Essential Depression

Early in his work, a patient described how he organised his life in such a way as to “smooth everything out”, to reduce to a minimum all perceptual, sensorial or motor excitation because it caused him chronic and uncontrollable pain (fibromyalgia). This was why he had lowered the ring tone on his phone and was using earplugs (boules Quiès). Rather than playing on the polysemy of the word he employed by repeating “Qui est-ce?”, the analyst chose to make an intervention that opened out onto affect and resituated the object: “When the telephone rings,” she said, “we can ask ourselves who is calling before answering. We are in a state of waiting or apprehension…”. The patient replied: “Ah, yes, I hadn't thought of that… Perhaps I am afraid that it will be my business partner; I am finding it difficult to break off relations with him.” “Breaking off all contact, so as not to suffer”, the analyst commented.

Hanna, the heroine of The Secret Life of Words, a 2005 film by Isabel Coixet, has become absent from her own existence. Taciturn and withdrawn, day after day she goes from the factory to her home where she repeats the same gestures unfailingly, like an automaton, in a mechanical and disembodied way.

This is a remarkable illustration of the typical “operational” (opératoire) mode of functioning of a patient affected by essential depression. For Hanna, the libidinal decathexis, both object- and narcissistic-related, affects both external objects and internal objects, and even the ego itself. This is the fundamental characteristic of essential depression, associated with a lowering of vital tonus. This extinction of psychic life is underpinned by the destructive drives and constitutes a survival mode of functioning.

When her boss suggests that she should take a holiday, go and rest somewhere in the sun, his words seem to reach Hanna emptied of their meaning and their capacity to arouse ideas or images in her. The words are reduced to their perceptual, phonetic dimension, as