Advanced Psychopathology

Sunday, February 26, 2006

 

Bowlby, McWilliams & Freud on Depression: Lucy's Reaction

Freud’s view of psychotic depression was that, like mourning, it was directly brought about by the loss of an object (either a real loss or a metaphorical loss such as disillusionment). The depressed subject deals with this object loss in a way that leaves her enervated, unable to love, unable to feel pleasure in living, and self-reproach. Psychotic depression is vastly different (as it is subjectively experienced) from mourning because the pain of the object loss is experienced as an ego deficiency. This is manifested the depressive’s guilt and self-hate, which is lacking in the mourner. Freud argues that psychotically depressive guilt and pain stems from the subject’s ambivalence towards the lost object turned inward against her own ego.

Bowlby supports Freud’s notion that mourning and depression/melancholia represent two branches of the same tree, one pathological and the other a normal process. Bowlby also endorses Freud’s idea that ambivalence characterizes the experience of the depressed subject to the lost object, but feels that anxiety produced by ambivalence is also part of the pain of mourning (which Freud did not). Bowlby criticizes Freud’s overemphasis on the narcissistic characteristics of depression, by saying that identification with the lost object is not the primary mechanism of defense, and that anger and rage actually play a much greater role than Freud allowed in this particular paper. In terms of etiology, Bowlby seems to feel that very early oral fixations/developmental failures are what set the stage for a psychotically depressed reaction to object loss. The most important difference between Freud’s and Bowlby’s etiological theories seems to me to be Freud’s emphasis on current experience of loss (real or subjective) and Bowlby’s emphasis on early childhood experience.

McWilliams integrates many aspects of both theories, while incorporating the factor of genetic predisposition into her model. Her model borrows Bowlby’s idea that object loss in childhood predisposes one to possible depression and extends his position, saying that all types of parenting styles, pathology and family restrictions on emotion -- particularly dysphoric affect -- can lead to depressive symptomatology later in life. McWilliams follows Freud’s rich description of the subjective experience of the depressed person, but doesn’t seem to retain his notion that psychotic depression is the direct consequence of adult object loss.

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