Freud believed that psychotic depression, formerly known as melancholia, was caused by internalized feelings of guilt, hatred, shame, or anger. The internalized feelings caused a regression to infantile narcissism, in which the person identified extremely with an original target of uncomfortable emotions. Instead of properly directing anger or hatred toward the originally intended target, the individual becomes self-absorbed. For example, Fr
Through psychotherapy, Freud traced the origins of her self-directed anger toward the woman's mother. The spot on the woman's arm that she continuously picked at happened to be the same spot in which her mother had a birth mark. With Freud's help the woman discovered that she had subsumed her personal identity by her mother's: instead of acknowledging her hatred of her mother she developed self-hatred. Appignanesi notes that the extreme misi
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