A Current View of the Psychoanalytic Theory of Depression—With Notes on the Role of Identification, Orality, and Anxiety

BEFORE DISCUSSING THE SUBJECT OF DEPRESSION WE MUST BE CLEAR about the differences between sadness, grief, mourning, and depression. Sadness is the emotional response of the ego to suffering, brought on by an experience or fantasy of loss or deprivation (Jacobson, 1957). Grief or mourning, which I will use here synonymously, are special types of sadness caused by a specific form of loss, namely, the permanent loss of a love object in reality. However, experiences of loss do not always evoke sadness. They may also trigger rage and hostile responses. If that rage is turned on the self representation and then transformed to a mood state, we are dealing with a depression. The essential elements in a depression are the self-directed aggression and the mood state to which it leads.

Because depressions are mood disorders, a brief digression about the nature of moods seems appropriate. A mood is an ego state which colors all ego functions, substructures, and modes of discharge with a uniform quality. It comes about by the spreading of a focal affective discharge process over the entire ego, whether the spreading is caused by the high intensity of the stimulus, or a low capacity on the part of the ego to relieve tension by focalized discharge. This redistribution of