Depression = Unloveable
Posted by Dr. Vollmer on November 11, 2014
As Richard III said…
And therefore, since I cannot prove a lover….
I am determined to prove a villain.
Karl Abraham..http://en.wikipedia.org/wiki/Karl_Abraham…describes depression as feeling unloveable, resulting in rage and violent impulses, followed by repression of these violent impulses, but developing a huge sense of guilt for violent or sadistic feelings. This persistent guilt causes the depression, which in turn, confirms to the patient that he is indeed unloveable. At the same time, the preoccupation with negative thinking, with his own thinking, leads to a certain narcissistic pleasure which is hidden from consciousness.This form of narcissism leads to further isolation which leads to a further confirmation of his unloveable feeling. The withdrawal from the world, Abraham would say, is “symbolic dying”. In this “symbolic dying” the patient does not attempt at finding love and feels more and more like the world is punitive and worthy of avoidance, in addition to feeling that he tarnishes the world,such that both thoughts combined lead to a futher “symbolic dying” process. This, in more common terms, is the downward spiral of depression.
Miley, who I spoke about previously, serves to illustrate this pathway. She states that her life is hijacked by her aging parents, but upon further exploration, before her parents took ill, she also led an impoverished existence. She has never dated seriously and she has few friends. She feels lonely, but she adamantly refuses to try new activities with the intent of making new relationships. She has very painful hostile feelings towards her parents, resulting in terrible guilt and further feelings of unworthiness. All of her negative feeling states cause significant withdrawal and isolation, while at the same time, she takes pleasure in feeling that she has “the worst life”. The word “worst” gives us a clue that within her suffering, is a feeling of being special, if for nothing else, but for the extent of her pain.
Miley’s silent rage surfaces with poor service at restaurants, at which point, by her own account, she is verbally abusive to the waiter, followed by horrible guilt, leading to more and more isolation. Miley understands that her rage is out of proportion to the situation, but she does not connect her rage to her feelings about taking care of her parents. This possible psychic connection is one focus of our work. Through her psychotherapy, Miley can see the connections between her feeling state and her isolation, such that if she could learn to tolerate her violent or sadistic thinking, she could then come to understand where those thoughts/feelings come from, rather than jump to a guilty/lonely place.