Depressed Patients and the Coniunctio

There are six particular people—patients—whose lives and therapies are at the empirical core of this paper. What they have in common is that their mothers were each of them seriously depressed during their son's or daughter's infancy and childhood. The other thing they have in common is that they had their analytical therapy with the particular analyst that I am, and that over the years I have had a growing interest in trying to find out more about what it is that enables someone effectively to emerge from long-term depressions. I would like to isolate one particular factor from those, often explored and discussed, concerning the nature, the manifestations and the treatment of depression. I am thinking of a factor whose absence could be a great disadvantage, but whose presence can enable a patient to become, in the course of therapy and time, less depressed, less frequently so, and less paralysingly; such a factor might also help the person to be less aggressive towards others and facilitate the development of a truly viable sense of self.

Depression as a form of feeling ill, and as a clinical syndrome or illness, has been known for thousands of years and described from the earliest days onwards both by sufferers and by their doctors. A precise or short definition cannot be offered here, particularly as I am not a psychiatrist and because all authorities agree that there is a wide spectrum of symptoms and indications. At one end of that spectrum, depression is a natural reaction to painful emotional experiences, to bereavement and loneliness, to physical ill-health or the approach of death—all features of the human condition. At the extreme melancholic or pathological end of the spectrum the mood change is extreme and persistent. If more of us had time to read (rather than occasionally dip into) Robert Burton's The Anatomy of Melancholy, first published in 1621, as well as to study modern psychiatric textbooks, we would appreciate even more wide