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Silencing the Self Across Cultures (Oxford University Press, 2010) is a cross-cultural study of depression. Alisha Ali, an associate professor in Steinhardt’s Department of Applied Psychology, co-edited the volume with Dana C. Jack, a professor at Western Washington University, who created the Silencing the Self Scale as a way to gain insight into the psychosocial factors behind women’s depression.

Your book is a collection of studies of women and men in 13 different countries using the Silencing the Self Scale to understand depression and related issues. Can you give an overview of this theory?

Dana Jack: The theory of silencing the self, offers a new way to think about depression, one that is based in relationships and in the specific conditions of peoples’ lives. Through listening to depressed women, I found that their self-silencing — not voicing their feelings, opinions or anger in order to avoid conflict or loss of relationship –led to their experience of “loss of self” and depression. So this theory does not understand depression as located in a deficit or problem within a separate individual; rather, research using the Silencing the Self scale and theory has found that self-silencing is rooted in relationships and cultures that tell women and men the ways to make and maintain intimacy. Self-silencing promotes isolation, affects relationships negatively, and correlates with depression.

I presented this theory in my 1991 book, Silencing the Self: Women and Depression. This initial research proved to be successful in identifying the problems associated with self-silencing, and the theory and research instrument, the Silencing the Self Scale, began to be used in a number of countries across the globe. Researchers were interested to see how varying societal pressures and rules might influence women — and men — to self-silence, and how the repercussions of self-silencing might change depending on cultural differences and dynamics.

What are the similarities and differences related to self-silencing and depression that the researchers found in different social and cultural contexts?

Dana Jack: It’s most interesting to us that in all studies so far, women’s self-silencing has correlated with depression, even in countries that are vastly different from each other. We think that this is because — as the World Health Organization has stated — “No country treats its women as well as it treats its men.” Women have to solve the puzzle of how to create intimacy within unequal relationships, and this actually occurs worldwide. The “feminine attachment behaviors” such as pleasing, compliance, self-sacrifice, and self-silencing have evolved as ways to solve the puzzle, but these behaviors can lead to mental and physical health problems in women, including depression.

What have you learned about gender and self-silencing from your studies? Do you think there are differences between how women and men experience depression?

Dana Jack: From studies conducted by various researchers, we’ve learned that men’s self-silencing is also harmful to them, though in ways that differ from women. No one benefits, or flourishes, from silencing the self because it leads to isolation. Men’s self-silencing is not always associated with depression; the findings regarding the consequences of their self-silencing are more complex than those of women’s. There are a number of chapters in the book that deal with gender, depression, and self-silencing, and we also are continuing to investigate this important issue.

Alisha Ali: We believe that further investigation of the ways in which women and men self-silence will help us not only to learn more about the factors associated with depression, but to more deeply understand the notion of gender as a learned, socially-prescribed construct.

How can Silencing the Self theory help us in treating depression and the other related consequences of self-silencing?

Dana Jack: Interventions that directly deal with the mental mind maps that lead people to silence — what they fear in sharing feelings and pursuing their dreams, for what purposes they are self-silencing, and the consequences of silencing — can be helpful. There are chapters in this book that deal with how important it is to directly address women’s self-silencing in treatment, not only for depression, but also for cancer, HIV/AIDS, eating disorders, and heart disease.

What are some the questions and surprises you found when you were putting the book together?

Alisha Ali: Some of the most intriguing themes that we see in this book concern the idea of depression not as an individual mental illness, but rather as a consequence of human rights violations. Around the globe, there are social conditions and forms of violence that serve to silence women’s voices and to compromise women’s sense of self. The question of how to counteract these forces is not primarily a psychological question, but rather a political and social one. We’re hoping that people who read this book – researchers, clinicians, and people who have experienced depression – will begin to consider the importance of addressing social problems such as inequality, discrimination, and various forms of oppression as a means of confronting the widespread problem of depression.

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