Contemporary Psychoanalytic

Question 1

McWilliams (1994) and depression

Answer 1

• When it is difficult for the child to realistically understand and grieve normally, this will lead to depressive tendencies
• Parent who disappears will generate assumptions about badness
• Major loss in separation individuation phase guarantees depressive dynamics
• Family atmosphere where mourning is discouraged encourages depressive tendencies
• Combination of abandonment and criticism
• Significant depression in parents especially in early year

Question 2

McWilliams and anxiety

Answer 2

• Mania is the flipside to depression, so mania is like a defense against depression (denial)
• Represents a depressive organization counteracted by denial as a defense
• Mania is a form of denial, Depression kicks in when mania (denial) fails
• Perpetual motion of people with mania suggests signal anxiety despite elevated mood
• So anxiety may be the result of drive derivatives (negative feelings) breaking into conscious awareness and person defends by fleeing into manic state
• history of manics shows pattern of repeated trauma separations with no opportunity for child to process loss

Question 3

Core defenses of mania

Answer 3

Denial
-attempts to ignore events that would distress or alarm others
Acting out
-mainly occurs in the form of flight, run from situations that would threaten them with loss, escape painful affects with other acting out
Devaluation
-Used when they contemplate making love attachments that they fear will disappoint them

Question 4

McWilliams and schizophrenia

Answer 4

-characteristic of psychotic level of personality structure
-common defenses are preverbal and pre-rational so as to protect the psychotic person against the level of distress that is so overwhelming:
 withdrawal
 denial
 omnipotent control
 primitive idealization
 devaluation
 primitive forms of projections and introjections
 splitting
 dissociation
-great difficulty with identity, deeply confused and not sure who they are or if they exist, struggle with basic issues of self-definition (body concepts, gender, sex orientation)
-difficulty with abstraction as limited or no use of secondary process thinking
-nature of conflict literally existential:
 life v death
 existence vs. obliteration
 safety vs. terror