ANACLITIC DEPRESSION

The term "anaclitic depression" was coined and promoted by René Spitz. Its first significant mention was in Spitz's article on "Hospitalism" (1945). The kindred concepts of hospitalism and anaclitic depression are described in chapter 14 of The First Year of Life (Spitz and Cobliner, 1965) in the context of a discussion of "The Pathology of Object Relations." Spitz might be said to have opposed both Otto Rank's thesis of the "trauma of birth" and the Kleinian idea of the "depressive position" in order to emphasize the study of anaclitic depression, weaning, and the development of the ego.

Spitz's use of the word "anaclitic" in this connection is in fact rooted in the Freudian notion of Anlehnung, or "leaning on," translated in the Standard Edition as "anaclisis." The etymological origin of "anaclisis" is the Greek ana-kleinen, "to support (oneself) on." The idea underlying Spitz's "anaclitic" is thus that of a relational object on which the subject can rely for support in the course of self-construction and self-differentiation; the perspective is the same as Freud's when he said that object-relationships depended anaclitically on the satisfaction of self-preservative needs. It will be recalled, too, that Freud distinguished between two types of object-choice, the anaclitic and the narcissistic: "there are two methods of finding an object. The first . . . is the 'anaclitic' or 'attachment' one, based on attachment to early infantile prototypes. The second is the narcissistic one, which seeks for the subject's own ego and finds it again in other people" (1905d, note added in 1915, p. 222n; see also Freud, 1914c, pp. 87-88).

The anaclitic object plays an important part in Spitz's theoretical model of the genesis of the object, a model taken up in France by such authors as René Diatkine and Serge Lebovici (1960). It may be defined as that object which the young child uses for purchase as he constructs and discovers his ego and as, at the same time and as part of the same progression, he passes through the three stages described by Spitz: an objectless stage, a pre-objectal stage, and an objectal stage properly so called. To characterize this object as anaclitic is furthermore quite in harmony with the Freudian notion of anaclisis, for it is through the satisfaction of its self-preservative needs that the baby in Spitz's model discovers the object and the object-relationship, a relationship that obtains not in the world of needs but in the world of wishes.

There can be no doubt that his extremely fruitful theorizing enabled Spitz, in his time, to propose a model of the genesis of mental representations that was at once developmental and metapsychological, and thus sharply distinct from that of John Bowlby, who has indeed been taken to task for somewhat shortcircuiting the issue of mental representations. At all events, two very different theoretical (and clinical) approaches to depression in infants have resulted.

For Spitz, such depressions are attributable to emotional deficiency—a partial deficiency in the case of anaclitic depression (which is reversible), but absolute in the case of hospitalism (irreversible, at least in principle). Mary Ainsworth (1962; see also Spitz, 1965, p. 267) has reiterated that such situations of emotional deficiency may be described as "quantitative" in that they are the outcome of an absence of the anaclitic object in actual historical reality (i.e., the physical separation of mother and child).

When the anaclitic object is missing from the relational environment, the child's instincts, and notably its aggressive instincts, are turned against the child itself; it has no external object upon which to focus, and at the same time no sufficiently stable and differentiated internal representation of the object yet exists. The danger of anaclitic depression and hospitalism is thus at its most acute between the ages of one and one-and-a-half, or in other words between the objectless stage and the fully objectal one.

Claims to the contrary notwithstanding, such psychopathological situations are by no means rare, and naturally they are very common during times of social disruption (war, displaced populations, natural disasters, etc.). It is interesting to note, historically speaking, that it was roughly at the same moment, in the immediate aftermath of World War II, that two things happened: no sooner had researchers turned their attention for the first time to the unsuspected abilities of babies, than René Spitz, Anna Freud, Dorothy Burlingham, John Bowlby, and others described depression, and Leo Kanner autism, in early infancy. It was as though according babies the "right" to a mental life of their own immediately entailed the possibility of their experiencing all the difficulties that inevitably attend any real mental activity: pain and suffering in the case of depression, madness in that of autism or early psychoses.

In more recent times the idea of anaclitic conditions has been widely questioned, even dismissed, yet it is still a point of reference for a good many authors, and there is no denying that it has effectively demonstrated the importance of the quality of the infant's relationship to the primary object in the construction of the ego, in the emergence of a representational capacity, and in the establishment of a psychosomatic equilibrium.

Bernard Golse

See also: Abandonment; Anaclisis/anaclitic; Hospitalism; Neurosis; Repetition.

Bibliography

Ainsworth, Mary D. Salter. (1962). The effects of maternal deprivation: A review of findings and controversy in the context of research strategy. In Mary D. Ainsworth and R. G. Andry (Eds.), Deprivation of maternal care. Geneva: World Health Organization.

Freud, Sigmund. (1905d). Three essays on the theory of sexuality. SE, 7: 123-243.

——. (1914c). On narcissism: An introduction. SE, 14: 67-102.

Lebovici, Serge. (1960). La relation objectale chez l'enfant. Psychiatrie de l'Enfant 1, 3,147-226.

Spitz, René A. (1945). Hospitalism: An enquiry into the genesis of psychiatric conditions in early childhood. Psychoanalytic Study of the Child, 1, 53-74.

Spitz, René A., and Cobliner, W. G. (1965). The first year of life: A psychoanalytic study of normal and deviant development of object relations. New York: International Universities Press.