Anaclitic depression in adults(A 5 point guide)

From the article below, we will understand what is anaclitic depression in adults, its symptoms, its causes and a case example.

What is anaclitic depression?

Blatt(1995), divides depression from a psychoanalytic cognitive-developmental perspective into introjective and anaclitic subtypes. 

Anaclitic psychopathology is characterized by primary preoccupation with relatedness, from more dependent to more reciprocal and mature relationships. The patient, during times of stress, uses avoidant defenses like withdrawal, repression etc to cope with it. They have issues related to interpersonal factors like trust, care, reciprocity, intimacy. From more to less disturbed, these disorders include borderline personality disorder, infantile (or dependent) character disorder, anaclitic depression, and hysterical disorders.

Adult anaclitic depression is caused due to the lack of a reciprocal attachment a patient has with whom he or she shares a strong emotional dependence. 

Suppose in the thought of an adult she/he is in strong emotional dependence with someone. However, someone is not behaving according to the expectation of the adult. In this case anaclitic depression can occur which means the adult is in strong dependency and attachment with someone and there is no care back as expected to the adult.

This kind of depression can hurt a person regularly.

Symptoms of anaclitic depression in adults :

Anaclitic depression is characterized by 

• feelings of helplessness

• Mental weakness 

• Feelings of depletion, exhaustion

• an  intense fears of abandonment 

• desperate struggles to maintain direct physical contact with the need-gratifying object.

• an intense wish to be soothed and cared for, helped, fed, and protected.

• Difficulty tolerating delay

• Fear about being rejected or abandoned

How attachment style is related to anaclitic depression?

A child, when born, gets attached to his or her primary care giver in a certain way which defines their attachment style and how their future relationships would be. There are two broad categories of attachment styles namely secure, insecure (ambivalent and avoidant) 

Secure attachment 

Children who are securely attached generally become visibly upset when their caregivers leave and are happy when their parents return. When frightened, these children will seek comfort from the parent or caregiver.

As adults, they have long lasting relationships; they can trust people; they have high self-esteem.

Insecure attachment 

Children who are insecurely attached seem to be in distress when separated from parents and may avoid seeking comfort from them after a long period of absence. 

As an adult, they  may be reluctant to become close to their partners in a relationship; may not trust the partner’s actions; may have problems with intimacy; may have issues with trust and intimacy; encompasses a negative self-model.

Evidence suggests that the insecure attachment styles, particularly those involving a negative-self model, are predictive of depression. 

What is research evidence claiming?

In a research study conducted on a sample of orphanage-reared and parent-reared children  by Hortacsu, Cesur, and Oral (1993), it was observed that signs of depression were more prevalent in those having insecure attachment while secure attachment was found to be negatively correlated with depression. 

Roberts et al. (1996) found elevated levels of depressive symptomatology for participants who were afraid of abandonment, anxious about the prospect of being unloved, and who perceived others as unavailable in times of need.

Another promising research by Zuroff(1990), suggests females who had insecure attachment ( anxious or preoccupied) scored higher on both dependency (related to anaclitic depression) and self-criticism (related to introjective depression) than securely attached controls.

Samantha Reis and Brin F. S. Grenyer in their study, worked on 245 participants to find out the relation between attachment style and the occurrence of depression. The results showed anaclitic depression had roots in insecure preoccupied attachment(People with a preoccupied attachment style feel a powerful need to be close to others, and they show this by clinging. They need a lot of validation and approval).

Object Relation theory and anaclitic depression 

Object relation theory an offshoot of psychoanalytic theory talks about how an object( a person or a thing) is emotionally represented by a subject.  Michael St. Clair writes, “For example, I love my children, I fear snakes, I am angry with my neighbor.” Drives like those for sex, hunger, and affection have objects.  In object-relations theory, objects are usually persons, parts of persons, or symbols of one of these.

Since birth, a child depends on an object to perceive and understand the world around them. The inherent drives a child is born with is always directed towards an object. For example, the drive of hunger(milk) in babies is derived from breasts. Breast that gives milk is good, breast that denies it bad. Object world during the first few months consists of gratifying and hostile parts of the infant’s real world. 

