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Granted essential agreement as to the dynamic, structural, and economic significance of depressive illness, Zetzel raises the question as to whether adult maladaptation can occur without important infantile prototypes. The life cycle may be considered from birth to death as a developmental sequence with specific critical periods. Psychic development does not have to be viewed as completed with latency or even with maturity. Environmental stresses are seen as causative factors in mental illness, especially those pertaining to the later crises of life. Whereas Abraham regarded depressive illness primarily as the result of instinctual regression to a level of pregenital fantasy and conflict, today the trend is to focus primarily on the regressive modifications of both ego and superego which facilitate the emergence of archaic states. These modifications may be induced by present maladaptation as well as by past.
Nacht and Recamier discuss the genesis and dynamics of depressive illnesses. The sense of loss of love is the fundamental depressive situation. The broken bond, once experienced as part of the primary relationship to the mother, is required by the depressive personality in order to be both very close and exclusively loved. Feeling constantly threatened by the massive irruption of his own aggressions, the depressive character needs the love of the object to maintain the equilibrium between love and hate which tend in him to defuse easily. He is unable to effect a true identification to replace the lost object since the need for love of the real object is too great. He does attempt an unneutralized introjection wherein the hatred can be discharged against a self which is now subject and object. The authors classify the clinical varieties of states of depression according to the degree of distintegration of the love relationship and according to the degree of internalization of object relations. They agree with the Kleinians that the fixation point of d