A Self-Loathing Voice & Depression

The End of the Tour shows that a self-loathing voice can’t be allowed to take center stage. It makes you believe other people are thinking terrible thoughts about you too. You keep your distance. It’s a lonely place to be. David Foster Wallace’s short story, The Depressed Person, shows he knew that struggle well. So does director James Ponsoldt’s film about David Lipsky’s road trip with him in, The End Of The Tour.

I left the theater incredibly sad, after witnessing David Foster Wallace’s (Jason Segel) a steady stream of self-denigrating apologies. I know from my work as a psychoanalyst it doesn’t have to be that way. Self-loathing is what every depressed person must work out in therapy.

I can’t begin to talk about one man’s complex emotional life. But, I can speak with years of experience about the ravages of unrelenting depression, terrible self-doubt, and constant apologies. There’s serious confusion in a depressed person’s mind about what to believe: self-loathing or something good.

A Self-Loathing Voice:  Real Or Not?

For a depressed person, this is a million-dollar question. It’s worse when it’s not a question at all. When the self-loathing voice has you convinced it’s the voice of reality. Jason Segel as David Foster Wallace, in The End Of The Tour, captures this exceptionally well in the film’s portrayal of David Lipsky’s (Jesse Eisenberg) interview:

“You’re welcome to stick around and write about my dogs, might be more interesting. I don’t even know if I like you yet, and I’m worried about whether you like me. If this piece would be about you, it’d be so much better. You’re a good-looking guy. We should have them photograph you and say it’s me – maybe I’d finally get laid. I spent years writing great literary stuff I couldn’t get published. If something sells really well it’s got to be shit. If I’m alone in a room, I can sound smart. I really can’t keep up with you.”

Feeling this way means, way too often, that as soon as you have a good thought or a good experience, the judging, self-loathing voice tells you not to trust it. David Foster Wallace and David Lipsky had great conversations and bonded during their road trip celebrating the acclaim for Infinite Jest. What did David Foster Wallace say about those really good things in his life? “It’s not real.”

Good experiences are terrifying if you don’t believe they can last. This makes that internal judge hovers over you all the time taking those experiences away first – looking, watching, and waiting to pounce with its infinite warnings. David Foster Wallace called that kind of self-consciousness toxic. He was right.

Toxic Self-Consciousness in The End of the Tour

Wallace’s story, The Depressed Person, gives us an excruciating window into toxic self-consciousness:

‘She almost always visualized the friend’s face, on the telephone, assuming a combined expression of boredom and pity and repulsion and abstract guilt, and almost always imagined she (i.e. the depressed person) could detect, in the friend’s increasingly long silences and/or tedious repetitions of encouraging clichés, the boredom and frustration people always feel when someone is clinging to them and being a burden.”

There couldn’t be a better example of how the self-loathing voice makes a depressed person feel, not to mention believe other people feel too. David Foster Wallace must have felt what he wrote with such vivid accuracy. Being constantly watchful for imagined judgments makes no one a safe bet. He couldn’t trust anyone to care about how he feels.

In therapy, the real feelings must be uncovered. That’s the only way to get that self-loathing voice out of the driver’s seat.

How Does Therapy Help Severe Depression?

Therapy with a depressed person will fail if the therapist stays emotionally distant or keeps the therapy on an intellectual level. The depressed woman, in The Depressed Person, says it well:

“If the therapist really wanted … the actual “gut” level truth … what was really unfair was that she (the depressed person) felt able … to share only painful circumstances and historical insights about her depression and its etiology … instead of feeling truly able to communicate and articulate and express … how the depression really felt … to someone who could … actually feel it with her.”

If therapy is limited to intellectual understanding or historical insights, it misses the boat of what is most important: feelings – very real feelings of sadness, loss, anger, rejection, jealousy, deprivation, and sometimes guilt. Understanding and insight are important. But, without taking seriously the real feelings attached – it’s nothing.

An empathic therapist will help you openly express the real feelings hidden inside. This is the only thing that will release you from a constant barrage of self-demeaning apologies. When you know without a doubt that the self-loathing voice is not the voice of truth, you’ll be able to hold onto good experiences, believe in them, and believe in all that’s good in you.

Tragically, it doesn’t seem David Foster Wallace could do that. Although many loved him and saw him clearly, he became in his own mind what the self-loathing voice made him fear.

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Dr. Sandra E. Cohen

I’m Dr. Sandra Cohen, a psychologist and psychoanalyst in private practice in Beverly Hills, CA. I work with creatives in therapy, story/character development, and entertainment consulting. If you are a writer, actor, or director and want help with a character – or a chance to do some of your own personal work - call at 310.273.4827 or email me at to schedule a confidential discussion to explore working together.