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Where damage to the self is rooted in very early developmental levels, prolonged depression often functions as a vain attempt to enhance fragile self-esteem. This may be especially marked in cases where the subject must deal with loss (e.g., the death of a parent). The subject's aggravated sense of guilt and responsibility can then act as signs of his capacity to love. It is an attempt to reassure himself that his love is not entirely deficient.* The fact that he feels so guilty is witness to his love. Mourning remains impossible since the subject must devote himself to shoring up self-esteem by proving his goodness in face of relentless self-attacks. His depression is taken by him as evidence of his sincerity.
To a significant extent depressive affect in mourning blocks assumes a binding or containing function. Through depression the subject tries to fill “holes” in his self-feeling. Depression often has an absorbant or cushioning quality that makes the subject feel more whole in a self-mothering way. However, since it functions as a substitute for genuine psychic work, gaps in psychic structure inevitably make themselves felt. At those moments depressive feelings may take on a stinging or abrasive force. In fact these two states (absorbant-stinging) are frequently mixed or oscillating.
The depressive person who becomes engaged in therapy undergoes a prolonged, if often muted, shock. His attempts to bend and reduce therapy to his depressive affect ultimately fail. He must begin by degrees to accommodate himself to the structure of the therapy situation or leave. If, however, a proper mixture of support and objectivity has been maintained, the patient will persevere in hope of being understood. In face of the patient's growing identification with the structure of the therapy situation, his depressive orientation gradually loses meaning.