On the Dark Side of Chronic Depression: Psychoanalytic, Social-cultural and Research Approaches

195 Pages·2022·6.536 MB·English

by  Marianne Leuzinger-Bohleber, Gilles Ambresin, Tamara Fischmann, Mark Solms

“This is a long-awaited book integrating psychoanalytic insights into chronic severe
depression with progress that has been made in psychoanalytic and sociocultural
research. It is an excellent and unique contribution which all clinicians will benefit
from.”
Peter Fonagy, Head of the Division of Psychology and Language Sciences at UCL;
Chief Executive of the Anna Freud National Centre for Children and Families,
London; Consultant to the Child and Family Programme at the Menninger
Department of Psychiatry and Behavioural Sciences at Baylor College of
Medicine; and holds visiting professorships at Yale and Harvard
Medical Schools
“As the prevalence of depression grows, the need for better treatments is heightened. This
volume provides an in-depth exploration of the psychodynamic and socio-cultural
mechanisms of depression including new research on the role of early childhood trauma. I
recommend this book to anyone who wishes to expand their understanding of depression
beyond conventional approaches.”
Richard D. Lane, MD, PhD, Professor of Psychiatry, Psychology and
Neuroscience, The University of Arizona, USA
“Reading this book is an inspiring experience. A fresh approach is presented to the
nature of chronic depression using modern interdisciplinary language. The book entails
a promise of important new understanding of why the suffering of people with long­
term depression has been so difficult to change. Highly recommendable.”
Johannes Lehtonen, Professor of Psychiatry Emeritus, University of Eastern
Finland; Adjunct Professor of Clinical Neurophysiology, University of
Turku, Finland; Member of The Finnish Psychoanalytical Society
“A book for readers who sense the value of an in-depth integrated understanding of
depression: how it is essential if an injured individual is to grow emotionally; and as well
for all of us as creatures, each with our natures, histories, nationalities and cultures in the
approaching global crisis of our species.”
Dr David Taylor, Training & Supervising Analyst of the Institute of
Psychoanalysis, London; Clinical Director of the Tavistock Adult
Depression Study (TADS); Visiting Professor at UCL; and a
trustee of the Melanie Klein Trust
“This book admirably shows why depression needs a psychoanalytic approach that goes
beyond the symptoms and addresses the suffering human beings, their bodies and minds,
their history and traumas, and their family and social life.”
Ricardo Bernardi, Professor Emeritus at the School Medicine, Uruguay; “Honorary
Member” (“Miembro de Honor”) and Training Analyst of the Uruguayan Psycho­
analytical Association (APU) and of the Uruguayan Society of Psychiatry; Full
Member of the National Academy of Medicine, Uruguay; IPA Extraordinarily
Meritorious Service to Psychoanalysis Award (2021); Mary S. Sigourney
Award for Major Contribution to Psychoanalysis (1999); International
Journal of Psychoanalysis (IJP) Best Paper Award (2003)
“This volume that originated in the work of the 2020 Joseph Sandler Conference in Lau­
sanne offers readers at all levels of psychoanalytic experience a comprehensive, state-of­
the-art exploration of an integrative model of depression seen from varying perspectives.
These include empirical, metapsychological, social-scientific, research-based and clinical
considerations. In doing so, it addresses core clinical issues of narcissism, trauma, intra-
psychic and relational conflict and examines and exemplifies the important role of
empirical research in psychoanalysis. The result is a much-valued resource for the under­
standing of the origins, presentations and treatment of depression in its many manifesta­
tions, that range from classical melancholia to essential depression and from neurosis to
psychosis.”
Howard B. Levine, Md, Editor-in-Chief, the Routledge
Wr Bion Studies Series
On the Dark Side of Chronic Depression

