On Maternal Symbiotic Depression1

The symbiotic relationship between mother and child serves a useful purpose in the development of the child and plays a dominant role in the biological and psychological maturational development of the mother. A pathological prolongation into the adulthood of the child may lead to anxieties, phobic reactions, hypochondriasis depression and involutional melancholia in either the mother or child, or both. Paranoid characterology—jealousy, rages, terror, fear, etc.—is frequently present in the clinical picture.

The cutting of the psychic umbilical cord that ties the mother to the child concerns both members of this union. The child attempts to break this tie while the mother wishes to preserve it. Fenichel's (4) assumption that the equivalent of the primary depressions can be observed during the first year of life was clinically reported by Spitz (17). This early evidence of the effects of the separation (2) of child from the mother was “related to a loss of the love object, combined with a total inhibition of attempts at restitution through the help of the body ego acting on anaclitic lines”, and Spitz called this an anaclitic depression.

Pappenheim and Sweeney (11) in reporting the treatment of the separation anxiety in a 4-year-old child and his mother revealed the constant interreaction of aggression and counter aggression of hostility and yet inability to let go of each other. Finally the development of the separation anxiety showed clearly the communication between the mother's and the child's unconscious. Many of these unconscious needs and fears of the mother perpetuate the child's dependency needs with resultant identifications that continue on in successive generations to a point where the symptoms evolved from this relationship produce severe psychopathological disorders requiring special psychiatric attention as described in the clinical material.

Often the basis of complaints in agitated and depressed mothers seen in general psychiatric practice is obscure. C