10/20/2011 08:34 am ET Updated Dec 20, 2011

Learning From Jerry West's Depression

As a psychiatrist I am on a constant quest to better understand (in hopes of better treating) those ailments of the mind that can cause what my late mentor, and suicide pioneer, Dr. Edwin Shneidman, referred to as "psychache" and by that meant, "general psychological and emotional pain that reaches intolerable intensity."

With former NBA star and General Manager and "Mr. Clutch," Jerry West coming forth in his about to be released book, "West by West: My Charmed, Tormented Life," and with his admission and full depiction regarding his battle with lifelong depression, a few more pieces have fallen into place.

Keys to West's depression were a scarily abusive father, lack of love in his childhood, death of a very "kind" brother and a lifelong tendency to go "dark" after defeats or losses in his career. Perhaps the most gutsy revelation in this book was West's view of his relationship with Lakers owner Jerry Buss and Coach Phil Jackson.  If you read between the lines it may be that West's feeling that he had worn out his welcome with Buss, who cared obsessively about winning and then his being ignored and dismissed by Jackson retraumatized him by landing him back in the perceived uncaring (where nobody stepped in to protect him from his father) and abusive environment he experienced as a child.

This brings to light how critical it is to our developing personalities when we hit an obstacle, a setback or defeat to be responded to over and over again by an "unconditional" comforting warmth (most often supplied by a non-narcissistic mother who would never be complicit with a husband's abuse of a child) and a "confident" and informed (dare I say, "coaching") reassurance (most often supplied by an optimistic, courageous, yet loving father).

When those are consistently the responses by the "caregiving surround," a term familiarized through  Self-Psychology to mean empathic based caring (or lack thereof as in "non caregiving surround") experienced by the developing, helpless infant they become internalized into a solid core which that person can always return to and buttress themselves up during times of let down, hurt , disappointment and physical and psychic injury.

When such caregiving is not present or worse is replaced by abuse or shaming, there is nothing to turn inward to help the psyche weather those downturns. Furthermore if instead of "paying forward" the pain and suffering others inflicted on you (because you don't want to hurt or anger them, which might have been the case with West and Buss and Jackson), when they are hurtful to you, you turn it inward and that is a recipe for a rapid descent into depression (you know, the old Freudian notion, "Anger turned inward" = depression).

In the midst of such experiences, one may at times turn to thoughts of suicide as relief for the pain. In fact, the suicidality as such an antidote to torment can be viewed as a loving and comforting way out of the pain.

In the middle and at the worst of such unattended and non-caregiving agony, one can experience despair. If you think of despair as des-pair, it is a feeling of being unpaired with hope (= hopelessness), help (= helplessness), worth (= worthlessness), meaning (= meaninglessness), usefulness (= uselessness), a point to it all (= pointlessness) in a world in which it seems that everyone else is paired with those feelings.

When felt collectively the despair can mount to a point that "pairing with death" as a relief becomes not only conceivable, but desirable. So knowing there is always that way out if it gets too bad can offer relief.

As one of my nearly continually suicidal clients (who thankfully never acted on it and is now living a life where they're glad to be alive) once told me: "If I didn't have my suicidality, I would have killed myself a long time ago."

From your interviews Jerry it appears that your torment has eased over the past years. For that, you, your fans and I are grateful, because for the life you have lived, you deserve to finally begin to feel it was a life worth living.

Sometimes, when you are in your mind, you're in enemy territory and what you think of yourself is not to be believed. Not easy to do when you are in a state of des-pair.

Thank you for writing your book, Jerry West. It will help many people feel less alone and may, in fact, cause you, with your words, to become the loving father to them that you never had.