[Aggression in depression].

Abstract

In the random sample of 18 patients (10 female and 8 male) with the symptoms of the major depressive episode, V/296, DSM-III the author examines the questions of the aetiology, aim, form and mechanisms or aggression by the psychoanalytically oriented individual psychotherapy. The author finds that the aetiology of aggression in patients with depression arises not only from the biological basis but also from the dynamic psychopathological constellations of the personality structure and the configuration of the unconscious. The aggression aim in these patients is the protection of the fulfillment of the primary narcissism pathological needs. Among other things the author finds that their narcissism looks for cosmic spaces and that it breaks under the laws of the natural constants and relativity, whereas the loss of space and the flow of time have the meaning of the sequestrations of their self and the cognition of the crushing defeat. Their basic mechanism is masochistically sadistic. The psychotherapy of these patients requires big efforts, the control of the countertransfers and the adaptation of techniques.