Trauma, Depression, And Mourning1

DISCUSSION IN PSYCHOANALYSIS has once more turned to trauma, as we reconsider that it does, indeed, have a pivotal etiologic role in psychopathology. This has begun to bring fresh perspectives to the field. Depression is often listed as one of the prominent symptoms in posttraumatic clinical syndromes. I want to consider here the effect depression has on the crucial process of remembering and of recovery in traumatic states, and some of the ways it contributes negatively to an already difficult mourning process. I would like to propose a model wherein depression is at times part of the dissociative effort of the adult self to contain an unbearable traumatic experience.

It is noteworthy that in the literature concerning depression and loss the concept of trauma appears relatively infrequently, and yet, to be sure, at no point in the history of humankind has there been a shortage of traumatic experience of the most vile kind. The definition of trauma that I wish to use is one in which trauma is experienced as the narcissistic injury par excellence, namely, as one that shatters the self, and by self I mean the ability to form a coherent sense of who one is and of the world one lives in (Ulman & Brothers, 1988).

To assess fully the impact of interpersonal trauma—the insidious abuse suffered at the hands of others—one needs to expand the concept of narcissistic beyond the classical model of orality, giving the other a larger role throughout individual development and self-maintenance, as it is implied, for instance, in the Sullivanian notion of consensual validation by the other, or in the Kohutian concept of affirmative selfobject function. Trauma, then, can also be defined as the frightening experience of the destruction of all self-nurturing, functional resources supplied by self or others and the environment.

Since depression has for some time been thought of as connected with