melancholia cont ..

Depressed patients appeared to Freud realistic in what they described as lack of interest and incapacity to love and achieve; he writes that they ‘must surely be right in some way…’ (p. 246). Furthermore, he found it interesting that patients seemed in tune with reality in describing themselves as petty, egoistic, dishonest and deceitful towards self and other. Freud suggests that they appeared honest in acknowledging their dishonesty, having a ‘keener eye for the truth’. He also points out that the emphasis should not be whether the depressive expressions should agree with opinions of others, stating his concerns when scientists contradict self-accusing patients. Such attitudes are still predominant in cognitive/behavioural and medical paradigms of depression treatment, opposed to other therapeutic and analytical approaches that would attempt to understand depressive self-reproaches rather than treat them. Freud touches upon contemporary issues; what might be the impact of rejection and contradiction of one’s melancholic reality, by experts or others in general?

In keeping with Freud’s ideas, Coyne (1985: 323) suggested that one’s depressive “distortions” and “misperceptions” might not only be congruent with one’s reality but also ‘with the social system in which the depressed person now finds himself.’ The above suggestions are in contrast to Beck’s (1967) approach to depression, according to which cognitive distortions dominate the information processing of the melancholic so that experiences are rigidly interpreted to maintain existing schema of personal deficiency, self-blame, and negative expectations. Other theorists like McPartland & Hornstra (1964) also argued that disorder of thought and perception are neither defining criteria nor widespread among melancholics.

Freud opens to the potential that there are disturbing but real and meaningful elements of one’s experience of depression, which can be understood as possibilities of increasing personal awareness. The unconscious experience of object-loss in melancholia (Freud, 1917), if brought into conscious light, might unfold important personal dimensions. However the rigidity and intensity involved may escalate to suffocating and destructive experiences with self-deceptiveness and manipulations (Coyne, 1985). Moreover, Jacobson (1954) argues that depressive complaints are usually more justified than they initially appear. According to her, melancholics often make others feel guilty and depressed, which provokes their defensive aggression and even malice, precisely when the depressed one is vulnerable and needy; highlighting interpersonal depressive patterns.

From an intra-psychic viewpoint, Klein’s (1935) distinction between ‘positive’ and ‘negative’ depressive elements, during one’s development, appears relevant here. The infant’s ‘depressive position’ is an essential maturational process towards accepting inevitable separations from mother. This position is understood as a step forward from narcissistic depression in the ‘paranoid-schizoid position’ with profound split senses of what is ‘good’ and ‘bad’ and intense aggression and fears of either merging with or loosing one’s self from mother, or significant others in later life.

Freud also suggests that one’s self criticisms and hostility often appear to relate less to the depressed one and more to a significant other, whom the melancholic loves, once loved or should love. This is a central formulation for Freud: The self-reproaches are shifted back from a loved object following complex intra-psychic dynamics. The process of melancholia would be initiated then by a real or imagined loss, with distressing and rejecting elements. He goes on to suggest that in natural mourning this would include a painful withdrawal of libidinal investment and a final displacement of it onto a new object.

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