Theoretical overview of the role of core shame in anaclitic and introjective depression etiology

Clinical and empirical evidence in support of Sidney Blatt’s theory suggests that depression revolves around two topics: interpersonal concerns such as feelings of abandonment and loneliness (anaclitic depression) and self-image disorder such as feelings of personal failure, inadequacy, and perfectionism (introjective depression). However, previous research, in line with the Roden et al.’s Model, considers narcissistic vulnerability to be the basis of depression, the essence of which is the experience of shame avoided by patients with both types of anaclitic and introjective depression through a certain type of defense mechanism. Although the two types of depression have similar symptoms, they need independent treatments with different levels of emphasis, so that patients with anaclitic depression need agency and independence in interpersonal relationships, while those with introjective depression need an emphasis on self-compassion. Although Blatt et al. have theoretically separated these two groups of depressed patients for many years, no studies have seriously focused on the common underlying factors in the two groups of patients and the different defenses of each group to avoid the underlying factors and subsequently design an appropriate treatment. Therefore, this study aims to investigate the common underlying factors of the two types of depression for which to seek appropriate treatment.