Anaclitic (Dependent) Depression
Anaclitic (Dependent) Depression
Anaclitic (Dependent) Depression
Helen H., a young, recently 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 nine years old,
and Helen's 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 six 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 said she had married in an attempt to extricate herself from a
consuming and destructive relationship with what she perceived as her erratic, labile, and
probably borderline 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 Helen 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 her mother's death.
Helen reported that she was conceived because of her parents' wish to avoid having her father
drafted for military service in the Korean War. 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 eczema, and in her early teens, as she tried to leave home for summer camp, she
developed psoriasis. Her parents were divorced when she was an adolescent, and she felt
abandoned by her father in the divorce as well as earlier because of his frequent absence from
home during her childhood, especially during evenings and weekends, when his work frequently
required him to be away. 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 had never done anything together. She
reported always feeling very upset when she saw a family together. For example, she abruptly
ran out of a friend's engagement party in tears because of 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.
Helen 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 brief 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 o fa heart attack. The
promiscuity had stopped several months before she began analysis with me, and she did not
report any of these relationships in the screening interviews.
Almost immediately, Helen 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 stop herself from falling sound asleep.
When awake, she often played with her eyeglasses, and it became apparent only later that she
was using them as a reflecting surface, a mirror, to keep me in sight during the psychoanalytic
sessions. Other indications of an association between object loss and an emphasis on vision
occurred. 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.
Helen 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 male
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 have to be hospitalized.
She requested that she and I "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 and was convinced she was going to remarry. After being
abandoned by these men, she felt used, abused, and angry. She was aware of, and frightened by,
her temptation to become a prostitute.
Her sleep during the psychoanalytic sessions also seemed to be a 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 often 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 most recent boyfriend on a trip—the first time she had ventured out of town. On her return,
she once again reported that she had 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 on reviewing the case record that I noted that this
interruption occurred exactly nine months to the day after Helen and I had first met for the initial
evaluation before entering psychoanalysis (seeG. Rose, 1962). The interruption also occurred
immediately after the Christmas-New 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.
During the course of her analysis, Helen reported several brief dream fragments. In onedream,
there was a knock on the door, and when she answered the door, no one was 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 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 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. 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 a spell over her and she was
frightened that she would eventually commit suicide or at least never remarry and would
become" lonely, old, and crazy" like her mother.