This book brings together cutting-edge expertise from psychoanalysis, psychiatry,
neuroscience and social science to shed light on the dark side of chronic
depression.
Considering different forms of depression on a continuum, the book develops
new diagnostical considerations on depression. It includes detailed case studies
from clinical psychoanalytical practice, conceptual considerations and histor­
ical analyses to current empirical and neurobiological studies on depression.
The book is unique in bridging a gap between Anglo-Saxon/German psycho­
analysis and French traditions in relation to clinical treatment techniques and
conceptualizations of depression and trauma. Chapters present new research on
the social, biographical, genetic and neurobiological determinants of severe
depressive disorder and explore how these can be differentiated and expanded in
the face of new cultural realities as well of new findings, particularly in modern
neurosciences.
The book explores new understanding and discussion of treatment options for
depression and will be essential reading for researchers and students in the field of
depression and mental health research. It will also enrich the conceptual and
clinical knowledge of psychoanalysts and psychotherapy researchers and students.
Marianne Leuzinger-Bohleber is Professor Emeritus for psychoanalysis at the
University of Kassel, past director in charge of the Sigmund-Freud-Institut in
Frankfurt and now researcher at the Universitymedicine in Mainz, Germany.
Gilles Ambresin is Research Lead in the research program on chronic
depression at the University Institute of Psychotherapy, Lausanne University
Hospital, Switzerland.
Tamara Fischmann is Professor of clinical psychology and psychoanalysis at
the International Psychoanalytic University (IPU) Berlin, Germany and
researcher at the Sigmund-Freud-Institut (SFI) Frankfurt a.M.
Mark Solms is Chair of Neuropsychology at the University of Cape Town
and Groote Schuur Hospital, South Africa.
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Edited by Lisa de Rijk, Richard Gray, and Frank Bourke
On the Dark Side of Chronic
Depression
Psychoanalytic, Social-cultural and
Research Approaches
Edited by
Marianne Leuzinger-Bohleber, Gilles
Ambresin, Tamara Fischmann and Mark
Solms
First published 2023
by Routledge
4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
605 Third Avenue, New York, NY 10158
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2023 selection and editorial matter, Marianne Leuzinger-Bohleber, Gilles
Ambresin, Tamara Fischmann, Mark Solms; individual chapters, the
contributors
The right of Marianne Leuzinger-Bohleber, Gilles Ambresin, Tamara
Fischmann, Mark Solms to be identified as the authors of the editorial
material, and of the authors for their individual chapters, has been asserted
in accordance with sections 77 and 78 of the Copyright, Designs and
Patents Act 1988.
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from the publishers.
Trademark notice: Product or corporate names may be trademarks or
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without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record has been requested for this book
ISBN: 978-1-032-24567-6 (hbk)
ISBN: 978-1-032-24568-3 (pbk)
ISBN: 978-1-003-27929-7 (ebk)
DOI: 10.4324/9781003279297
Typeset in Times New Roman
by Taylor & Francis Books
Contents

List of figures ix
List of contributors x
Preface xv
1 Introduction: On the dark side: chronic depression and trauma –
signatures of our time? Some societal, conceptual and
methodological considerations 1
MARIANNE LEUZINGER-BOHLEBER
2 From acedia to melancholy: Sadness in the presence of God 30
J. N. DESPLAND
3 The unpast core of depression 39
DOMINIQUE SCARFONE
4 The invisible depression 49
NICOLAS DE COULON
5 The denied object of melancholy 58
J. C. ROLLAND
6 The psychoanalysis of a chronically and severely depressed
patient: Or “Don’t even think of coming close!” 61
BERNARD REITH
7 “Switching the light off to cast the shadow away” 70
JEAN-FRANÇOIS SIMONEAU
8 Getting out of the shadow of the object 78
ANNE BRUN
9 Together in the magma of despair 88
VALÉRIE BOUVILLE
viii Contents
10 The presence of God in a melancholic patient 97
GÉRARD WINTERHALTER
11 Some aspects of early development and depression: The case of
Thea, an adolescent 104
SILKE KRATEL CAÑELLAS
12 Early depressions: Loss of liveliness, withdrawal, psychosomatic
issues and risk of developmental delay 112
CHRISTINE ANZIEU-PREMMEREUR
13 Pluralism in psychoanalytic research: Conceptual framework of
the MODE study 121
GILLES AMBRESIN, TAMARA FISCHMANN AND MARIANNE LEUZINGER­
BOHLEBER
14 Memory re-consolidation and dreaming: Shadows of the night 133
TAMARA FISCHMANN, MARIANNE LEUZINGER-BOHLEBER AND
GILLES AMBRESIN
15 Depression in neuropsychoanalysis: Why does depression
feel bad? 144
MARK SOLMS
16 Thoughts on the failure of intersubjective development following
maternal–child trauma and loss 156
DANIEL S. SCHECHTER
17 Containing darkness 166
SIRI ERIKA GULLESTAD
Index 172
Figures

1.1 Pathways to depression (Bleichmar, 1996) 10

1.2 Integrative memory model (Lane et al. 2015) 17

13.1 Psychoanalytic research: a plural science of the unconscious

(adapted from Leuzinger-Bohleber, 2015b, 21) 124

14.1 Human sleep and age. The predominance of rapid eye

movement (REM) sleep in the last trimester of pregnancy (after

conception) and in the first year of life progressively declines as

waking time increases. Despite its early decrease, REM sleep

continues to occur for about 1.5 hours per day throughout life 136

14.2 Dream-generation model 139