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Shahar, G. (2018). The (Suicidal-) Depressive Position: A Scientifically Informed Reformulation. Psychodyn. Psych., 46(2):265-293.

(2018). Psychodynamic Psychiatry, 46(2):265-293

The (Suicidal-) Depressive Position: A Scientifically Informed Reformulation

Golan Shahar, Ph.D.

Despite considerable progress in depression research and treatment, the disorder continues to pose daunting challenges to scientists and practitioners alike. This article presents a novel conceptualization of the psychological dynamics of depression which draws from Melanie Klein's notion of the positions, reformulated using social-cognitive terms. Specifically, Klein's notion of position, consisting of anxieties (persecutory vs. “depressive”), defense mechanisms (“primitive”/split based vs. neurotic/repression based), and object relations (part vs. whole) is reformulated to include (1) affect, broadly defined, (2) affect regulatory strategies (defense mechanisms, coping strategies, and motivation regulation), and (3) mental representations of self-with-others, all pertaining to the past, present, and future. I reformulate the depressive position to include—beyond sadness, anxiety, and anhedonia—also anger/agitation, shame, disgust, and contempt, all of which are down-regulated via diverse mechanisms. In the depressive position, the self is experienced as wronged and others as punitive, albeit seductive. Attempts to appease internal others (objects) are projected into the future, only to be thwarted by awkward and inept interpersonal behavior. This might propel the use of counter-phobic, counter-dependent, and “manic” affect regulatory mechanisms, potentially leading to suicidal depression.

[This is a summary or excerpt from the full text of the article. PEP-Web provides full-text search of the complete articles for current and archive content, but only the abstracts are displayed for current content, due to contractual obligations with the journal publishers. For details on how to read the full text of 2018 and more current articles see the publishers official website.]

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