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Our psychoanalytic knowledge of depression goes back to the investigations of Freud (9) and particularly Karl Abraham. (1) Their findings have remained valid with regard to the instinctual functions involved, but today we see the problem more from the point of view of the adaptive functions of the ego and of object relations. This presentation is limited to the dynamics of the depressive character, which is the matrix of any depressive illness and therefore basic for our understanding of depression.
The depressive character is immensely frequent, at least in Western civilization. There is general agreement that a depressive state of mind in later life is a continuation or a reproduction of a primal depression in childhood. In my experience, every one of these patients had an unhappy childhood. He was—or at least had reason to feel—unloved or rejected or mistreated. Unhappy events, such as disruptions of the family, may have had traumatic effects. In other cases the child was unable to fulfill the expectations which the family held for him and was confronted with critical and punitive attitudes which hampered the development of his self-esteem. (6) Some parents cannot love their children because they are depressives themselves. For this information we need not rely on childhood histories alone; it is amply verified by men and women who in their analyses reveal their often unconscious hostilities against their children.
Frustrations and traumatizations in childhood, which may weaken the child's survival potential, are so numerous that the great frequency of depressive conditions seems to be fully explained. However, such childhood situations cause the disposition to depression only if they coincide with a particular constitutional factor.
The depressive patient had, or still has, a great need for gratification by way of mouth and body surface. His oral and skin erotisms are constitutionally stronger and more demanding than average. The infant is absolutely dependent on h