Introjection
Aggression that would actually be directed outward is turned inward - against the Self.
Psychodynamic Model - Depression
The Depressive Structure at a Glance
Section titled “The Depressive Structure at a Glance”In depression, a characteristic constellation emerges: The EGO is “tilted,” the Self is “in the basement” and the ego discrepancy is massively enlarged. The affected person experiences themselves as worthless, incapable and hopeless.
The EGO Structure in Depression
Section titled “The EGO Structure in Depression”The Tilted EGO
Section titled “The Tilted EGO”The Defense in Depression
Section titled “The Defense in Depression”The defense mechanisms (A) work differently in depression:
Regression
Retreat to earlier developmental stages with helpless, passive behavior.
Identification with the Lost
In loss, the lost object becomes part of the Self - and is then devalued.
Repression (insufficient)
Painful contents can no longer be effectively repressed.
The SUPEREGO Structure in Depression
Section titled “The SUPEREGO Structure in Depression”The Three Pillars
Section titled “The Three Pillars”The conscience in depression is often excessively strict:
- Constant self-reproach
- Inappropriate guilt feelings
- “I should have done this or that”
The ego ideal is unreachably high:
- Perfectionistic demands
- Constant feeling of failure
- “I am not good enough”
The discrepancy between ideal self and real self is maximal:
- The ideal self appears unreachably distant
- The real self is experienced as worthless
The Pressure on the EGO
Section titled “The Pressure on the EGO”The Self in Depression
Section titled “The Self in Depression”The Four Components - All Affected
Section titled “The Four Components - All Affected”- Self-image - Negatively distorted (“I am worthless, incapable, a burden”)
- Self-awareness - Collapsed (“I no longer know who I am”)
- Self-esteem - In the basement (“I am worth nothing”)
- Social self - Withdrawal (“I am only a burden to others”)
The Maximum Ego Discrepancy
Section titled “The Maximum Ego Discrepancy”The Dynamics of Depression
Section titled “The Dynamics of Depression”The Vicious Cycle
Section titled “The Vicious Cycle”- Trigger: Loss, offense, overwhelming demands
- EGO tips: The balance is lost
- Self slides down: All Self components sink
- Ego discrepancy grows: Distance to the ideal self increases
- SUPEREGO presses harder: Conscience becomes stricter
- EGO tips further: The cycle reinforces itself
Aggression Turned Inward
Section titled “Aggression Turned Inward”A central concept of psychodynamic depression theory:
The Legend to the Model
Section titled “The Legend to the Model”EGO Structure
Section titled “EGO Structure”| Symbol | Meaning |
|---|---|
| A | Defense mechanisms - altered/insufficient |
| B1 | Forces from Pillars I and II - excessively strong |
| B2 | Forces from Pillar III |
| C | Defense energies - exhausted |
| A+C | Defensive action |
| D | Connection to the Self - the Self has slipped downward |
| E1, E2 | ID impulses - often reduced (lack of drive) |
| G | Inversive joint |
Self Components
Section titled “Self Components”| Symbol | Meaning |
|---|---|
| SB | Self-observation - often excessively negative |
| S | Comparison of social self with Self |
| SE | Self-knowledge - distorted |
| SF | External image transition - negatively filtered |
| SR | Self-regulation - impaired |
| SS | Influence of social self - only negative aspects |
| IS | Ego discrepancy - maximally enlarged |
| VI | Comparison - the Self appears worthless |
SUPEREGO Structure
Section titled “SUPEREGO Structure”| Symbol | Meaning |
|---|---|
| VI | Comparison ego ideal versus ego ideal |
| U | Primal imprints through the parental imago |
| B1 | Total force from Pillars I and II - excessive |
| B2 | Total force from Pillar III |
Forms of Depression
Section titled “Forms of Depression”By Cause
Section titled “By Cause”Reactive Depression
Triggered by external events (loss, trauma, overwhelming demands)
Endogenous Depression
Coming “from within,” often without a recognizable external trigger, biological component
Neurotic Depression
Based on a personality structure (e.g., dependent personality disorder)
The Role of the SUPEREGO in Different Forms
Section titled “The Role of the SUPEREGO in Different Forms”In all forms, a similar SUPEREGO dynamic is evident:
- Strict, punishing conscience
- High, unattainable ideals
- Large ego discrepancy
The difference lies in the cause of this constellation:
- Reactive: Triggered by external events
- Endogenous: Biologically determined
- Neurotic: Predisposed by personality structure
The Connection to Other Disorders
Section titled “The Connection to Other Disorders”Depression in Dependency
Section titled “Depression in Dependency”Depression in Borderline
Section titled “Depression in Borderline”In borderline, depressive phases frequently occur, but:
- They are often reactive (to abandonment, offense)
- They shift more quickly
- The basic structure is different (fragmented EGO)
Depression in Narcissism
Section titled “Depression in Narcissism”Narcissists can also become depressed:
- When the grandiose self-image collapses
- In narcissistic injury
- The depression is then particularly severe because the Self “has nothing” left
Therapeutic Implications
Section titled “Therapeutic Implications”Medication (antidepressants) can treat the biological component and thus provide the EGO with more energy - but the structural problems require psychotherapy.