Unipolar depression
Grief and loss
The psychodynamic approach to understanding depression focuses on how unconscious
motives drive our behaviour and experience. The psychoanalytical explanations for
depression are based on grief, loss and inadequacy. How the child deals with and responds
to loss in childhood sets the pattern for how the child will deal with similar experiences as an adult in later life.
Grief as a result of loss in early childhood is usually followed by feelings of desertion and rejection. But the loss
need not be physical; it can also be symbolic e.g. withdrawal of affection, support or a rejection can induce
depression.
Because the child’s ego is highly self centered, the child interprets these irrational feelings as resulting from
something they have done, making them feel alone, abandoned and unlovable. Unable to express this anger and
rage at others for this loss, these feelings of anger are turned into the self resulting in self blame and self
punishment for the loss.
Loss
Freud called this the introjection hostility theory of depression. When loss happens in adulthood the person is
likely to regress or return to an early childhood stage of psychosexual development called the oral stage. If the
child is not able to come through the feelings of desertion and rejection as a child, then regression to this stage as
an adult means that the adult is not able to deal appropriately with grief and loss. The outcome is depression.
This then leads depressives to blame themselves when faced with difficulties.
While most people for a while feel depressed when they experience a serious loss in their life, they come through
and return to normal once the loss has been grieved. However some people maintain their depression after loss
and this is because they have regressed back to the high dependency of the oral stage.
Inadequacy
Another explanation is the feelings of inadequacy which result from failure to meet the standards and expectations
of parents in the first five years of life. If the child has overbearing, critical and authoritarian parents, it is likely that
whatever the child does it will never be enough to please the parent. In adulthood this may cause depression
because such a person will always be setting themselves standards they cannot achieve. Failure then leads to
depression and lack of motivation to even try any more.
Exam question
Briefly explain one reason from a psychodynamic perspective why an individual might develop depression
(6 marks).
Studies to support
Maier & Lachman (2000) supported the relationship between early loss experiences and later depression. They
surveyed 2998 adults aged 30-60 by questionnaire and telephone interview. They found that symptoms of
depression were more common in those whose had lost a parent in childhood by divorce or death. In addition selfacceptance was sharply lower in those who reported an early loss experience.
Evaluation
Swaffer & Hollin (2001) provides partial support for the link between anger and depression. They gave 100 young
offenders questionnaires to assess anger and health, Depression, along with general health, was associated with
levels of anger, those who suppressed their anger having a greater tendency for depression.
Evaluation
Klein et al (2002) identified a small number of personality traits that are commonly shown by people with
depression. ‘Dependency on others; belief that they must be perfect in all respects; low self esteem and an
inability to express anger openly, especially to those close to you’.
Therefore research has offered some support for the psychodynamic description of parents of people with
depression as cold, moralistic, demanding perfection and asking for total devotion.
Lack of an Attachment
Psychodynamic explanations of depression have led to the development of interpersonal theories of depression.
These are concerned with how people interact, seek for and maintain close and intimate relationships in their adult
lives. Such theories draw heavily on the attachment theory (Bowlby, 1951) with the basic claim that unsatisfactory
or poor attachments to parents in early childhood may lead to adult depression. This is because the person
attempts to seek approval from others to compensate for the feelings of rejection caused by poor childhood
attachments.
Bipolar depression
The psychodynamic explanations for mania in bipolar depression can be explained by how the three components
of personality (id, ego, and superego) interact with each other. During the depressive phase the superego
dominates the ego. Since the superego is made up of a persons ego-ideal and conscience, the result is that the
ego experiences extreme feelings of guilt and inadequacy resulting in depression. The ego tries to take control
away from the superego and in doing so overreacts and the individual enters the manic phase. The cycle is
repeated, with the superego and the ego alternately taking control.
Exam question
Briefly explain one reason from a psychodynamic perspective why an individual might develop depression
(4 marks).
Evaluations
It is difficult to establish good scientific evidence for the claims about the influence of early childhood experience.
However, Bowlby’s work on attachment and loss has enjoyed support and has been based on empirical
observations – his work with 44 juvenile thieves showed that those individuals who had made an attachment in the
critical period of their lives grew up to have affectionless psychopathy amongst other traits.
The early theories of Freud led to the development of an interpersonal theory of depression which resulted in an
effective treatment for depression – you will add to this by the end of lesson:
However, Freud’s theory is often characterised as UNSCIENTIFIC since it is difficult to observe, operationalise
and measure concepts such as actual and symbolic losses or regression. Yet, the mere fact that a theory is
difficult to test does not mean that it is not valid.
Also, Freud’s work has been criticised as he based his work on case studies and it is argued that it is difficult to
generalise from case studies especially those based on Jewish, middle-class neurotic women.
But this claim is now outdated. Focusing on clinical case studies where the mind goes wrong - may illustrate how
the mind works and this has been well illustrated in the case of memory and Clive Wearing for example. Cases of
severe depression may be a rich, insightful source of data, and yield hypotheses for testing.
Nevertheless, solely focusing on the unconscious mind may be deterministic suggesting that the unconscious
mind determines our actions and behaviour and permits little role for free will.
It may also be reductionist attempting to explain depression solely in terms of the unconscious mind. Perhaps we
are determined by our INSTINCTS (thanatos - a negative force, the death wish), and our EARLY CHILDHOOD
EXPERIENCES.
This represents a combination of nature and nurture and is a good example of a theory focusing on PROCESSES
and INTERACTION and how we CONSTRUCT our experiences. All our experiences are SOCIALLY
CONSTRUCTED.
Yet the focus on the unconscious mind provides a strong contrast to the COGNITIVE perspective.
Exam question
Describe and discuss the psychodynamic explanations for mood disorders. Refer to empirical reserach in
your answer. (12 marks)