Let us now apply to melancholia what we have learned about sadness. In a number of cases, it is quite obvious that it can also be a reaction to the loss of a loved one. For other reasons, it can be established that a more ideal loss in nature took place.
The object did not really die, but was lost as an object of love (for example, the case of the abandoned bride).
In other cases, one may think that the assumption of such a loss is quite correct, but it is impossible to establish exactly what was lost, and even more so, one can assume that the patient himself cannot clearly understand what exactly he has lost.
This case can also occur when the patient knows the loss that caused melancholy, because he knows whom he has lost, but does not know what he has lost in him.
Thus it seems natural to us to relate melancholy to the loss of an object somehow inaccessible to consciousness, in contrast to sadness, in which there is nothing unconscious in the loss.
In sadness, we have found that the delay and lack of interest is entirely due to the work of sadness, which completely captured the «I». A similar inner work will be the result of an unknown loss in melancholia, and is therefore responsible for the melancholic delay (Hemmung). The point is only that the melancholy delay produces an incomprehensible impression on us, because we cannot see what exactly so completely captured the sick. The melancholic shows us one more feature that is not present in sadness — an unusual decrease in one’s well-being, a huge impoverishment of the «I». With sadness, the world became impoverished and empty; with melancholy, the “I” itself.
The patient paints his “I” for us as unworthy, worthless, worthy of moral condemnation — he reproaches himself, scolds himself and waits for rejection and punishment. He humiliates himself in front of every person, pities each of his loved ones that he is associated with such an unworthy person. He has no idea of the change that has taken place with him, and he extends his self-criticism to the past; he claims he has never been better.
This picture of a predominantly moral delusion of understatement is complemented by insomnia, food refusal, and, psychologically, a very remarkable overcoming of the drive that makes all living things cling to life.
Scientifically as well as therapeutically, it would be equally pointless to object to a patient who raises such accusations against his «I».
In some respect he must be right in saying something that fits his idea. Some of his instructions we must immediately confirm without any restrictions. He really is so alien to all interests, he is so incapable of loving and working, as he claims. But, as we know, this is a secondary phenomenon, a consequence of an inner work unknown to us, similar to the work of sadness that absorbs his “I”.
In some other self-accusations, he also seems to us to be right, evaluating the present situation, only somewhat more sharply than other non-melancholics.
If, in heightened self-criticism, he portrays himself as a petty, selfish, insincere, dependent person, always striving only to hide his weaknesses, then, perhaps, as far as we know, he came quite close to self-knowledge, and we only ask ourselves why first get sick to understand this truth. Because there is no doubt that the one who has reached such a self-esteem and expresses it before others — Prince Hamlet’s assessment for himself and for all others … — he is sick, regardless of whether he speaks the truth or is more or less unfair to yourself.
It is also easy to see that there is no correspondence between the magnitude of self-humiliation and its real justification.
A nice, sensible and faithful woman, in a fit of melancholy, will condemn herself no less than a really worthless woman. And perhaps the former is more likely to fall ill with melancholy than the latter, about which we could not say anything good.
Finally, we should be struck by the fact that the melancholic behaves not quite like the one normally overwhelmed by remorse and self-reproach.
The melancholic does not have shame in front of others, which is most characteristic of such a state, or shame is not so pronounced. In a melancholic, one can, perhaps, emphasize the state of obsessive sociability, which finds satisfaction in self-disclosure.
Thus, it does not matter whether the melancholic is so right in his painful self-humiliation that his self-criticism coincides with the judgment of others about him. More importantly, he correctly describes his psychological state. He has lost his self-respect, and of course he has a reason for this, in any case, here we have a contradiction that poses an intractable riddle to us. By analogy with sadness, we must come to the conclusion that he has lost the object; it follows from his words that his loss concerns his own self.
Before dealing with this contradiction, let us dwell for a moment on what is revealed to us thanks to the disease of the melancholic in the constitution of the human «I». We see in him how one part of the «I» is opposed to another, makes a critical assessment of it, makes it, as it were, an extraneous object. All further observations will confirm our assumptions that the critical instance split off from the “I” will show its independence under other circumstances as well. We will indeed find enough reason to separate this instance from the rest of the «I». What we are dealing with here is the agency usually called conscience. Together with the censorship of consciousness and the study of reality, we will rank it among the most important formations (Institutionen) and somehow find evidence that this instance can become ill by itself. In the picture of the illness of the melancholic, moral dissatisfaction with oneself comes to the fore in comparison with other complaints; physical weakness, ugliness, weakness, social low value are much less often the subject of self-esteem; only impoverishment takes precedence among the fears and statements of the patient.
