tendencyto remainata critical distance from our

own existence. The affective

stance is what is of value,

worryingthe same old bone,as Percy puts it; not mere

awareness of distance but

anxietyoverit.

I have come to believe

that much of the discussion

of cosmetic psychopharma-cology is not about pharma-

cology at all-that is to say,not about the technology.Rather, "cosmetic pharma-cology" s a stand-infor wor-

ries over threats to melan-

choly. That psychotherapycaused lessworry may speakto our lack of confidencein

its efficacy.We do, asa culture,value

melancholy.Some months ago, I at-

tendedan exhibition of the paintings

of "the young Picasso."Seeing theearlycanvases,I thought, "Here is a

marvelous technician." I turned a

corner to confront the works of the

Blue Period,Picasso'sresponse o the

suicide of his friend Carlos Casage-mas. InstantlyI thought (as I believe

the curator intended): "How pro-found." That pairing-melan-

cholic/deep-is a centraltropeof the

culture. Or to allude to another re-

cent museum exhibition, for years




the rap on PierreBonnardwas that

his paintingswere too cheerful to be

important.Here is the corresponding

trope:happy/superficial.

Surelythe centraltenet of literarycriticism s Kafka's: Ithinkwe oughtto readonly the kind of books that

wound and stab us. ... [W]e need

the books thataffect us like a disaster,thatgrieveus deeply, ike the deathof

someone we loved more than our-

selves, ikebeingbanished nto forests

far from every one, like a suicide."7

This need may even be pragmatic. n

his poetry (I am thinking of "Ter-

ence, this is stupid stuff"), A. E.

Housman arguesthat painful litera-

tureimmunizesus against he painof

life'sdisappointments.And here I want to lay down two

linkedchallenges hatare ntentional-

ly provocative.The firstis to say that

the literary aesthetic makes most

sense in relationto a particular em-

perament(the melancholic, n which

one feels great pain in response to

loss) in a particular ulture(one lack-

ing technologies o preventor dimin-

ish that pain). What if Mithradates

had an antidote, so that he did not

require prophylactic arsenic and

strychnine?Might poetry appropriateto the antidepressantrabe more like

beer-drinking?And might that new

art still proveauthenticto the way of

the world?

The second challengeis yet more

provocative,call it intentionallyhy-

perbolic:to say that thereis no neu-

tral venue for this debateover alien-

ation or cosmesis becauseour sensi-

bility has been largely formed bymelancholics.Much of philosophyis

written,and much art hasbeen creat-

ed, by melancholicsor the outright

depressed,as a response o their sub-

stantial vulnerabilities. To put the

matteronly slightly essprovocatively(and to returnto the firstchallenge),much of philosophy s directedat de-

pressionas a threateningelement of

the humancondition.

As MarthaNussbaum'sThe Thera-

py of Desire demonstratesin detail,classicalmoralphilosophyis a means

for coping with extremes of affect

that follow upon loss.8The ancient

Greeks' recommendations for the

good life, in the writingsof the Cyn-ics and Stoics and Epicureansand

Aristotelians, amount to ways to

bufferthe vicissitudesof attachment.

If losswere lesspainful,the good life

might be characterizedot by atarax-

ia but by gusto. The connection be-tween philosophy and melancholycontinuesin the medievalwritingson

akadie and then in the Enlighten-ment, through Montaigne, and

throughPascalwho writes"Man s so

unhappy that he would be bored

even if he had no cause for boredom,

by the very nature of his tempera-ment."9In a study of Kierkegaard,Harvie Ferguson writes, "Modern

philosophy,particularlyn Descartes,

Kant, and Hegel, presupposedas a

permanentcondition the melancholy

between melancholyand sanguinity,thenwe will need to worryaboutthe

association between creativity and

mood. What if there is a consistent

bias in the intellectualassessmentof

the good life or the wise perspectiveon life, an inherentbias againstsan-

guinityhidden(andapparent)n phi-

losophyand art?An argumentof this sort is worri-

some-more worrisome han the co-

nundrum we began with. And yetcanwe in good faithignorethe ques-tion of who sets the values?I have

been in effectproposingstill another

thought experiment: maginea med-

ication that diminishesthe extremes

of emotionalresponse o loss, impart-

ing the resiliencealreadyenjoyedbythose with an even, sunny disposi-

tion. What would be the central

philosophical questions in a culture

The concern over alienation is the valuation of the

melancholic over the sanguine. It seems less a matter

of mistrusting pharmacology than of

valuing melancholy.

of modern life."?1Even those like

Kierkegaardwho chide melancholics

do so from such a decided melan-

cholic position that theirwriting re-

inforces the notion that melancholyis profundity.It is Kierkegaardwho

inspires Walker Percy, Kierkegaardwhose body of work implies that

melancholy s appropriateo moder-

nity.As for literature,studies indicate

that an astonishingpercentage,per-

hapsa vastmajority, f seriouswriters

are depressives. Researchers have

speculatedon the cause of that con-

nection-does depressionput one in

touch with important ssues,of dete-

rioration and loss? But no one has

askedwhat it means for us as a cul-

tureor even as a speciesthat our un-

acknowledged egislatorssufferfrom

mood disorders,or somethinglike. If

there s no inherentmoral distinction

where the use of this medication is

widespread?Aesthetic values do change in the

light of changingviewsof healthand

illness.Elsewhere,I have askedwhywe are no longercharmedby suicidal

melancholics-Goethe's Wertheror

Chateaubriand'sRene or Chekov's

Ivanov.Becausewe see majordepres-sion andaffectivelydrivenpersonalitydisorders as medically pathologic,what once exemplified authenticitynow looks like immaturity or ill-

ness-as if the romantic writers had

madea categoryerror.

