The Roots of the Psychodynamic Theory of Unipolar Depression

Americans today are becoming more aware of depression, its symptoms, and its impact on both the sufferer and those around them. However, what seems to still be misunderstood is why. Why does depression affect so many people each year? As an answer to this, psychology, most commonly turns to several different viewpoints: the psychodynamic, cognitive, and the behavioral. The first of these has deep rooted beginnings with the famed Sigmund Freud.

The psychodynamic model was first developed by Freud and Karl Abraham, his student early in the twentieth century. This early psychodynamic model calls upon the similarities between depression and the grief experienced by those who lose a loved one (Comer, 2005). Of the similarities cited are "constant weeping, loss of appetite, difficulty sleeping, loss of pleasure in life, and general withdrawal" (Comer, 2005). It is also noted that mourners regress to the initial stage in Freud's developmental stages, the oral stage. Regression to the oral stage allows the mourner to regain the lost loved one symbolically through merging their identity with that of the lost person. Eventually, this leads to closure and the ability to move on. However, individuals that do not come to a resolution through this oral stage regression develop depression through worsening grief and inability to cope.

According to Freud and Abraham, individuals most likely to become clinically depressed are those whose needs were under met, or excessively met, during the first 18 months of their life (the oral stage). Bemporad (1992) notes that these individuals often spend their lives searching for love and approval, which can in turn impact greater loss on the individual when an individual passes on.

Taking this information, Freud and Abraham formulated a theory appropriate for those who had not experienced the loss of a loved one, but exhibited signs and symptoms of depression nevertheless. For this, the concept of imagined loss was used. Imagined loss is a concept in which a person unconsciously interprets life events with a severe loss, such as the loss of a loved one. Under this theory, a simple failure may be equated with a severe loss, such as the loss of the love of a parent or the loss of a friend. Circumstances are made more severe and impact the individual more since they are interpreted as more severe losses. This in turn causes depression among these individuals as they are unable to cope with their circumstances, and are unable to distinguish between the imagined circumstances and the actual circumstances.

While this humble beginnings are no longer held as fact by psychodynamic theorists, it still influences the current theories. In fact, psychotherapists continue to use the relationships between parents and their children; losses in childhood; and the excessive meeting or, lack of meeting, childhood needs in their explanations of depression. However, imagined loss is a concept that cannot be tested due to its unconscious and intangible nature. As such, empirical evidence is lacking. This does not, however, stop current psychodynamic theories from being one of the most popular theories to turn to when dealing with unipolar depression.

Bemporad, J. R. (1992). Psychoanalytically orientated psychotherapy. New York, Guilford Press.

Comer, R. J. (2005). Fundamentals of Abnormal Psychology, 4^th Edition. New York, New York. Worth Publishers.