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Lerner, H.D. (1986). Pre-Oedipal Phenomena, AffectDisorders, and Biological Psychiatry. Psychoanal. Psychol., 3(1):81-92.

(1986). Psychoanalytic Psychology, 3(1):81-92

Pre-Oedipal Phenomena, AffectDisorders, and Biological Psychiatry

Howard D. Lerner, Ph.D.

With the emergence of biological psychiatry as a major political, conceptual, and treatment force, the diagnosis of endogenous depression is being applied across a broad range of clinical conditions. In such a climate, controversy surrounding the diagnostic enterprise, the somatic treatment of affect disorders, and the conceptualization of psychopathology poses important and exciting challenges to psychoanalytic psychologists practicing in medical settings. These issues are examined through a clinical illustration involving an 18-year-old adolescent girl diagnosed and treated as a “major affect disorder.” Her Rorschach protocol is highlighted with a view toward describing and coming to understand the patient's experience of depression, significant others, and herself. The role of psychoanalytic object relations theory, developmental psychoanalysis, and self-psychology in providing a phenomenologically based, “experience near,” unified view of the whole person is advanced as one possible corrective measure for slowing down and critically evaluating the movement toward an exclusively biological view of psychopathology and treatment.

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