Doctor Feelgood | History | Smithsonian

Doctor Feelgood

Stricken by "vile melancholy," the 18th-century critic and raconteur Samuel Johnson pioneered a modern therapy

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Mel Gibson did it. Brooke Shields too. So did Uma Thurman, Ben Stiller and Carrie Fisher. They and dozens of other celebrities have all come forward, in books or on TV, to discuss their struggles with alcoholism, or drug addiction, or postpartum depression, or other long dark nights of the soul. Quite possibly, misery has never loved company more than in American pop culture right now. So strong is our preference for redemptive narratives of adversity overcome that after James Frey's purported memoir A Million Little Pieces was revealed to contain a pack of fabrications, it returned to the New York Times nonfiction bestseller list for an encore appearance.

Samuel Johnson was no Mel Gibson, but his biography includes the makings of a modern celebrity sobfest: birth into poverty; a host of ailments, both physical and psychological; and, of course, the burdens of fame. In his time (1709-84), Dr. Johnson was a renowned critic, biographer, moral philosopher and creator of A Dictionary of the English Language. He was also known to be a bit strange. But in his moments of crisis, he issued no statements through his publicist (or his protégé and future biographer, James Boswell), and he declined to retreat into solitude; instead, he fashioned his own recovery, in ways that anticipate popular currents in contemporary psychology.

Johnson went on to write about happiness and melancholy, joining a larger Enlightenment dialogue on those topics among such luminaries as Voltaire, Diderot, Rousseau and Jeremy Bentham. (Like our own time, the 18th century was preoccupied with the idea of happiness.) His writings don't provide the drama of, say, addiction-induced kleptomania, but they do offer a refreshing contrast to the current template for melodramatized suffering and contentment. With diligent effort and keen insight into the workings of the mind, Johnson simply figured out how to work around his afflictions and make himself happy.

He started out with the odds against him. "I was born almost dead and could not cry for some time," he recalled late in life. In infancy, scrofulous lymph nodes were found in his neck and attributed to the tuberculosis of his wet nurse. He was transported to Queen Anne's presence in the belief, common at the time, that the royal touch could cure "the King's Evil," as scrofula was called. All his life he had poor vision and hearing. Bizarre tics, odd vocalizations ("too too too," he muttered when excited) and wild gestures rendered his appearance, one observer said, "little better than that of an idiot."

But Johnson was a precocious lad. He read prodigiously, mastered Latin ("My master whipt me very well," he told Boswell) and was so helpful to his fellow students that they carried him to school in gratitude. Neurologists now believe that Johnson's convulsions and odd behavior were symptoms of Tourette's syndrome, a disorder first identified in 1885 by George Gilles de la Tourette. Johnson's contemporaries left vivid accounts of its effects on him: "His vast body is in constant agitation, see-sawing backwards and forwards, his feet never a moment quiet; and his whole great person looked often as if it were going to roll itself, quite voluntarily, from his chair to the floor," wrote Fanny Burney, the English diarist and novelist. Frances Reynolds, sister of the painter Sir Joshua Reynolds, recorded the curious method by which Johnson led a blind member of his household through a doorway: "On entering Sir Joshua's house with poor Mrs. Williams...he would quit her hand, or else whirl her about on the steps as he whirled and twisted about to perform his gesticulations; and as soon as he had finished, he would give a sudden spring, and make such an extensive stride over the threshold, as if he was trying for a wager to see how far he could stride."

As if his oddness were not enough, Johnson inherited from his father, Michael Johnson, what he called a "vile melancholy," which, he confided to Boswell, made him "mad all his life." Johnson's first major depressive episode occurred at age 20 while he was on vacation from Oxford, where he was an impoverished but extremely well-read student. Johnson, Boswell wrote, "felt himself overwhelmed with an horrible hypochondria, with perpetual irritation, fretfulness, and impatience; and with a dejection, gloom and despair, which made existence misery."

But even in this early period, Johnson exhibited a genius for self-analysis. He wrote up his own case in Latin and gave it to his physician and godfather, Dr. Samuel Swinfen. The doctor was "so much struck with the extraordinary acuteness, research, and eloquence of this paper," writes Boswell, "that in his zeal for his godson he shewed it to several people." Naturally, Johnson was furious.

The gloom lifted, and it may be just as well that Johnson didn't seek further medical help after the gross violation of doctor-patient confidentiality. The preferred treatments for melancholy in his time were purges, emetics, bleedings and physical punishment.

Johnson prepared to manage his own case, a contemporary noted, by studying medicine "diligently in all its branches," giving "particular attention to the diseases of the imagination." His greatest fear was that he might lose his reason, for it was his powerful intellect that allowed him to keep a grip on sanity. "To have the management of the mind is a great art," he told Boswell, "and it may be attained in a considerable degree by experience and habitual exercise." Johnson would have agreed wholeheartedly with the sentiment of the Greek philosopher Epictetus, who wrote: "People are not disturbed by things, but by the view they take of them." This is the idea at the heart of cognitive-behavioral therapy, a pragmatic, short-term form of psychotherapy now widely used to treat a host of psychological problems.

Cognitive-behavior therapists believe that emotional disturbances are caused by "distortions in thinking," erroneous beliefs or interpretations that can trigger anxiety, depression or anger. Take a patient who tells himself: "I got a parking ticket; nothing turns out well for me." Cognitive-behavior therapists refer to this as "catastrophic thinking." It is the therapist's task to help the patient replace such distortions with more realistic interpretations, as in, "It's too bad I got a ticket, but it's a small matter in the scheme of things."

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