Winnicottian Depression
This paper will explore the clinical phenomena of depression through Donald Winnicott’s model of object relations. Winnicott viewed early development as a progression through phases of dependence, each requiring a specific form of caregiver adaptation to sustain the infant’s emerging sense of self. One of Winnicott’s core concepts is that, as infants, we are born into a phase of absolute dependence. The personality at this level of development requires a good enough facilitating environment to support the fundamental tasks of integration, personalization, and realization, all of which are prerequisites to feeling real in the world with a coherent sense of personal identity (Palombo, Bendicsen, & Koch, 2009). When a good enough facilitating environment fails in certain critical ways—what Winnicott calls impingement—the child’s capacity for a relatively calm existence is disrupted, with potentially significant emotional consequences, including depression.
Absolute Dependence and Undifferentiated Experience
The initial phase of life is one of absolute dependence. This occurs during the first six months of life when the proto-mind has no experience of externality. Winnicott stressed that the baby has no awareness of an external world—mother and infant form a unit, and the mother’s adaptive responses practically create the environment the infant inhabits. According to Winnicott’s theory, however, the infant has not yet experienced the differentiation between self and other. Because the infant cannot yet integrate feelings of frustration within the psyche, there must be an active, good enough maternal adaptation to the infant’s needs “that gradually lessens, according to the infant’s growing ability to account for failure of adaptation and to tolerate the results of frustration” (Winnicott, 1971, p. 13).
A failure or chronic lack of responsiveness at this stage can generate primitive anxieties about annihilation—what Winnicott (1960) calls the fear that “the alternative to being is reacting, and reacting interrupts being and annihilates” (p. 47). If the caregiver consistently fails to adapt, the baby cannot continue ‘going-on-being’ but instead must react by organizing defensive structures to manage the imagined threat of annihilation. This scenario plants the seeds for a defensive structure Winnicott refers to as the false self. In severe or prolonged environmental failure, a majorly depressed state rooted in a pathologically mantled false self can emerge, as the infant’s earliest impulses for aliveness are stifled by unmanageable frustration and an absence of essential holding.
Anaclitic and Introjective Depression
Historically, at least two different categories of depression exist in psychoanalytic literature. Rene Spitz (1945) identified anaclitic depression, a form of depression resulting from an infant’s experience of profound separation from their primary caregiver. The main issue in anaclitic depression is unmet dependency needs, and the core fears are related to neglect, abandonment, and loneliness. Sydney Blatt’s (2004) notion of introjective depression, on the other hand, focuses on an overly harsh introjected critical parental imago, resulting in feelings of guilt, worthlessness, shame, failure, and a pervasive fear of criticism or disapproval. The introjective version of depression is rooted in Freud’s notion of melancholia. A key discerning factor in these two types of depression is that anaclitic depression manifests more as hopelessness and helplessness, whereas introjective depression manifests more as self-hatred. The introjective type of depression requires consideration of aggression and how it gets managed intrapsychically. Winnicott underscored that a good enough holding environment helps contain aggression in an integrated self without over-reliance on the false self. Integration here means that the true and false selves coexist and integrate. He argued that humans begin with an inviolable connection to the true self—our ‘ground’ of experience—a connection with whose vitality counters depression. It is important to note that the false self is also a significant achievement in the developing personality. The false self is related to the reality principle, in which the mind understands that delay of gratification and role performance are essential to living with others and thriving in the world. The false self is critical because it gives the subject a sense of efficacy and power. The true self is also necessary because it gives the personality a sense of vitality, which is the opposite of depression.
Impingements in the holding environment, especially during early dependency phases, can create a situation in which the infant must comply or adapt to the caregiver’s needs at the expense of personal spontaneity. This is Winnicott’s concept of traumatic impingement. Over time, this compliance becomes a defensive structure, i.e., the pathological aspect of the false self. Winnicott outlines this as follows:
“If maternal care is not ‘good enough,’ infants do not come into being but instead develop a personality based on reactions to environmental impingements. These impingements prevent the development of the True Self. The mother who is not ‘good enough’ struggles to manage the child’s omnipotence and instead substitutes her own, leading infants to become compliant. This experience is a precursor to the emergence of the inauthentic and defensive False Self” (Palombo, Bendicsen, & Koch, 2009, p. 151).
