The Problem of Melancholia1

The insight which psycho-analysis has gained into the clinical picture of melancholia is the result of the investigations of Freud and Abraham. Abraham was the first to turn his attention to this subject. As early as 1911 he asserted [1]2 that melancholia represents a reaction (comparable to that of grief) to the loss of love (the object). Some years later Freud, having in the interval begun his researches into the nature of narcissism, took the decisive step which led to the analytical elucidation of the subject of melancholia [2]. He recognized that in melancholia the object which has been renounced is set up again within the ego and that thus in his self-reproaches the patient is continuing his aggressive tendencies against that object. The first conditioning factor in this process he showed to be the regression from an object-relation to a narcissistic substitute for it and, next, the predominance of ambivalence, which replaces love by hate and oral incorporation. In a later work [3] Freud supplemented this hypothesis by the observation that the cruelty of the super-ego in melancholia results from the defusion of instincts which accompanies the act of identification. In 1923 Abraham published a second and comprehensive work on melancholia [4]. By a number of excellent individual observations he was able to confirm Freud's conclusions in all points and he added several important clinical discoveries. He emphasized the melancholiac's incapacity for love—an incapacity springing from his ambivalence—indicated the large part played in the mental productions of such patients by cannibalistic and oral instinctual impulses and revealed in the history of their childhood a primal depression' from which they had suffered at the height of their Oedipus development as a reaction to the double disappointment of their love for mother and father.

We now understand the mechanism of melancholia in so far as Freud has dissected it into its separate parts and Abraham has tr