3.2 Psychodynamic theories
Psychodynamic theories view depression in terms of inwardly directed anger, loss of self-esteem or self-worth, egotistic or excessive narcissistic or personality demand, or deprivation in mother-child relationship (loss or rejection by a parent). Freud’s (1917) psychoanalytic theory is an example of the psychodynamic approach. Repressed anger at a loss (symbolic or actual loss of a loved one during childhood, for example) is directed inwards, reduces self-esteem and increases vulnerability to further experiences in the future, causing the individual to ‘re-experience’ (symbolic or actual) the loss when encountering similar triggering stimuli during adulthood. The theory argues that people prone to depression have an excessively high interpersonal dependency (i.e. they seek approval and reassurance from others – to be loved, respected, admired, appreciated,etc. and depression arises when they fail to receive it). Those who may depend on others for their sense of self-esteem may therefore remain in a more vulnerable ‘depression-prone’ state. Alternatively, they may hold lofty ideals, standards and goals, in which case depression arises when they fail to achieve these. Congruency models view both a high dependency on social sources of approval, and a high dependency on achievement outcomes as important aspects of depression. The main problems with the psychodynamic approach relate to difficulties in testing the theories scientifically, using operational definitions that allow empirical (clinical and experimental) investigation. A lack of emphasis on distressing life events and conscious negative rumination and ‘self-verbalisation’ are further criticisms. Beck’s model of depression, which we will examine shortly, was heavily influenced by psychodynamic theories.