If environmental failures are repeated or severe, the false self can dominate, leaving the true self hidden or ‘encapsulated,’ with an attendant loss of vitality. It is this loss of vitality—an absence of spontaneous experience or a ‘sense of realness’—that Winnicott considered the essence of many depressive states.
Destruction of the Object and Relative Dependence
Winnicott speculated that at roughly six months of age, the infant becomes aware that she does not control the sources of gratification. This is what he refers to as 'destruction of the object.’ This kind of aggression is not intentionally directed towards the object, as in Melanie Klein's theory of primary envy. Instead, it is the primordial act of separation-individuation itself. It marks the transition from the period of ‘oneness’ to ‘twoness’—from omnipotent harmony to a reality in which differentiation exists. Winnicott says, “There is no anger in the destruction of the object... though there could be said to be joy at the object’s survival” (Winnicott, 1968, p. 715). It is a period that involves a grieving process, and transitional objects and phenomena are supposed to help with this loss of assumed omnipotence. This marks the beginning of the period of relative dependence.
As the infant’s ego capacity grows, the child transitions to relative dependence, becoming increasingly aware of her external environment. Where the baby previously assumed a merged unity with the mother, now there is some recognition of the mother as a separate person. This shift also corresponds to the infant’s need to manage separation anxieties and the frustrations inherent in discovering that needs are not automatically or omnipotently met. One of Winnicott’s most important ideas for the phase of relative dependence is the use of transitional objects, which mediate between the child’s inner world of omnipotent fantasy and the outer world of reality. The famous ‘teddy bear’ or ‘blanket’ becomes imbued with psychological qualities drawn from the mother, helping the child manage temporary absence and reduce annihilation anxiety. Winnicott (1971) writes:
“The infant can employ a transitional object when the internal object is alive, real, and good enough (not too persecutory). However, this internal object depends on its qualities, such as the external object's existence, aliveness, and behavior. Failure of the latter in some essential function indirectly leads to deadness [anaclitic depression] or a persecutory quality of the internal object [introjective depression]” (p. 13; brackets added).
A child deprived of an attuned caregiver at the phase of absolute dependence may experience a pervasive sense of alienation and hopelessness. This type of anaclitic depression can manifest as an inner deadness, reflecting a fundamental doubt in the reliability of external and internal sources of comfort. Introjective depression’s developmental etiology occurs in the phase of relative dependence because the trauma that creates depressive symptomology occurs after the establishment of subject-object distinction. In Winnicott’s theory of mind, I believe that introjective depression would be related to the loss of the object and subsequent failure to mourn rather than the annihilation anxiety stemming from the earliest anaclitic phase.
Aggression and ‘Destruction’ of the Object
In the stage of absolute dependence, the infant ‘relates to’ objects in a largely subjective manner: the object (caregiver) is experienced as an extension of the infant’s internal world (i.e., a projection of the infant’s needs, fantasies, and aggression). The caregiver is not fully recognized as an independent ‘other’ but as something the infant imagines or creates in their mind. Winnicott posits a crucial developmental leap: the child moves from ‘relating’ to ‘using’ the object, which requires acknowledging the caregiver’s actual, separate existence. This transition involves the child testing the object—often through benign aggression (anger, frustration)—and discovering that the object survives (i.e., remains present, unbroken, and loving) despite that aggression. When the caregiver can withstand the child’s intense emotional expressions without retaliating, collapsing, or withdrawing love, the child internalizes a new awareness: “My aggressive impulses didn’t destroy you; you exist outside of my omnipotent control. Therefore, I love you.” Survived aggression is a key protective factor against clinical depression of any form.
Winnicott sees aggression as serving two functions, first ‘as a source of energy,’ and second as a reaction to frustration.’ (Winnicott, 1984, p. 92). The element of aggression as a source of energy is linked to the true self. In contrast, the element that is a reaction to frustration is responsible for creating the pathological false self, which can have a deadening effect. The pathological aspect of the false self is a defense against the annihilation anxiety that manifests when the infant or child experiences a chronic failure in their primary holding environment. This creates a whole range of personality disorders. Depression may be linked to the false self, which would imply a sort of self-narrative about the depressed sense of one’s life, which is very often found in forms of major depressive disorder.
