© 2009 The Royal College of Psychiatrists
Anger and depression
Fredric N. Busch is Clinical Associate Professor at Weill Cornell Medical College and a faculty member of the Columbia University Center for Psychoanalytic Training and Research. His publications and research have focused on the links between psychoanalysis and psychiatry, including psychodynamic approaches to specific disorders, psychoanalytic research, and psychoanalysis and medication.
Correspondence: Correspondence Dr Fredric N. Busch, 10 East 78th Street, New York, NY 10075, USA. Email: fnb80{at}aol.com
A series of psychoanalytic theorists and clinicians have suggested that conflicts about anger play a central role in the development of depression. Research data have supported the notion that patients struggle with the experience and expression of angry feelings. Anger in people with depression often stems from narcissistic vulnerability, a sensitivity to perceived or actual loss or rejection. These angry reactions cause intrapsychic conflicts through the onset of guilt and the fear that angry feelings will disrupt relationships. These conflicts lead to anger being directed inwards, further lowering self-esteem, creating a vicious cycle. Defence mechanisms that are triggered, including passive aggression, reaction formation, denial and identification with the aggressor, are ineffective at managing these conflicts and further prevent the appropriate expression of anger. This article discusses how to identify and detoxify angry feelings and fantasies using a psychodynamic approach.
Related articles in APT:
- Eclecticism
- Joe Bouch
APT 2009 15: 241.[Full Text]