Developmentalist metatheory of depression and psychotherapy

Abstract

Examination of the theoretical and clinical literature reveals that the psychological understanding of depression is complex and varied, often differing among major schools or theorists. These variations in conceptual perspective (e.g., drive, ego, object relations, self, interpersonal, cognitive) also naturally impact, directly or indirectly, upon the nature of treatment. This paper has attempted to integrate diverse points of view by offering a developmentalist metatheory based on the psychosexual maturation of the patient. More specifically, four basic prototypes of depression have been depicted: Dyadic deficit depression (DDD), dyadic conflict depression (DCD), triadic deficit depression (TDD), and triadic conflict depression (TCD). Each etiologically relates to early childhood experiences of the individual and is traced to different developmental periods with their own unresolved conflicts or deficient parent(s)/child scenarios. Clinical signs and symptoms as well as therapist/patient interactions have been described and respective technical measures recommended. This schema has therapeutic implications both for the reapproachement of multiple frameworks and for individualized practice in the treatment of depression.