Project on Depression, cont..

  Psychoanalytical theories:

Early influences on psychoanalysis can be traced back to the philosopher Spinoza (1632-1677) who wrote that physical processes are experienced psychologically as emotions, thoughts and desires. Spinoza saw psychological processes having the same roots to physical events and as a consequence he rejected the idea that man possessed an absolutely free will. In implication this was the beginning of the psychodynamic approach (Zax & Cowen, 1976). Spinoza argued that self-preservation is the reason behind all psychic processes retaining consciously only the experiences that positively enhance power and survival. This notion led the way to Freud’s idea of ‘repression’ (Ziboorg et al, 1949). Freud (1917) put forward repression as a main psychic function in melancholia.

With his influential paper on ‘mourning and melancholia’ Freud moves implicitly from his topographical to the structural model, which describes a more relational internal world between man’s instinctual forces (id), rational mind (ego) and symbolic internalisations of the father figure and cultural regulation, which forms man’s conscience (super ego) (Smith, 1999). Freud (1917) saw depression resulting mainly from a conflict between one’s ego and one’s superego. Strachey (1955) also notes that what Freud regards as the most important aspect of his paper was ‘its account of the process by which in melancholia an object-cathexis is replaced by identification’ (p. 242). Later in The Ego and the Id, Freud (1923b) argues that these regressive identifications are not restricted in depression but form one’s personality, with the earliest ones been derived by the dissolution of the Oedipus complex and forming the core of one’s super-ego. The following psychoanalytical review of depression is divided into intrapsychic and interpersonal theories.

Intrapsychic psychoanalytical theories

Freud (1917) express his doubts about grouping aspects of depression in a unity, pointing also out that his observations ‘suggest somatic rather than psychogenic affections’ (p. 243). He puts forward that both depression and mourning involve a gloomy mood with similar symptoms, however what is lost when one mourns is clearer; as Freud argues: ‘mourning is regularly the reaction to a loss of a loved person, or to a loss of some abstraction…such as one’s country, liberty, an ideal, and so on’ (ibid: 243). While both involve a dejected mood with a loss of interest in living and loving and an inhibition of activity, what seem to distinguish melancholia from mourning according to Freud (1917), is one’s ‘disturbance of self-regard’ involving a profound loss of self-value and respect which expresses itself in shameless self-rejection and self-hostility.

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, suggesting that they appeared honest in acknowledging their dishonesty, having a ‘keener eye for the truth’. Freud also pointed out 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 intrapsychic 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. In keeping with Freud and the idea of loss, Alice Miller (1979) put forward the following:

‘What is described as depression, and experienced as emptiness, futility, fear of impoverishment and loneliness, is frequently recognizable as the tragedy of loss of the self, or alienation from the self, which is seen regularly in our generation and society (p. 61).