What is it about?

There is an emotional configuration of depression that is experienced by many patients as only somewhat recognizable. It is what I call a state of “distant or unfamiliar me.” In this article I describe the nature of this self-state, and how it manifested on a psychiatric inpatient unit. I also address the act of interpersonal “witnessing” that facilitates therapeutic access to this aspect of self. Finally, I describe how clinicians contribute meaningfully to the process of therapy when they are willing to express their own suffering.

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Why is it important?

The self-state of depression that is described is largely unaddressed in the psychoanalytic literature. In addition, my focus on openly using the therapist's suffering contributes to the humanistic movement in psychoanalysis that benefits both clinician and patient. Finally, there has been a shortage of literature in recent years that describes in detail the nature of psychiatric inpatient units and how a psychoanalytic approach can be utilized in that setting.


Writing this article was deeply important to me. I worked on a psychiatric inpatient unit for over a decade, and the observations that inform this article are drawn from that period. While the paper is theoretical, it is grounded in what was a unique and moving experience: patients speaking openly to me and each other in a group setting. I am fortunate to have had the opportunity to facilitate these groups, as they were often painful, beautiful, and eye-opening. I hope I have succeeded in giving voice to a group of patients who often don't speak, and are not always heard when they do.

Adam Kaplan

Read the Original

This page is a summary of: Hidden in plain sight: Creating space for the elusive “me” of depression., Psychoanalytic Psychology, April 2018, American Psychological Association (APA),
DOI: 10.1037/pap0000163.
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