Psychodynamic Approach to Depression

The Psychodynamic approach focuses on how unconscious motives drive our behaviour and experience.

Freud's explanation of depression lies in the early relationship with our parents.

He noticed the similarity between depression and grief, e.g. loss of appetite, extreme sadness, insomnia, withdrawal from society

Freud described depression as “excessive and irrational grief” as a reaction to loss. This loss could be real or imagined loss of affection from the parent that the person was most dependent upon.

Freud suggested that actual or symbolic losses lead us to re-experience parts of our childhood,becoming dependent and clingy.

The greater the experience of loss, the greater the amount of regression as an adult.

Unresolved feelings of hostility towards parents can be directed inwards as guilt. Guilt can lead to feelings of unworthiness or suicide.

Psychodynamic psychotherapy helps people explore the long- term sources of depression or anxiety. These involve conflicts and problematic connections with attachment figures, such as parents.

In this type of therapy, the relationship between the depressed patient and the therapist is considered to be very important. Previous problematic relationship conflicts will tend to play themselves out within the current relationship between the therapist and patient through a process known as Transference

A patient who has grown up with an overbearing parent may unconsciously find it difficult to risk developing a close relationship with the therapist out of fear that all close relationships will necessarily involve a domineering partner. The therapist will point out this pattern, allowing the patient to try out new ways of relating to other people.

Bowlby and Harlow & Harlow did demonstrate the importance of early relationships for healthy emotional development.

Freud's theory is often criticised as being unscientific it is difficult to observe, operationalise and measure concepts such as actual and symbolic losses, regression.

Freud's work has been criticised as he based his work on case studies and it is argued that it is difficult to generalise from case studies.

However, case studies can be rich and accepted sources of information, e.g. Clive Wearing.

This focus on early relationships and the unconscious mind could be somewhat deterministic. It could also be regarded as reductionist, thinking of depression solely in terms of instincts.

Therapy means weekly meetings so it is a big commitment in terms of time and money.

Another derivative of psychodynamic theory, Coyne's Interpersonal Theory of Depression has led to a successful form of treatment, known as Interpersonal Therapy or IPT

According to interpersonal theory a depressed person's negative interpersonal behaviours cause other people to reject them. Depressed people's symptoms then start to worsen as a result of other people's rejection and avoidance of them. IPT has been designed to help depressed people break out of this negative spiral.