Loss and Internalisation

A previous paper (Pedder, 1982) reviewed psychoanalytic concepts of depression, starting with Freud's classic paper Mourning and Melancholia, then Kleinian views of the depressive position and Winnicott's re-naming of this concept as the stage of concern. Also considered from a psychoanalytic viewpoint was the work of Brown and Harris (1978) on the social origins of depression and particular attention was given both to their finding that loss of mother before the age of eleven predisposes women to depression and to the links between this phenomenon and the development of self esteem.

This paper is an attempt to look again at the essence of the ideas I was trying to bring together there and to focus on those that need further exploration.

Background

Although the concept of the depressive position has been a seminal one in psychoanalytic circles, it does not seem to have passed into the general body of psychiatric thinking in quite the same way as have, for example, the original psychoanalytic concepts of defence mechanisms.

In Segal's words (1964) ‘The depressive position has been defined by Melanie Klein as that phase of development in which the infant recognises a whole object and relates himself to this object’ (p.55). This central idea turns up again and again in different language: that a crucial stage occurs in infant development when other people are recognised as separate individuals. Recognising mother as a whole person, the source of good and bad experiences, heralds the depressive position and the realisation by the infant that his own destructive impulses may harm the object that he both loves and totally depends on.

Winnicott (1962), in writing of similar phenomena, chose to speak of the capacity for concern in order to emphasize the positive, rather than the negative, side of the same experiences, i.e. that the infant is beginning to care about and feel responsible for what happens to the object. He felt the term depressive position to be a bad n