Repressed Sadism and Disappointment in Love

The first coherent psychoanalytic description of melancholy came not from Freud but from Karl Abraham, whose 1911 essay on the subject remain authoritative. Abraham began by stating categorically that anxiety and depression were “related to each other in the same way as are fear and grief. We fear a coming evil; we grieve over one that has occurred.” So anxiety is distress over what will happen, and melancholy is distress over what has happened. For Abraham, on e condition entailed the other; to locate neurotic distress exclusively in the past or future was impossible… Depression, Abraham says, occurs when hate interferes with the individual’s capacity to love. People who se love is rejected perceive, paranoiacally, that they world has turned against them and so they hate the world. Not wishing to acknowledge such hatred to themselves, they develop an “imperfectly repressed sadism.” (pp. 323-324)

「不完全に抑圧されたサディズム」。外に向かうはずの攻撃が自己に対する攻撃に転化するということか。

“Where there is a great deal of repressed sadism,” according to Abraham, “there will be a correspondingly severity in the depressed affect.” The patient, often without realizing it, gets a certain pleasure from his depression as a result of his sadistic attitude… In the end, Abraham admitted that the kind of trauma that leads to depression can also lead to other symptoms, and “we have not the least idea why at this point one group of individuals should take one path and the other group another.” This, in his words, is “the impasse of therapeutic nihilism.” (p. 324)

Six years later, Freud wrote his brief, seminal essay “Mourning and Melancholia,” which has probably had more effect on contemporary understanding of depression than any other single piece of written material. Freud questioned the coherence of what is called melancholia; the definition of depression “fluctuates even in descriptive psychology.” And what, asks Freud, are we to make of the fact that many of the symptoms of melancholia, which we are so anxious to alleviate, occur also in grief?... “In grief,” Freud wrote, “the world becomes poor and empty; in melancholia, it is the ego itself [which becomes poor and empty].” The mourner is distressed by an actual death; the melancholiac, by the ambivalent experience of imperfect love. (pp. 324-325)

Abraham, responding to “Mourning and Melancholia,” proposed that depression has two phases: the loss of the love-object, and the resuscitation of the lobe-object through internalization. He describes the disorder as the result of a hereditary factor, a fixation of the libido on that lost breast of the mother, an early injury to self-love because of a real or perceived rejection by the mother, and a pattern of repetition of that primary disappointment. “An attack of melancholic depression is ushered in by a disappointment in love,” he wrote; and the melancholic becomes “insatiable” for attention. (p. 325)

愛情への失望感から……。言い当てているような気がする。

With the publication of his book, I forsake an expedient privacy. I would have to say, however, that talking about my depression has made it easier to bear illness and easier to forestall its return. I’d recommend coming out about depression. Having secrets is burdensome and exhausting, and deciding exactly when to convey the information you’ve kept in check is really troublesome. (p. 365)

It is also astonishing but true that no matter what you say about your depression, people don’t believe you unless you seem acutely depressed as they look at and talk to you… No one ever told my grandmother that she didn’t really have heart disease. No one says that increasing rates of skin cancer are in the public imagination. But depression is so scary and unpleasant that many people would just as soon deny the disease and repudiate its sufferers. (pp. 365-366)

何年も前に「カミングアウト」した。隠しているより気が楽というのは、まったくその通り。しかし、周囲には理解したような顔をした人でも、実際は何にもわかっていないことがある。そんな場合の方が多いような……。

Prejudice, rooted largely in insecurity, still exists. Driving some acquaintances recently, I passed a well-known hospital. "Oh, look," said one of them. "That's where Isabel got herself electrocuted." And he moved his left index finger around his ear in a sign for crazy. All my activist impulses rising towards the surface, I asked what exactly happened to Isabel and found, as I'd anticipated, that she had received ECT at the hospital in question. "She must have had a hard time," I said, attempting to defend the poor girl without being too earnest. "Think how shocking having shock must be." He burst out laughingly. "I nearly gave myself electroshock treatment the other day when I was trying to fix my wife's hair dryer," he said. I am a great believer of sense of humour and I was not really offended, but I did try -- and fail -- to imagine our going past a hospital at which Isabel might have had chemotherapy and making similar jokes. (p. 366)

前回この部分を引用したのは去年の１月１日のようだ。数週間後に自分がＥＣＴを受けることなど想像できなかった。