Consenting to be robbed so as not to be murdered

Abstract

This paper first addresses the place of psychoanalysis in relation to certain other key bodies of knowledge: the thesis is that psychoanalysis is best understood as a highly specialized branch of human biology. Within this framework the main psychoanalytic ideas about depression in adults are described, giving particular attention to depression when it becomes a chronic, treatment-resistant state. Goldberg shows (pages 236–247 this issue) that the advances in genetics and neurobiology can be connected with those in developmental research (Murray & Hill, pages 185–199 & 200–212 this issue). This enables new light to be thrown upon the psychobiological diathesis which seems to underlie depression. This paper argues that an investigation of subjectivity and meaning is also necessary if our account of depression is to be complete. Without an understanding of meaningfulness, the function of the brain cannot be fully known. Finally, some clinical material shows why psychic reality has to be approached in its own terms.

Keywords:

• psychoanalysis
• chronic depression
• compromise equilibrium
• subjectivity

Notes

1. TADS Principal Investigator: Professor Peter Fonagy [formerly Phil Richardson (deceased, 2007)]; Senior researchers: Felicitas Rost, Adam Campbell, Susan McPherson and Jo-anne Carlyle; Junior researchers: Lucy Gibson, Donna Oxley, Rachel Tucker, Lucy Chan and Peter Cairns; Research administration: Sharon Novara; Research Clinician: Rachel Thomas; current affiliates: Drs Niloufar Noktehdan, Hiroshi Amino and Maxine Dennis.

2. The members of the TADS workshop include Mary Bradbury, Cyril Couve, Stephen Dreyer, Marcus Evans, Caroline Garland, Liz Gibb, Francesca Hume, Birgit Kleeberg, Julian Lousada, Michael Mercer, David Millar, Matthew Patrick, Phil Stokoe and Nollaig Whyte.

3. The co-worker on this project is Dr Niloufar Harris. The dynamic typology will be the subject of a forthcoming paper.

4. The answer to the question of whether this is sufficient to demonstrate a clinically significant difference according to the changes in the standard measures will become known when the first results begin to be analysed in 2011/12.

5. This material preserves the clinical veracity but is disguised and varied to preserve confidentiality.

6. The reason for the change in attitude, the abandonment of a belief that only behaviour exists and is worth taking seriously – the cognitive revolution – may in some circles at least be connected with the greater evidence of the objective correlates of mental activity that could be found in brain function, and of all sorts of consequences and performances that can be observed and investigated.