ABSTRACT
In Chapter 1 of this book I suggested that a return to theory might provide an opportunity to shed some additional light on the gloomy impression nowadays that most depressions are refractory and prognostically susceptible to relapse. In this chapter the phenomenon of relapse will be explored within an object relations framework. The intention is to show that a certain long-standing strand of thinking within psychoanalytic theory may allow for a different conceptualization of the structure of depression that, in turn, may provide some new thoughts on the apparent intractability of the disorder, as re¯ected in the high prevalence of relapse so frequently documented in the research and the clinical literature. This structure, incidentally, was pre-eminent in how the early pioneers in psychoanalysis approached depression: they always took notice of the interrelationship between depression and mania.
