part. They are those which occur after the loss of a loved object, whether by death or as a result of circumstances which have necessitated the withdrawal of the libido from the object. A psychogenic melancholia of this sort can end in mania, and this cycle can be repeated several times, just as easily as in a case which appears to be spontaneous. Thus the state of things is somewhat obscure, especially as only a few forms and cases of melancholia have been submitted to psycho-analytical investigation.[1] So far we only understand those cases in which the object is given up because it has shown itself unworthy of love. It is then set up again inside the ego, by means of identification, and severely condemned by the ego ideal. The reproaches and attacks directed towards the object come to light in the shape of melancholic self-reproaches.[2]
A melancholia of this kind may also end in a change to mania; so that the possibility of this happening represents a feature which is independent of the other characteristics in the symptomatology.
- ↑ Cf. Abraham: 'Ansätze zur psychoanalytischen Erforschung und Behandlung des manisch-depressiven Irreseins', 191 2, in Klinische Beiträge zur Psychoanalyse, 1921.
- ↑ To speak more accurately, they conceal themselves behind the reproaches directed towards the person's own ego, and lend them the fixity, tenacity, and imperativeness which characterize the self-reproaches of a melancholiac.