A finalthoughtexperiment: mag-ine that the association between

melancholy and literary talent is

based on a random commonalityof

cause:the genes for both cluster,say,side by side on a chromosome. And

let us further imagine a culture in

which melancholy,now clearlysepa-

HASTINGS CENTER REPORT 17March-April000



rate from creativity, s treatedphar-

macologicallyon a routine basis. In

this culture, it is the melancholics

manques who write, melancholics

renderedsanguine-so that the re-

ceivednotions of beautyand intima-

cy and nobility of character elate to

bravado, decisiveness, and connec-

tions to social groups, not in themannerof falsecheerleading,but au-

thentically, from the creative well-

springsof the optimistic.What would be the notion of au-

thenticity under such conditions?

Perhaps in such a culture "strongevaluation" would find psychic re-

silience superiorto alienation. Even

today, many a melancholic looks at

Panurgeor Tom Joneswith admira-

tion-how marvelous to face the

world with appetite!The notion of asanguineculture horrifies hose of us

resonantwith an aestheticsof melan-

choly, but morally, s such a culture

inferior,assuming ts art correspondsto the psychicreality? s therea prin-

cipledbasisforlinkingmelancholy o

authenticity? s therea moral hierar-

chy of temperaments?

* * *

haveoffered nextreme ersion fan argument that might be more

palatable in subtler form. I hope I

have been convincing, or at least

troubling, n one regard, he assertion

that there is no privileged place to

stand, no way to get outside the

problem of authenticity as regards

temperament.Elliott askswhetherwe do not lose

sight of something essential about

ourselveswhen we see alienationand

guiltassymptomsto be treatedrather

than as clues to our condition as

human beings.The answer s in part

empirical, n part contingent (on thesocial conditionsof humanlife, a cul-

ture's technological resources, and

such), and altogetheraesthetic.If ex-

tremes of alienation are shown to

arisefrom neuropathology, nd if as-

pects of that pathology respond to

treatment,our notion of the essential

will change.And it may be thatwhat

remains of the experience and the

conceptof alienationwill be yet more

morally admirable-alienation

stripped of compulsion, alienationindependent of genetic happen-stance,alienation hat arises romfree

choice.

I want to end by sayingthat, like

Percyand Elliott, in my privateaes-

thetic, I value depressionand alien-

ation, see them as posturesthat have

saliencefor the culture and inherent

beauty.But the role of philosophyis

to question preferences.The case for

and againstalienationseemsto me at

this moment wide open. It has be-come easy,in the light of the debate

over Prozac,to imaginematerialcir-

cumstances hatmightcauseus to re-

assesswhich aspectsof alienationfall

into which category.The challengeof

Prozac is precisely that it puts in

questionour tastesand values.

References

1. P.D. Kramer, isteningoProzacNewYork:VikingPress,1993).

2. C. Elliott,"TheTyrannyof Happi-ness:Ethicsand CosmeticPsychophama-cology,"nEnhancing umanTraits: thicaland Social Implications,ed. E. Parens

(Washington,D.C.: GeorgetownUniversi-

ty Press,1998),pp. 177-88,at 183.

3. W Percy,Lost in the Cosmos NewYork:WashingtonSquarePress,1983), p.79, quoted in C. Elliott,"Prozac nd theExistentialNovel: TwoTherapies,"n TheLastPhysician:WalkerPercy nd the Moral

LifeofMedicine,d. C. ElliottandJ. Lantos

(Durham, N.C.: Duke UniversityPress,1999),p. 65.

4. E. Wilson, "Philocheles: he Woundand the Bow," n E. Wilson, The Woundand the Bow: Seven Studies n Literature

(Cambridge,Mass.:Riverside ress,1941),

pp.272-95;L.Trilling, heLiberalImagina-tion:Essays n Literaturend Society NewYork:Viking,1950),pp. 160-80.

5. P.D. Kramer,ntroduction o OnBe-

cominga Person,by C. Rogers (Boston:

HoughtonMifflin,1995).

6. See ref.2, Elliott,"Tyrannyf Happi-ness,"p. 183.

7. E Kafka, etterto OskarPolluck,27

January 904.

8. M. Nussbaum,TheTherapyfDesire:

Theoryand Practice n HellenisticEthics

(Princeton: Princeton University Press,1994).

9. B. Pascal,quoted in H. Ferguson,

Melancholynd the Critique f Modernity:Soren Kierkegaard's eligious Psychology(London:Routledge,1995),p. 25.

10. See ref.7, Ferguson,MelancholyndtheCritique f Modernity, . 32.

11. See ref. 1, Kramer,Listeningto

Prozac,p. 297, and P D. Kramer, StageView:What IvanovNeedsIsanAntidepres-sant,"NewYork imes, 1 December1997.


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