Session 6b - Mood Disorders 'A psychodynamic understanding'

Question 1

From a psychodynamic viewpoint, what are three ideas/theories used to explain depression?

Answer 1

Mourning (Melancholia)
Rank theory
Attachment theory

Question 2

What is the difference between mourning and melancholia?

Answer 2

Mourning - love object is dead. Love still exists. May get hallucinations. Reality Testing. Recovery possible.

Melancholia/Depression - Loss of love object, but person still exists. Experienced after a break up/divorce. Love and hate idea - love ‘takes in’ the person, whilst hate ‘kills off’ the person. Recovery not possible. Attention seeking depression.

Question 3

How does psychodynamic therapy view mania?

Answer 3

Mania is a super defence against depression. Structural model applied:
ID - sex and aggression
Ego - Euphoric self satisfaction
Superego - intolerable self criticism.
Manis is perceived as the other side of the coin to depression, and is the best way to hide it.

Question 4

Use Rank theory to explain depression.

Answer 4

This is an evolutionary theory of depression. It proposes that depression promotes the survival of genes. Depression is an adaptive response to losing status (rank) and losing confidence in the ability to regain it.

Question 5

Use Attachment theory to explain depression.

Answer 5

Attachment in infants is primarily a process of proximity seeking to an identified attachment figure in situations of perceived distress or arm of rate purpose of survival.
Infants become attached to adults who are sensitive and responsive.
If this doesn’t occur - depression is more likely to occur.

Question 6

Explain the neurobiology of attachment.

Answer 6

First year of life is a critical period for the brain to grow and neuronal networks to develop. Importance of early enriching environment. [Gene environmental interaction]
Mother - infant interaction - regulates brain chemicals (opiates, endorphins, cortisol) - effect on genes - brain development

Question 7

What is the relationship between the right side of the brain and attachment?

Answer 7

Attachment memories stored in R hemisphere - in the implicit memory. R hemisphere associated with emotional regulation and how people react to stress.

Question 8

What is the focus of psychodynamic/ psychoanalytic therapy?

Answer 8

Emphasis on establishing a safe therapeutic environment. Safe, confidential space allows exploration of feelings. The therapeutic relationship is the focus of treatment. Links made between past and present.