The Letter, Issue 26, Autumn 2002, Pages 212 - 224
DEPRESSION, SIGN OF THE TIMES? ON THE REAL IN CLINICAL WORK
Els Van Compernolle
Depression is omnipresent in contemporary clinical praxis. With statistics showing an enormous increase in the number of depressions in the last decades, depression is diagnosed as a sign of the times, inextricably bound up with the fate of the post-modern subject. Simultaneously, another change or shift is taking place: the so-called classical symptoms, with a psychosexual aetiology, seem to have disappeared (the disappearance of classical hysteria being a well-known example); instead, 'new symptoms' are emerging, with borderline, self- mutilation, eating disorders, aggressive and sexual acting out, etc... operating as new labels. It is as if the real is gaining ground on the symbolic in present-day psychopathology.
In this paper, I discuss whether these two parallel trends are linked through a common cause, meaning that there is an underlying structural reason. My central thesis is that what we are seeing today in the high prevalence of depression is an anxiety-neurotic depression. By this I mean a form of depression functioning as a limit of the psychosexual or symbolic efficacy, situated at the border between the Real of puissance (the Other of the body) and the symbolic play of signifiers (the Other of language). I will argue, firstly, that depression can be phenomenologically present in the different clinical structures (that there's the possibility of a psychotic, perverse and neurotic way of being depressive), and secondly, that different modalities of depression in one and the same structure can occur, by opposing the anxiety-neurotic depression to the 'classical depression' (as can appear in the transference situation). Here, I will confine myself explicitly to the neurotic structure.