1st Edition

On the Dark Side of Chronic Depression Psychoanalytic, Social-cultural and Research Approaches

    194 Pages 5 B/W Illustrations
    by Routledge

    194 Pages 5 B/W Illustrations
    by Routledge

    This book brings together cutting-edge expertise from psychoanalysis, psychiatry, neuroscience and social science to shed light on the dark side of chronic depression.

    Considering different forms of depression on a continuum, the book develops new diagnostical considerations on depression. It includes detailed case studies from clinical psychoanalytical practice, conceptual considerations and historical analyses to current empirical and neurobiological studies on depression. The book is unique in bridging a gap between Anglo-Saxon/German psychoanalysis and French traditions in relation to clinical treatment techniques and conceptualizations of depression and trauma. Chapters present new research on the social, biographical, genetic and neurobiological determinants of severe depressive disorder and explore how these can be differentiated and expanded in the face of new cultural realities as well of new findings particularly in modern neurosciences.

    The book explores new understanding and discussion of treatment options for depression and will be essential reading for researchers and students in the field of depression and mental health research. It will also enrich the conceptual and clinical knowledge of psychoanalysts and psychotherapy researchers and students.


              Marianne Leuzinger-Bohleber, Gilles Ambresin, Tamara Fischmann, Mark Solms

              Part 1: Introduction

    1. On the Dark Side.
    2. Marianne Leuzinger-Bohleber

    3. From Acedia to Melacholy: Sadness in the Presence of God
    4. Jean-Nicolas Despland

      Part 2: Clinical and conceptual psychoanalytical approaches to depression and trauma

    5. The unpast core of depression 
    6. Dominique Scarfone


    7. The invisible depression
    8. Nicolas de Coulon

    9. The denied object of melancholia
    10. JC Rolland

    11. The psychoanalysis of a chronically and severely depressed patient
    12. Bernard Reith,

    13. "Switching the light off to cast the shadow away"
    14. Jean-François Simoneau

    15. Getting out of the shadow of the object
    16. Anne Brun

    17. Together in the magma of despair
    18. Valérie Bouville

    19. The presence of God in a melancholic patient
    20. Gérard Winterhalter


    21. Some aspects of early development and depression: The case of Thea, an adolescent
    22. Silke Kratel Cañellas

    23. Early Depressions: Loss of liveliness, withdrawal, psychosomatic issues and risk of developmental delay
    24. Christine Anzieu-Premmereur


      Part 3: Empirical and interdisciplinary research on depression and trauma

    25. Outcome Studies on longterm psychoanalytical psychotherapies on chronic depression: The MODE Study
    26. Gilles Ambresin, Tamara Fischmann, Marianne Leuzinger-Bohleber

    27. Memory re-consolidation and dreaming: shadows of the night
    28. Tamara Fischmann, Marianne Leuzinger-Bohleber, Gilles Ambresin

    29. Depression in Neuropsychoanalysis: Why does depression feels bad?
    30. Mark Solms,

    31. Thoughts on the failure of intersubjective development following maternal-child trauma and loss
    32. Daniel S. Schechter

    33. Containing darkness:

                Siri Gullestad


    Marianne Leuzinger-Bohleber is Professor Emeritus for psychoanalysis at the University of Kassel, past director in charge of the Sigmund-Freud-Institut in Frankfurt and now researcher at the Universitymedicine in Mainz, Germany.

    Gilles Ambresin is Research Lead in the research program on chronic depression at the University Institute of Psychotherapy, Lausanne University Hospital, Switzerland.

    Tamara Fischmann is Professor of clinical psychology and psychoanalysis at the International Psychoanalytic University (IPU) Berlin, Germany and researcher at the Sigmund-Freud-Institut (SFI) Frankfurt a.M.

    Mark Solms is Chair of Neuropsychology at the University of Cape Town and Groote Schuur Hospital, South Africa.

    "This is a long-awaited book integrating psychoanalytic insights into chronic severe depression with progress that has been made in psychoanalytic and sociocultural research. It is an excellent and unique contribution which all clinicians will benefit from." 

    Peter Fonagy, Head of the Division of Psychology and Language Sciences at UCL; Chief Executive of the Anna Freud National Centre for Children and Families, London; Consultant to the Child and Family Programme at the Menninger Department of Psychiatry and Behavioural Sciences at Baylor College of Medicine; and holds visiting professorships at Yale and Harvard Medical Schools. 


    "As the prevalence of depression grows, the need for better treatments is heightened. This volume provides an in-depth exploration of the psychodynamic and socio-cultural mechanisms of depression including new research on the role of early childhood trauma. I recommend this book to anyone who wishes to expand their understanding of depression beyond conventional approaches."

    Richard D. Lane, MD, PhD, Professor of Psychiatry, Psychology and Neuroscience, The University of Arizona, USA


    "Reading this book is an inspiring experience. A fresh approach is presented to the nature of chronic depression using modern interdisciplinary language. The book entails a promise of important new understanding of why the suffering of people with long-term depression has been so difficult to change. Highly recommendable."

    Johannes Lehtonen, Professor of Psychiatry Emeritus, University of Eastern Finland; Adjunct Professor of Clinical Neurophysiology, University of Turku, Finland; Member of The Finnish Psychoanalytical Society


    "A book for readers who sense the value of an in-depth integrated understanding of depression: how it is essential if an injured individual is to grow emotionally; and as well for all of us as creatures, each with our natures, histories, nationalities and cultures in the approaching global crisis of our species."

    Dr David Taylor, Training & Supervising Analyst of the Institute of Psychoanalysis, London; Clinical Director of the Tavistock Adult Depression Study (TADS); Visiting Professor at UCL; and a trustee of the Melanie Klein Trust


    "This book admirably shows why depression needs a psychoanalytic approach that goes beyond the symptoms and addresses the suffering human beings, their bodies and minds, their history and traumas, and their family and social life."

    Ricardo Bernardi, Professor Emeritus at the School Medicine, Uruguay; "Honorary Member" ("Miembro de Honor") and Training Analyst of the Uruguayan Psychoanalytical Association (APU) and of the Uruguayan Society of Psychiatry; Full Member of the National Academy of Medicine, Uruguay; IPA Extraordinarily Meritorious Service to Psychoanalysis Award (2021); Mary S. Sigourney Award for Major Contribution to Psychoanalysis (1999); International Journal of Psychoanalysis (IJP) Best Paper Award (2003)


    "This volume that originated in the work of the 2020 Joseph Sandler Conference in Lausanne offers readers at all levels of psychoanalytic experience a comprehensive, state-of-the-art exploration of an integrative model of depression seen from varying perspectives. These include empirical, metapsychological, social-scientific, research-based and clinical considerations. In doing so, it addresses core clinical issues of narcissism, trauma, intra-psychic and relational conflict and examines and exemplifies the important role of empirical research in psychoanalysis. The result is a much-valued resource for the understanding of the origins, presentations and treatment of depression in its many manifestations, that range from classical melancholia to essential depression and from neurosis to psychosis."

    Howard B. Levine, MD, Editor-in-Chief, The Routledge WR Bion Studies Series