Die entkopplung des selbst in der depression: Empirische befunde und neuropsychodynamische hypothesen

The self and the changes in the subjective experience or the self are central dimensions or depression and psychodynamic accounts. Thereby the experience of loss of the own self dominates in acute depression. Based on empirical findings, we here develop neuropsychodynamic hypotheses about the self in depression. We assume that the empirically well demonstrated elevated resting state activity in depression constitutes a neural predisposition for the subsequent reactivation of former traumatic experience of loss of object-relations; this leads to reduced rest-stimulus interaction and introjection coupled with negative affect and sadness as associated with the lost object. Due to reduced rest-stimulus interaction, the neuronal structure and organization is supposed to develop abnormally in depression thereby impacting and imposing the previous object-loss onto the current encounter with actual objects. We therefore hypothesize that the abnormally elevated resting state activity decouples and dissociates the self from actual object-relations. This loss of subjectively perceived and experienced actual objects is compensated for by the increased constitution of internal objects as either somatic-bodily or cognitive-mental as a sort of mental environment replacing the physical one.