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Peto, A. (1972). Body Image and Depression. Int. J. Psycho-Anal., 53:259-263.

(1972). International Journal of Psycho-Analysis, 53:259-263

Body Image and Depression

Andrew Peto

SUMMARY

The thesis of this paper is that a particular body image, as a significant representation of pathologically lowered self-esteem, is an essential factor in the mechanisms of psychotic as well as neurotic depression. This body image is that of a latency child. It is a debased, 'creepy', malformed image with vague boundaries. It indicates the significance of the oedipal phase in depressions, in addition to the generally accepted oral factors. It is the genetic and structural bridge that connects the intrasystemic conflict of low self-esteem with the intersystemic conflict between ego and superego. This intersystemic conflict is in turn determined, pari passu, by the vicissitudes of the debased body image which is the result of the insufficient separation of self and object representations (Jacobson).

This body image of fluctuating structures and boundaries promotes dedifferentiation of ego and superego boundaries and agencies and, subsequently, deneutralization of aggression. This may culminate in the act of suicide. Suicide is conceived as an attack on this particular degraded self-representation.

The suggested hypothesis is supported by the fact that depression is an almost ever-present mechanism in perversions. These always include, preconsciously or unconsciously, a debased or deformed body image of phallic character coupled with pathologically lowered self-esteem.

While in depression elation is the denial of the debased body image, acting out with the idealized body of the partner is in perversions the corresponding defensive manoeuvre.

Consideration is given to this body image as the structure that marks the vital crossroads: complex inhibition against further maturation on the one hand, and on the other hand a defensive measure against further regression and dissolution.

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