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What is depression and how does psychoanalysis account for it?

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Introduction

WHAT IS DEPRESSION AND HOW DOES PSYCHOANALYSIS ACCOUNT FOR IT? Depression, or 'the depressive position', in psychoanalysis was first proposed by Melanie Klein. Klein observed young children and noted how they experienced acute anxieties. Following these observations Klein proposed a theory of the paranoid-schizoid and depressive positions encountered by children during development. The two positions, although each is a model for all paranoid and all depressive behaviour throughout life, are seen as stages through which children progress even though there can also be regression from the depressive to the paranoid-schizoid position. The relationship between the two positions is a continuous and dynamic one likened by Bion (1963) to a chemical equilibrium. The depressive position is also a psychoanalytical model for adult functioning for a range of states from everyday grief to clinical depression. We will now consider the psychoanalytical basis of this position as accounted by Klein. In order to understand the depressive position a little must also be said about the preceding paranoid-schizoid position as they have been said to exist in a state of equilibrium (Steiner, 1992). The paranoid-schizoid position describes a state of paranoia in which the child is a constant spiral of aggression and fear. Having not been able or not had the opportunity to establish a 'good internal object' (a sense of have a source of support inside oneself brought about having been supported in such a way) ...read more.

Middle

The anxiety produced by the fear of hurting the mother he loves causes the child to feel true concern for her. Secondly, loss is also felt due to losing the concept of ideal objects. A child growing up must come to realise that there is no such thing as an ideal object which will provide unlimited satisfaction and this realisation can be especially painful. The conflict produced by being disappointed in the mother for being imperfect and the concern about hurting or losing her causes the mixture of feelings which Klein described as depressive anxiety. This depressive anxiety is similar to the grief suffered by bereavement and is in essence a state of mourning (Klein, 1940). Klein believed that the child begins to move from the paranoid-schizoid and into the depressive state at around 3 to 6 months of age. Klein believed that this depressive state was normal and that the depression experienced was appropriate when reacting to the loss of a loved object. As mentioned previously, Klein stated that the position could be used as a psychoanalytic model to describe all the various periods of depression in adult life as well. Adult depression can range from everyday grief for the loss of an object - which could be a valued idea as well as a person - to clinical depression, this will be considered later. The child's progression into this position marks a more mature level of functioning and Klein suggested that this depressive state is an inevitable part of the human condition (Klein, 1935; 1940). ...read more.

Conclusion

However, when reality intrudes into the world of manic defence with the knowledge that the damage was not fixed and the object was in fact held dear, the individual crashes down into depression. The psychiatric state of manic-depression occurs when the person resorts to mania as a long-term strategy and becomes caught in the cycle between mania and depression as these two states are always in equilibrium. In summary, Klein extended the work of Freud when she placed emphasis on the acute anxieties that children experienced and created her theories about the paranoid-schizoid and the depressive positions. The depressive position occurs later developmentally and also provides a psychoanalytic model for normal adult functioning. In the depressive state the individual has internalised a good object from which they can draw support and they have also realised their ambivalence towards objects. The primary anxiety is for the welfare of the internal good object when in the depressive position. However, the depressive position is repeatedly lost and in need of re-establishing (Temperley, 2001). When it is lost the person regresses to the more primitive paranoid-schizoid state and the fluctuations between these states can take place over months or years. There is no state beyond that of the depressive position and hence to be truly adult requires an ability to live in the depressive position and to be able to handle the grief and sadness which are inevitable when loved objects are lost. ...read more.

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