[Movie totally spoiled herein: don’t read if you have not yet seen it!]
Pixar’s “Inside Out” is so remarkable to my therapist’s eye because it really got the human mind right (which Linda McCabe’s article addresses), particularly in presenting a depiction and map of how depression happens, and what is depression’s cure. It was also quite moving to me personally, as someone with a long (and thankfully now resolved) history with depression, that the film presented it with such compassion and wisdom, and especially with such a credible and real understanding that there is indeed a way out.
As a therapist specializing in depression, I’ve pulled a lot of hair out over how the popular culture—not to mention sectors of my own field—looks at and maps depression. For the large part, both see depression as analogous to a fungal rash: surface deep, without essential meaning, without development or unfoldment, and best treated topically. I don’t quite know what it means that an utterly mainstream, ostensibly kid’s movie, has one of the best readings of depression that’s been presented in pop culture—but I guess you take it where you can get it.
Here’s what “Inside Out” gets so right: in essence, depression results from an obstruction in grieving, from experiencing the futility of holding onto what is gone, but not being able to let go.
Riley’s journey, then, is her discovery of the fact that Joy cannot exist robustly unless it is partnered with Sadness, because Sadness’ function and purpose is to register, speak to, and facilitate the release of the pain of, the experience of loss. In other words, sadness’ function is to grieve. Without grief, when exposed to the inevitable changes and losses of life, Joy is unequipped for the pain, and it’s depression that becomes the solution to the unremitting pain of the loss, of relationships as well as self..
Ok, but before getting further, let’s define grief. My personal definition is, “grief is the emotional process of letting go of that which is already gone.” Grief is not an emotion per se, but an emotional process that involves the different discrete emotions (anger, sadness) and emotional states (shock/denial, depression, acceptance).
Ideally, grief happens like this: A loss is briefly buffered by shock/denial, then moves into registration (“yes, there is a loss”), which opens access to the hurt (anger) and bereavement (sadness) necessary to move towards acceptance via a brief depression (marking the inevitability of that loss (“yes, what I was attached to is gone”). Through grief, we arrive at acceptance and reconciliation to reality, being a poignant softness in the face of the loss, in which we recognize fully that we have lost and survived. Then the energy that was attached to what was lost is returned to us, allowing for new and creative engagements with the present (as with Riley’s joining the hockey team at the film’s end).
The drama of “Inside Out” is in its portrayal of the obstruction of this process within Riley, the incomplete moving through of the registration, feeling, speaking, and clearing the pain of loss. The cause of the obstruction is twofold, being Riley’s own childhood naïve beliefs about the nature of joy (that it exists in exclusion of sadness), and her parents’ own misunderstanding of the need for grief (as when mom, in her own stress over the move cross-country, asks Riley to be a happy girl). Until the denouement, neither Riley nor her parents are particularly aware of grief as grief, or feel safe to engage it.
Riley’s loss of her known world, of childhood in Minnesota, with her love of hockey and close friends, doesn’t become apparent to her until she gets to San Francisco. She is used to being and identifying with Joy, and her inner life has been an unchallenged rule of Joy, who before the move was able to organize and keep in line her various other emotions. That was the status quo neither she nor her parents knew was the status quo.
But the shock of her dislocation, once it becomes apparent (her breaking down in her new school), initiates the inevitable grieving process, but without her or her family being able to validate and feel the sadness (she struggles to keep the joyful memories from being “contaminated” by sadness). We see how this unintegrated sadness makes her personality structure (the “personality islands” made of core memories) weak and vulnerable to collapse, which they do one by one through the film.
The results of the failure to grieve is Riley’s slide into depression, because again, depression is a protective mechanism that buffers us against the unrelieved pain of loss. In others’ hands, the story could have been either a dark tragedy, or a story of heroic repression of sadness. But the brilliant and true insight of the film is that when we grow, unavoidably being exposed to more complex life and more complex pain, the earlier structures of self really do die; those “personality islands” as they had existed, fused to memories of Minnesota, are actually and truly “already gone”. (Bing Bong, remember, does not just get to retire to a cozy place at the back of Riley’s mental house. He actually, permanently, dies.) But without acceptance of these deaths, and therefore reclaiming the essences of each island to be reformed out of the reality of her new home, she is left with more and more of nothing. Her core self becomes progressively filled with void; the absence of meaning and identity threatens to become her new self.
When we don’t understand what is happening when we experience a loss (having false maps of the inner world, particularly a false conception of grief as a process, and the right relation of joy and sadness), and when there’s not enough understanding and holding from our environment (her parents’ distraction and stress that make them unavailable and unsupportive of Riley), we cannot tolerate the pain of the loss. We become overwhelmed, see nothing but destruction, then avoid the grieving process, and therefore cannot rebuild our world in the present tense. We are left with an expanding void, a destruction of what was, without a building of what can be. Riley keeps trying to restore the old, limited model of Joy, but Joy is no longer in control (it gets sucked out of the control room), and can only return when accompanied by Sadness. Which means the child’s version of Joy, in its relative dis-integration with the other emotions, is truly gone, and will never come back.
Depression could well have locked in as Riley’s new identity if Bing Bong’s sacrifice (he’s the symbol of the self-referential, pre-personal child’s world) hadn’t allowed Joy and Sadness to escape the bleak, decaying realm of the Memory Dump. But as this happens, and Joy+Sadness return to the control room, Riley realizes (on the verge of literally and metaphorically abandoning the company of family) that there is hope, that there are relationships still available to her, and then returns home to parents who love and hold and contain her, allowing her to grieve.
In terms of what heals depression, this last point is huge. Rarely is the inability to grieve only internal; we need an environment, and most importantly, our relationships, to be able and willing to be with us and hold us through the grieving process. We need to be able to “come apart” in order to “come back together” if we are to move through grief and not get stuck in depression. We can’t do that on our own, because as in the film, under the shock of loss, our various parts become dis-integrated. We need a space (which the embrace of mom and dad represents…and c’mon, you cried then, right?) that provides that integration from the outside. Not until then can we grieve, let go, reform, and reintegrate ourselves on the inside.
There is a tremendous amount to say about depression—its nature, etiology, phenomenology, and course of healing—which makes the achievement of “Inside Out” so amazing and heartening to a therapist like me. I talked recently to a friend with two young children, and we reflected on what the world will be like when such accurate, research-based, and wise maps of inner reality are there from the beginning for his kids, becoming the accepted touchstones of understanding our and others’ experience. Maps profoundly matter, and for upcoming humans to have good ones just makes my therapist heart fill with Joy.