Considerations on depressive conflict and its different levels of intensity: implications for technique.
This article considers the problem of depressive conflict (DC) and the difficulties that arise in integrating aggression towards the object of libidinal cathexis. This conflict results, in particular, from the destructive omnipotence that infantile fantasies attribute to the aggression. In order to better clarify Klein's very broad concept of the depressive position, three levels of severity of depressive conflict are proposed, depending on the type of fantasies concerning the loss of the object that predominate in the individual. These are: fantasies of catastrophic and irreparable destruction of the object ("parapsychotic" DC); fantasies of death and serious damage of the object ("para-depressive" DC); and fantasies of rejection and loss of the love of the object ("para-neurotic" DC). Having looked at these theoretical hypotheses, their implications for technique will then be considered, particularly the importance of focusing the interpretation on guilt feelings rather than on drives in the transferential relationship. A clinical example drawn from the work of Klein and a clinical vignette of a particularly difficult analysis illustrate this technical hypothesis.
41 Chemin Crêts-de-Champel, 1206 Geneva, Switzerland. Elke.David@hcuge.org
Francisco Palacio
FP
Espasa
D000328:Adult; D000339:Affect; D003220:Conflict, Psychological; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008297:Male; D009289:Narcissism; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy / Q000379:methods; D012720:Severity of Illness Index