Shirah Vollmer MD

The Musings of Dr. Vollmer

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.

 

4 Responses to “Depression = Unloveable”

  1. Shelly said

    Is narcissism as defined in this blog a good thing? Don’t we all, in some way, try to act or think of ourselves as special? Are we all narcissistic?

    • Narcissism, like almost everything else in life, is good to an extent, and harmful in excess. Yes, we need to maintain a sense of ourselves as special, while at the same time, appreciate that there is a universality in human experience that we can all connect with. Straddling this seeming contradiction, this dialectic, is the art of living. Kohut talked about healthy narcissism, which is to your point, that a good amount of self-involvement pays off with vitality and enthusiasm for life, but too much results in painful loneliness and despair. Thanks.

  2. Ashana M said

    I would, instead, posit that her narcissism is the cause of her depression. Her belief about herself is that she is special, and her unpleasant life is understood through that lens. She has the “worst” life. If she were happy, she would believe she had the “best” life. She is looking at what is through the lens of who she is.

    She rages about poor service because her sense of specialness is undermined by poor service: Incompetent waitstaff wound her view of herself. At the same time, because she is special, she feels entitled to rage at them: she does have a conscience, so she feels guilty about this, but since she is so special, her guilt must also be terrible, just as her life must be the “worst.”

    At the same time, her sense of her own specialness drives others away. It annoys people, it is off-putting, and it is just a tad delusional. And so she is isolated. The isolation is causing the depression. Lack of connection to others causes depression and anxiety. It creates a sense of powerlessness and of being under threat.

    High degrees of narcissism impede social connections and, in that way, cause people to be difficult to love–or even like. Being unloveable does cause depression.

    Miley will do better if she can learn skills which allow her to have reciprocal relationships.

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