In psychodynamic theory, depression is understood as a complex dynamic between the intrapersonal and interpersonal ‘experience of Loss’. Even the symptom-based nosology, the DSM, acknowledges the potential connection between loss and depression when depressive symptoms ‘are not better accounted for by bereavement’. While first experienced interpersonally, loss is finally felt and repeated intrapersonally. Freud writes that ‘An object-choice, an attachment of the libido to a particular person, had at one time existed; then, owing to a real slight or disappointment coming from this loved person, the object-relation ship was shattered’ (1917, pp. 248–249; emphases added). While Freud argued that many things may contribute to the two possibilities, mourning or melancholia, the loss of a loved object is common to both. And much of psychodynamic ‘theory’ sees depression as self-directed anger.
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