Psychoanalysis and depression

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Psychoanalysis and Depression

Explains what depression is and how it is approached by psychoanalysis

The word "depression" must be associated with states such as discouragement, despair etc. Depression involves all these states and is characterized by total or partial loss of interest in real life (in the case of serious depression, we can speak of a symbolic death of the world).

Depression is usually associated with mourning. Mourning is the consequence of a loss of someone or something highly valued. A loss may be that of a dear parent who died. But we do not lose tragically only close relatives, we can lose freedom, self-esteem, life aspirations, religious beliefs and many other abstract things that have a major affective value for our psychic life. All these losses developed depressing feelings.

Dr. A. Stevens, following his experiences at an abandoned children center, was able to draw a pertinent pattern of behavior specific to depression (1) in three phases:

Refusal to Lose . The individual rejects the reality of the loss and revolts against any certainty or perception that proves the loss. At this level we find the spontaneous attempts to conceal the loss, which, for example, appear in dreams. Somebody lost a dear parent, but dreams he/she is alive and talks with him/her. At this level we can also find melancholy - the neurotic melancholy - which is also a form of resistance to loss, through the intense fantasy activity that accompanies it. A doctor was abandoned by his girlfriend and he lived for a long time melancholic states consisting in dear memories related to his loved one.

Acceptance of loss. This stage is imposed by the logic of life events. There is not something admitted willingly, following a conscious loss analysis. At this level interest in the outside world is diminished to the maximum. The individual retires emotionally from the current life, indifferent, absent, living somehow as luck would have it.

Indifference to loss. In the last phase of depression, when it is about to vanish itself, the individual becomes even indifferent to the object of his depression. Its memory no longer awakens in him. The affected person regains his desire for life and returns to his current activities that were not contaminated by depression.

This phase we all live after separating from a person that we once loved. We meet him/her after a long time and we do not notice him/her anymore. The beloved one becomes for us a foreigner. If we are aware of this, we are surprised by our total indifference to the one who has once represented so much for us!

In general, depression can not be treated by psychoanalysis. Taking into account that its acute forms bring a withdrawal from the outside world (2) of the affected person, it is unlikely to cure it.

However, in the case of mild depression, in which there is still emotional transfer, we use the free associations and especially the dream analysis . The next steps are to assess the context of the occurrence of depression - an important social or intimate event - and to integrate this event as a constituent part of the mental and social reality of the depressed person. However, it must be established whether depression is not in fact an innate inclination to introversion. We often mistook the missing of person's interest for outside world, his/her attraction to reflection or meditation (which may be personal constitutional features of someone) for depression.

Notes:
1. I followed this schema only as guidance and I completed it with elements of my own experience in the field.

2. Withdrawal from the outside world is a state we find in schizophrenia. It can be accompanied by an extremely lively fantasy activity - which is the symbolic expression of the unconscious life of the individual - or, on the contrary, by a total mental void (as in autism).

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Paper by J Jones

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