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On the development of depressive states from a psychodynamic viewpoint

Abstract The author analyzes the temporal dimension of depression by making reference to one of the clinical cases he treated and re-examining a clinical case analyzed by Edith Jacobson. According to the result of his observations, the developmental psychodynamics of a depressive state normally appears to take place in two distinct phases: a first narcissistic loss, which gives rise to an integrative conflict and to the formation of a certain identificatory structure, is later followed by a second narcissistic loss, which leads to the real depressive state. The two phases present a specific, intrinsic connection constituted by the implication of the same identificatory element of the self, recognition of which can favour a clinical work that more closely adheres to the deep dynamics of depression.