The object is valued only for its capacity to provide needed gratification. It supplies us with satisfaction and assurance. 

Thus, there is an inordinate fear of abandonment and an excessive vulnerability to object loss (Rochlin, 1965)3 and a difficulty expressing anger and rage for fear of destroying the object as a source of satisfaction. 

The root of anaclitic depression in adults lies in the fear or pain received because of lack of assurance, love and gratification due to object loss in infancy. Adults with anaclitic depression depend on an object(a person or a thing) which they represent as a source of satisfaction, self-worth and love. If the object is taken away from the person, her or she faces depression which can further be named as anaclitic depression. 

A case Example  derived from the journal “The Psychoanalytic Study of the Child”

Helen H., a young married woman, entered analysis because of recurrent and intense feelings of depression, tension, and anxiety. She was in the process of obtaining a divorce and was frightened that she would become lonely, old, and crazy like her mother, or that she would commit suicide.

Her mother had made a serious suicide attempt when Helen was in latency and her outstanding memory of this event was of being left behind, alone, frightened, and screaming as they rushed her mother to the hospital.

This reminded her of her own hospitalization for a tonsillectomy at age 5 and her feelings of being “left alone” in the darkness of the anesthesia and her fear that she would die.

Helen was never able to sleep away from home as a child, and as an adolescent she was unable to take trips out of town. She married in an attempt to extricate herself from a consuming and destructive relationship with her erratic, labile, and probably psychotic mother; but after her marriage she rented an apartment within view of her mother’s home.

The mother called several times each day, frequently berating Helen. Although Mrs. H. was very upset by these endless calls, she could never place limits on them. She was convinced that she would be free of her mother only after the mother’s death. After Helen’s birth, her mother was confined to bed because of severe back pains and was unable to care for her.

The mother was unable to lift and cuddle Helen and the father assumed primary responsibility for her care and feeding. As an infant she had exzema and in her early teens, as she tried to leave home for camp, she developed psoriasis.

Her parents were divorced when she was an adolescent, and she felt abandoned by her father in the divorce and earlier in his frequent absence from home during her childhood. She believed that she had never had a childhood and a chance to play, and that she had to work for anything she wanted.

She maintained that she had never seen warmth, love or tenderness at home and that her family never had done anything together. She always became very upset when she saw a family together. For example, she abruptly ran out of a friend’s engagement party in tears because she became upset by the warmth, closeness, and affection expressed by the family members of her friend. She went to her apartment and slept for more than 12 hours.

At her own wedding her parents fought and her mother cursed her father. Mrs. H. had great difficulty tolerating feelings of loneliness. Shortly after she separated from her husband, she became intensely involved in a long series of brief relationships, most of which lasted only a few days.

She ran frantically from one brief affair to another, each time convinced that this was “the real thing,” “the perfect relationship,” and that she would marry again.

She felt little conscious guilt or embarrassment about these affairs, only disappointment and feelings of having been used and abandoned. Almost without exception she chose depreciated men from lower socioeconomic and educational levels.

The men were of such a nature that she was convinced that if her parents found out about these affairs, her mother would commit suicide and her father would die of a heart attack.

The promiscuity had stopped several months before she began analysis with me, and she did not report any of these incidents in the screening interviews. Almost immediately on starting analysis, Mrs. H. seemed to have difficulty with the demands of the analytic process. Beginning in the third hour of the analysis, she began to doze when painful issues came up.

The drowsiness increased in frequency and intensity; although she struggled to stay awake so she could “benefit from analysis,” she was often unable to control her falling sound asleep.

When awake she often played with her glasses, and it became apparent only later that she was using her glasses as a mirror to keep the analyst in sight. In the course of her analysis there were other indications of an association between object loss and an emphasis on vision.

For example, she was very proud of having earned the money to buy contact lenses; yet on the day after the assassination of President Kennedy she confused which lens was for which eye and never wore her contact lenses again. She had difficulty with separations in analysis.