The Surviving and Non-Surviving Objects in Depression
If the caregiver ‘survives’ the child’s aggression, the child begins to feel genuine concern for the object as a separate being. The child can then experience guilt (in a healthy, integrative sense) over their aggression and a wish to repair potential damage they’ve done. This capacity for concern is central to mature relating and fosters empathy, responsibility, and emotional depth. If, in response to the child’s ‘destruction,’ the caregiver becomes emotionally unavailable, retaliatory, or punishing—or if the environment is chronically failing—the child’s aggression feels genuinely destructive. The child may then internalize a belief that they have, in fact, ‘killed’ or destroyed their object, contributing to overwhelming guilt, shame, or despair—core features of introjective depressive states.
When the caregiver does not survive (i.e., cannot contain the child’s aggression), the child cannot integrate love and hate. In this position, there is no stable, reliable ‘other’ to help the child form a balanced sense of self and other. This lack of integration can manifest in introjective depression, where hate and love remain split or under-acknowledged. Suppose the child (later the adult) feels they have destroyed the object they depend on for love. In that case, they may live with chronic, unresolved guilt. Without the experience of object survival, the person may doubt relationships can withstand conflict or aggression. Hopelessness and basic mistrust can underpin both anaclitic and introjective depressive worldviews: “No one can bear me as I am.” A child whose aggression was not survived by the object might develop a defensive or compliant false self to prevent further ‘damage’ to fragile caregivers.
In therapy, the analyst/therapist ‘surviving’ the patient’s aggression without retaliating or collapsing re-enacts the possibility of object survival. This corrective experience can mitigate depression by gradually showing the patient that their aggression isn’t inevitably destructive, allowing genuine concern and hope for reparation to re-emerge. By holding and understanding both loving and aggressive impulses in the psychoanalytic process, the patient can move from a polarized, despairing view of self/other to a more integrated sense of relating (object usage), easing depressive symptoms tied to guilt and perceived destructiveness. Object survival is pivotal: the child’s aggression is developmentally normal, but it can become a source of deep depression if the caregiver fails to survive as a stable, loving presence. ‘Using the object’ means discovering that one’s primary object is not annihilated by aggression; this lays the groundwork for empathy, concern, and healthy relating. Depression can arise when there’s a failure at this developmental step, leaving the individual feeling chronically guilty, unworthy, or as if meaningful relationships cannot endure their real feelings.
In conclusion, it is worth noting that not all non-surviving objects are equal. A caregiver who inconsistently responds versus one who is outright abusive produces different diagnostic outcomes. The degree and timing of these failures can shape whether someone ends up with a more introjective guilt-depressive dynamic (e.g., “I destroyed my object”) or a more externalized, antisocial stance (“No one ever survives, so I don’t bother caring”). Early aggression or anxiety can be directed outward in one child (leading to acting out and antisocial traits) and turned inward in another (leading to guilt, self-reproach, and depressive symptoms). How that aggression is managed—by the child’s temperament, the caregiver’s attunement, and the broader environment—helps explain why these paths diverge. Winnicott’s concept of the ‘surviving object’ highlights a core developmental process—the child’s discovery that they can be angry or destructive and remain in a relationship with a stable, loving caregiver. Jan Abram (1996) reminds us that this process isn’t just isolated to the beginning phases of life: “Survival-of-the-object is required at each stage of development from childhood to adulthood and is part of the provision of a stable environment that contributes to the internalized continuity-of-being that facilitates the tasks facing each stage of development” (p. 45).
References
Abram, J. (1996). The surviving object: Psychoanalytic essays on psychic survival. Routledge.
Blatt, S. J. (2004). Experiences of depression: Theoretical, clinical, and research perspectives. American Psychological Association.
Palombo, J., Bendicsen, H. K., & Koch, B. J. (2009). Guide to psychoanalytic developmental theories. Springer.
Spitz, R. A. (1945). Hospitalism—An inquiry into the genesis of psychiatric conditions in early childhood. Psychoanalytic Study of the Child, 1, 53–74.
Winnicott, D. W. (1960). The theory of the parent-infant relationship. International Journal of Psychoanalysis, 41, 585–595.
Winnicott, D. W. (1968). The use of an object and relating through identifications. The International Journal of Psychoanalysis, 49(2-3), 711–716.
Winnicott, D. W. (1971). Playing and reality. Routledge.
Winnicott, D.W. (1984). Deprivation and delinquency. London: Tavistock.