Meetings of the New York Psychoanalytic Society

DISCUSSION: Dr. Rudolph Loewenstein spoke of the possibility of guilt feelings in childhood before the development of the superego. Similarities between the child's guilt feelings and later guilt feelings are sufficient so that one 'cannot define them away'. Dr. Loewenstein noted that the child has partially identified with the punishing person even before the completion of superego formation. If

guilt is an essential element in every depression, why are severe guilt feelings so often seen with no depression? Dr. Loewenstein feels that the character of the object relations may be an essential factor, conferring variety to depressive illnesses.

Dr. Manuel Furer raised the question of the narcissistic elements in depression. In his experience it has not been possible to separate guilt from moral failure as a narcissistic mortification. The classical triad of melancholia in the adult—profound, painful dejection, psychomotor retardation, and self-reproach—is never found in childhood even after the period assigned to superego formation. Dr. Furer noted two factors of development and maturation which are relevant to the differences between childhood symptoms and later depressions: the continuing need of the child for an actual love object and his ability to tolerate greater distortion of reality in the service of defense. He doubted the wisdom of limiting the use of the term 'depression' to only those symptoms involving the superego in a manner implying complete internalization.

Dr. Edith Jacobson agreed that it is desirable to distinguish among the affective states, but she believes that there are depressive states in which there is no superego conflict. She has used the term 'mood condition' to refer to depression in which the 'whole self and correspondingly the world is changed' and to distinguish this from superego conflicts to specific impulses which arouse guilt feelings but do not lead to 'mood condition'.

In response, Dr. Beres emphasized that the supere