Reflections on Aspects of Depression
24th September, 20100 Comments
In this paper I shall explore aspects of depression which I feel are important, such as ambivalence, hopelessness, masochism, hostility and addictive relationships, and explain some of the dynamics behind these. I shall try and show how these feelings and their defences develop from childhood.
Freud realised that unconscious, ambivalent feelings towards the object, which complicate the relationship with it “is a precondition for melancholia”. (Freud, 1917:251) We have unconscious struggles due to our ambivalent feelings because of traumatic experiences in connection with the object, but these remain in “the region of the memory traces of things”. (Freud, 1917:256) The object can thus be kept good.
Bibring touches on the concept of ambivalence when he talks about ‘depersonalisation’ which develops in place of an outburst of anger. This is a defence mechanism against overwhelming tensions within the ego, (Bibring, 1953:28) presumably because of ambivalent feelings towards the object, which cannot be expressed.
Fairbairn develops Freud’s ideas of ambivalence: the child internalises his bad objects because he wants to control them and needs them “for if they neglect him, his need for them is increased.” (Fairbairn, 1943:67) This is a chilling statement in terms of the development of ambivalence because of a strong fixation to the bad object in the small child. While the object is present, the internalised bad object is modified by its better qualities, but once the object is lost, the person is then left to the mercy of the internalised bad object; if he cannot embrace the healthy mourning process, he is then left objectless. (Fairbairn, 1943:70)
An ambivalent relationship with an object can be caused by the object’s own depression, silent hostility or withdrawal, “brutally transforming a living object, which was a source of vitality for the child, into a distant figure, toneless, practically inanimate.” (Green, 1986:142) This may cause a premature disillusionment, a loss of love and meaning. “The infant has the cruel experience of his dependence on the variations of the mother’s moods.” (Green, 1986:153) These memory traces remain in abeyance within the subject and “the child’s ambivalence is structured by the fear of the loss of the object” or the loss of its love. (Armstrong-Perlman, 1991:348)
Hopelessness and Helplessness
Freud touches on this theme when he writes about the fact that in depression, the subject finds it difficult to consciously perceive what he has lost, which presumably induces a nebulous feeling of defeat and low self-esteem. “In mourning it is the world which has become poor and empty; in melancholia it is the ego itself.” (Freud, 1917:246)
Bibring defines depression as “the emotional expression of a state of hopelessness and powerlessness of the ego” (Bibring, 1953:24), which leads to a “collapse of self-esteem of the ego.” (Bibring, 1953:26) In the oral stage, frustration can lead to a feeling of helplessness, in the anal stage, feelings of powerlessness and fear of punishment may be added which can lead to a sense of guilt, remorse and too much/lack of control over aggressive impulses. In the phallic stage the fear of being defeated, ridiculed and humiliated could be incurred. “…such traumatic experiences occur in early childhood and establish a fixation of the ego to the state of helplessness.” (Bibring, 1953:39) “A predisposition to depression may be created in early childhood due to a lowering of self-esteem because of weakness, defeat, lack of attention or respect.” (Bibring, 1953:42)
Against the shamefulness of these experiences, defences are erected. In terms of the child and his bad objects, “It is obviously preferable to be conditionally good than to be conditionally bad…it is preferable to be conditionally bad than unconditionally bad.” (Fairbairn, 1943:66) This is the defence of guilt, or the moral defence. The child attempts to repair the bad object, the ‘dead mother’ (Green, 1986) and feels “the measure of his impotence after having felt the loss of the mother’s love and the threat of the loss of the mother herself.” (Green, 1986:150) This leads to a general feeling of impotence “to love, to make the most of one’s talents” (Green, 1986:148). This can cause the feeling of emptiness, so characteristic of depression.
Hostility and Masochism
As these patients have learnt to be acutely perceptive and adaptive to the needs of others, they are not in touch with their own anger. This leads to unconscious hostility and possibly masochism. Patients treat themselves as objects, directing against themselves “the hostility which relates to an object.” (Freud, 1917:252) “The patients usually succeed…in taking revenge on the original object and tormenting their loved one through their illness, having resorted to it in order to avoid the need to express their hostility to him openly.” (Freud, 1917:251) This, I think, can be the self-righteousness of the moral defence: “The ego may enjoy in this the satisfaction of knowing itself as the better of the two, as superior to the object.” (Freud, 1917:257)
Fairbairn explains that the child, who experiences a relationship with a bad object as intolerably shameful, prefers to become bad himself, to make his objects good, “he is really taking upon himself the burden of badness which appears to reside in his objects.” (Fairbairn, 1943:65) This means that the child establishes some outer security at the cost of inner confidence, the ego being left at the mercy of internal persecutors. Defences are erected, such as repression, the bad objects are banished to the unconscious, the good objects become the superego, which causes the ego to feel inadequate and guilty, leading to the moral defence: “…it is better to be a sinner in a world ruled by God than to live in a world ruled by the Devil.” (Fairbairn, 1943:66) The child blames himself: “The subject attributes the responsibility to himself, his manner of being…it becomes forbidden for him to be.” (Green, 1986:151) The child would rather die than direct destructive hostility to the outside world, because of the fragility of the object.
Hostility and Addiction
Armstrong-Perlman writes about how the frustrating, shameful, humiliating and hated aspects of these addictive, perverse and masochistic relationships are denied. “The individual is fixated to a particular form of object choice.” (Armstrong-Perlman, 1991:346), i.e. an ambivalent object found to be both exciting and rejecting, like the original object, the mother with her “duality of aspects.” (Armstrong-Perlman, 1991:347)
This shows that when working with depressed patients it is important to get them to a stage where they can acknowledge the ambivalence towards the original object and therapist, so that the patient can begin to dissolve the cathexis to the exciting object and accept that their wish for the loving acceptance by the original object is hopeless. They need to feel that they can survive this trauma with sadness and mourn for that which they did not receive and that this no longer means that there is no hope for the self. As Fairbairn says, the appeal of the good object, the therapist, rather than the allure of the bad object, can promote the dissolution of the cathexis of the internalised bad object. (Faribairn, 1943:74) There will be anger and ambivalence towards the therapist, who will be consistent, but will also fail the patient. The patient hopefully replaces depression with some healthy aggression towards life.
ARMSTRONG-PERLMAN, E.M. (1991) The Allure of the Bad Object, Journal of the British Association of Psychotherapists, No 22
BIBRING, M. D. (1953) The Mechanism of Depression, in Affective Disorders (1953) ed. P. Greenacre N.Y. International University Press.
FAIRBAIRN, R. (1943) The Repression and Return of Bad Objects (with Special Reference to the ‘War Neuroses’), in Psycho-Analytic Studies of the Personality, Routledge.
FREUD, S. (1917) Mourning and Melancholia, Standard Edition Vol XIV, Hogarth Press.
GREEN, A. (1986) On Private Madness, Chapter 7, Karnac Books, 1986.
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