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Depressed people are often needy, steadily seeking some accomplishments to
make them feel good. They may be strongly dependent on others for
encouragement and support. Self psychology theory, founded by Heinz Kohut
(1971), called such a supportive relationship a “self-object.” The depressed
person especially needs others to feel positive about him/her. As a child, the
depressed person needed to idealize his/her parents and, in turn, have them
offer ample support and affection, otherwise he/she feels alone and
vulnerable. The young child wants to feel clearly and openly loved, powerful
and adored. If this doesn’t happen with the parents, the child and later the
adult constantly look to others for affirmation.
According to Kohut and O’Connor, depression is a result of suppression or loss
or denial of the parts of the self that contain deep hurts. A depressed person
the painful childhood memories and feelings. O’Connor calls these defenses
the “skills of depression.” The problem is: the pain, hidden by the defenses to
protect us, continues to cause the misery of depression but the repression
keeps us from being aware of the sources of our depression. And just as
Freud said, insight therapists believe these suppressed, hurtful feelings, like
being unloved as a child, have to be uncovered, re-possessed, looked at again
and worked through as an adult to overcome the pains of childhood. With
defense mechanisms at work, the depressed person would probably make use
of various other symptoms produced by the defenses, such as denial,
excuses, distortions of reality, and focus on other problems to hide the real
hurts and fears. Since the defenses hide our needs for love and security, we
devise other indirect ways of asking for care and concern, e.g. complaining
about feeling tired, having aches and pains, or complaining about other
people, arguing, and getting in trouble or just plain withdrawing.
O’Connor makes the point that depressed people do depression very well—the
defenses against past hurts get rid of the upsetting memories. So, he says
what needs to be done is to undo depression…to undo the defenses and deal
with the pain instead of denying it so we can learn to experience all the
emotions life brings—pain and hurt as well as joy and excitement. Undoing
depression requires new skills. Most depressives feel guilt and a sense of
failure. They are often perfectionists. They feel responsible for bad
happenings. Their self-esteem is probably low. Feeling unlovable they may be
lonely. It is natural to try to put bad feelings out of mind. Changing this
tendency requires new viewpoints and a different way of thinking.
Getting better—in therapy or by oneself—involves past hurts and one’s own
guilt. For example, you may have felt intense anger towards someone and the
defenses have helped you put that episode behind you, but the guilt about
the anger may still be there in full force. The anger and the guilt need to be
dug up and understood in terms of why you did what you did and in light of
the current situation. Keeping a daily mood journal may help you uncover
underlying feelings, assess the appropriateness of your emotions, see the
history and causes of your irrational emotions, understand the role of your
defense mechanisms in prolonging your depression, etc. Antidepressants may
reduce the depressed person’s sad feelings but they can still lack confidence,
be shy, lack social skills, feel guilt and shame, avoid hard tasks, be faced with
an unhappy marriage or work situation. New skills taught by a therapist or