Weekends away from work and analysis were empty and painful. She seemed unable to tolerate the loneliness and she had frequent visitors and numerous phone calls each night.

During the first extended separation from analysis for a month-long summer holiday she feared she would go crazy and would have to be hospitalized. She requested to “keep in touch” by mail. During the summer vacation she again became frantically involved in a series of brief affairs. Each affair lasted a few days and each time she again felt intensely in love. After being abandoned, she felt used, abused, and angry.

She was aware of, and frightened by, her temptations to become a prostitute. Her sleep in analysis also seemed to be in response to the feelings of loneliness and abandonment she experienced in my silences in analysis and her inability to keep me in sight.

Her sleep in analysis had a peaceful, restful quality; she seemed to want to be held and enveloped. During the second extended separation from analysis, a two-week Christmas holiday, she joined her new boyfriend on a trip–the first time she ventured out of town: On her return she reported that she had once again fallen in love and that she was planning to get married.

After a few days she abruptly announced that she had decided to interrupt her analysis because her boyfriend objected to it. It was only upon reviewing the case record that it was noted that her interruption of the analysis occurred exactly nine months to the day of her first meeting with the analyst (Rose, 1962).

The interruption also occurred immediately after the ChristmasNew Year holiday, when themes of birth and the start of a new life are prevalent in society as a reaction to the emptiness, barrenness, and darkness of the winter solstice. Mrs. H. reported several brief dream fragments during the analysis. In one dream there was a knock on the door and when she answered the door, there was no one there.

She also had frequent nightmares of being attacked and raped, but she would not elaborate on these in any detail. She briefly mentioned a dream she had had shortly before her marriage in which she awoke screaming, “Catch the baby, catch the baby before it falls from the shopping cart.” In a current dream a rat bit her hand, and in another a boyfriend turned her over to other men for them to have intercourse with her.

She was unable to associate to any of these dreams. She also commented that she often felt tempted to assume “a fetal position” when masturbating, but she was frightened by the implications of this.

An image of her mother was frequently present in her masturbation fantasies, but she was unwilling to elaborate on this. At one point in analysis, while following a series of thoughts about her mother, she abruptly stopped and said she felt like she was “in quicksand, being sucked in.” She often expressed the thought that her mother had cast spell over her and she was frightened that she would eventually commit suicide or at least never remarry and become “lonely, old, and crazy” like her mother. 

Diagnostically, Mrs. H. seemed to have an anaclitic depression in a basically infantile narcissistic character disturbance with possibly borderline features. Her depressive concerns focused on her feelings of being unwanted, unloved, and abandoned, which she defended against by seeking direct physical and sensory contact with objects.

She had a desperate need to be close to people, to have direct contact with them, and to keep them in view. Her sadomasochistic fantasies and activities were ways of seeking intense sensory stimulation as well as expressing her rage about deprivation and abandonment. She had to seek substitutes for the loss of a need-gratifying object, yet she constantly provoked abandonment in her indiscriminate search for objects who would provide some sense of contact and need satisfaction.

In numerous ways the clinical material illustrated her impaired object representations and her attempts to cope with potentially dangerous and frightening experiences of object loss and abandonment by maintaining direct, immediate, sensorimotor contact.

Conclusion

From the article above, we got to know what is anaclitic depression in adults, its symptoms, its correlation with object relation theory and attachment style. Along with a case example we acquired knowledge about how anacltiic depression can affect an individual.

FAQs: Anaclitic depression in adults 

References:

Reference: Blatt, S. J., Shahar, G., & Zuroff, D. C. (2001). Anaclitic (sociotropic) and introjective (autonomous) dimensions. Psychotherapy: Theory, research, practice, training, 38(4), 449.

https://sci-hub.se/https://doi.org/10.1080/00797308.1974.11822616

https://web.sonoma.edu/users/d/daniels/objectrelations.html#:~:text=Representation%20refers%20to%20the%20way,has%20invested%20with%20emotional%20energy.

https://en.wikipedia.org/wiki/Attachment_theory