The above contradiction is explained by an observation that is not difficult to make. If one listens patiently to the various self-accusations of the melancholic, one cannot help but be under the impression that the heaviest reproaches are often very little suited to the patient’s own personality, but, with some minor changes, are easily applicable to some other person whom the patient loved, loves or should have loved. No matter how many times you check the situation, this assumption is always confirmed. Thus, you get in your hands the key to understanding the picture of the disease, having discovered in self-reproaches reproaches against the beloved object, transferred from it to your own «I».
A woman who verbally pities her husband for being associated with such a worthless wife wants, in fact, to accuse her husband of worthlessness, in whatever sense this may be understood. There is nothing to be surprised that among the imaginary self-reproaches directed at oneself, some real ones are woven; they have been able to come to the fore, since they help to cover up others and contribute to the distortion of the true state of things: they arise from the struggle for and against love, which led to the loss of love. Now the behavior of patients is becoming much clearer. Their complaints are accusations (Anklagen) in the former sense of the word, they are not ashamed and do not hide themselves, because all the humiliating things that they say about themselves are said about others; they are far from being able to show in relation to those around them the humility and humility that would correspond to such unworthy persons as themselves; on the contrary, they are extremely quarrelsome, always as if offended, as if a great injustice had been done to them. All this is possible because the reactions of their behavior also proceed from the spiritual orientation of indignation, translated through a special process into melancholic depression.
Further, it is not difficult to reconstruct this process. First there was the choice of the object, the attachment of the libido to a certain person; under the influence of real grief or disappointment on the part of the beloved type, this attachment to the object was shaken. The consequence of this was not the normal withdrawal of libido from this object and its transfer to a new one, but another process, for the appearance of which, apparently, many conditions are necessary. Attachment to the object turned out to be unstable, it was destroyed, but the free libido was not transferred to another object, but returned to the «I». However, here it did not find any application, but served only to identify (identify) the «I» with the abandoned object. The shadow of the object has thus fallen on the «I», which in this case is considered by the said special instance in the same way as the abandoned object. Thus the loss of the object became the loss of the «I» and the conflict between the «I» and the loved person became a clash between the criticism of the «I» and the «I» itself changed by identification.
Some of the premises and results of such a process can be directly guessed. On the one hand, there must have been a strong fixation on the beloved object, and on the other hand, in contradiction to this, a slight stability of attachment to the object. This contradiction, as O. Rank rightly remarks, seems to require that the choice of object be made on a narcissistic basis, so that in the event object attachment is hindered, that attachment regresses to narcissism. The narcissistic identification with the object then replaces the attachment to the object, and this has the consequence that, despite the conflict with the loved one, the love affair must not be interrupted. This replacement of object love by identification constitutes a significant mechanism in narcissistic illnesses.
Melancholia thus takes part of its characteristics from sadness and another part from the process of regression from the narcissistic choice of object. On the one hand, melancholia, like sadness, is a reaction to the real loss of the object of love, but, in addition, it is also associated with a condition that is absent in normal sadness or turns it into pathological in those cases where this condition is added. The loss of a love object is a great opportunity to awaken and express the ambivalence of a love relationship. Where there is a predisposition to compulsion neuroses, the ambivalent conflict gives the sadness a pathological character and causes it to manifest itself in the form of self-reproaches that one is guilty of the loss of the beloved object, i.e. he wanted her. In such depressions in obsessive neuroses, after the death of a loved one, we are confronted with that which accomplishes the ambivalent conflict in itself, if the regressive withdrawal of libido does not take part in this.
The causes of melancholia, for the most part, are not limited to a clear case of loss due to death and cover all situations of grief, resentment of disappointment, due to which the opposite of love and hatred is drawn into the relationship or the existing ambivalence is intensified. This ambivalent conflict, sometimes of a more real, sometimes of a more constitutional origin, always wins attention among the causes of melancholy.
If love for an object that cannot be abandoned, while the object itself is being abandoned, finds its outlet in narcissistic identification, then hatred is manifested in relation to this object, which serves as a substitute, as a result of which this new object is insulted, humiliated and inflicted on him. suffering, and through this suffering, hatred is sadistically gratified.
It is this sadism alone that solves the riddle of the suicidal tendency that makes melancholy so interesting and so dangerous.
In the primal state from which the life of instincts proceeds, we have discovered such an enormous narcissism of the «I» in the fear arising from life-threatening danger, we see the release of such an enormous amount of narcissistic libido that we do not understand how this «I» can go to self-destruction. . Although we have known for a long time that no neurotic has a suicidal impulse, not based on the impulse to kill another, turned on himself. But it still remained unclear what forces could play such an intention into an act.
Now the analysis of melancholy shows us that the «I» can kill itself only if, by turning the attachment to objects on itself, it relates to itself as an object, if it can direct against itself hostility that is related to the object and replaces the original reaction » I», to the objects of the external world …
Thus, in the regression from the narcissistic choice of object, this object, although eliminated, was still more powerful than the self itself. In the two opposite positions of extreme love and suicide, the object completely overcomes the ego, albeit in completely different ways.