AN EXPERIMENTAL STUDY OF

PSYCHOANALYTIC THEORIES OF DEPRESSION

SAMUEL SLIPP, M.D.

New York University School of Medicine
and Postgraduate Center for Mental Health
124 East 28th Street
New York, New York 10016

STEVEN NISSENFELD, Ph.D.

Hay Associates
1 Dag Hammarskjold Plaza
New York, New York 10017

One of the fundamental concepts in psychoanalysis is that pa-

thology is a response to and an expression of unconscious conflic-
tual thoughts and their associated feelings. Beginning with Freud,
psychoanalytic theory has developed from the astute observations
of psychoanalysts based on clinical case studies of patients in
treatment. In recent years exciting new laboratory procedures
have added a new dimension, and enable us to explore through
controlled experiments the influence of these unconscious factors
in a wide variety of psychiatric conditions. The methodology was
pioneered by Silvennan (1971) and enables us now to test out and
validate in the laboratory psychoanalytic theories of psychopa-
thology. The method has been tenned by Silvennan "subliminal
psychodynamic activation," since subliminal messages presented
by a tachistoscope to the subject bypass conscious awareness, are
registered unconsciously, and activate psychodynamic processes.
The psychological effects of this stimulation can then be accurate-
ly measured by tests to see if the "triggering" of specific uncon-
scious thoughts and feelings does influence certain symptoms as
psychoanalytic theory holds. It was found that only messages that
were subliminal and not supraliminal were effective, and only
This study was conducted at New York University Medical Center as part of a doc-
toral dissertation by Dr. Nissenfeld for Yeshiva University.

Journal of The American Academy of Psychoanalysis, Vol. 9, No.4, 583-600 (1981)

C> 1981 John Wiley & Sons, Inc. CCC 0090-3604/81/040583-18501.80
584 / SLIPP AND NISSENFELD

specific subliminal messages activated the corresponding fantasy in

the patient's unconscious. The methodology of "subliminal psy-
chodynamic activation" was used in this study conducted at New
York University Medical Center to experimentally test psychoana-
lytic theories of depression. This paper will report on the effects
of subliminal stimulation with a neurotically depressed female
population around unconscious conflicts over dependency, aggres-
sion, and achievement.

BACKGROUND
A large number of previous studies in "subliminal psychody-
namic activation" have been done with a variety of populations of
patients and other subjects. In nine studies with "relatively differ-
entiated" schizophrenics, the presentation of a "symbiotic gratifi-
cation stimulus" (the message, "Mommy and I are one"), was
found to reduce the level of psychopathology (Silverman, 1979),
while in eight separate studies, an aggressive message ("Destroy
Mother") increased psychpathology 1 (Silverman, 1971). Specifi·
cally, these stimuli led to objectively measured changes in "pri-
mary process ego pathology," this term being used to describe the
loose, illogical thinking and inappropriate behavior characteristic
of schizophrenics.
Other researchers have found this "symbiotic gratification"
message to have pathology-reducing and other positive effects on
nonschizophrenic groups as well: (l) Martin (1975) found that in
two groups of obese women given behavior modification treat-
ment, the group given subliminal symbiotic stimulation showed
significantly more improvement than a group given subliminal
neutral stimulation. (2) A study of male homosexuals (Silverman
et aI., 1973) showed a decrease in the level of anxiety and defen-
siveness after the same symbiotic condition. (3) A group of insect-
phobic patients receiving systematic desensitization showed signifi-
cantly more improvement when the treatment was accompanied
by subliminal symbiotic stimulation (Silverman et aI., 1974). And
(4) a study of alcoholics showed that A.A. counselling treatment
was significantly more effective for those who received the sym-

I Such increases in pathology have been shown to be fleeting with the subject's level
returning to its "baseline" in approximately 15 minutes. For a discussion of the ethical
issues involved in these experiments, see Silverman (l978b).
 AN EXPERIMENTAL STUDY /585

biotic intervention (Schurtman, 1979). (See Silverman, 1980 for

an up-to-date summary of studies using subliminal symbiotic stim-
ulation.)
These findings suggest that the activation of maternal symbiotic
fantasies, via subliminal stimulation, can have an ameliorative
effect on diverse populations of subjects. Interestingly, improve-
ment has often been reported by clinicians after their patients gave
evidence of reexperiencing their symbiotic wishes as gratified in
therapy. This was noted by Ferenczi (1920) and Sechehaye (1963),
who felt that regression to the fused infantile state of oneness with
the mothering object needed to be reexperienced with sicker
patients to resolve d.evelopmental fixation and facilitate psycho-
logical growth. Winnicott (1965) considered that psychoanalytic
therapy provided a safe holding environment that had been lacking
with the mother, served as a transitional object to facilitate giving
up omnipotent destructive fantasies, and allowed for differentia-
tion from the mothering object. Others who also held this "nurtur-
ant-reconstructive" orientation were Alexander, Balint, Fromm-
Reichmann, Guntrip, Khan, Kohut, Little, and Thompson.
In a review of the symbiosis research, Silverman (1978a) sug-
gests that the ameliorative effects of the symbiotic fantasy arise
from the wide range of needs it can potentially gratify. It can (1)
fulfill libidinal wishes for oral gratification, (2) insure against
feared object loss, (3) restore narcissistic equilibrium and remedy
negative self-representations (4) rectify impaired ego function,
(5) ward off destructive impulses, (6) dissipate guilt for harmful
thoughts against mother, (7) defend against oedipal wishes, and
(8) in males, provide disguised gratification of incestuous wishes
towards mother.
The study reported in this paper investigated, in part, the
effects of activating this symbiotic fantasy in depression, to de-
termine if an ameliorative effect would occur in this population.
In reviewing psychoanalytic theories of depression, starting with
Abraham (1953) and Freud (19 I7), the greatest emphasis has been
placed on the retroflexion of aggression on the ego or the self.
Accompanying this, there is also a persistent theme that the de-
pressive is involved in a pathological dependency that prevents the
direct expression of aggression towards the loved maternal object
because of fear of abandonment. The retroflexion of rage was seen
as serving as a defense to preserve this dependent relationship.
Rado (1927), Deutsch (1923), Klein (1948), and Jacobson (1971)
stressed the magical intrapsychic maneuvers of the depressive,
586 I SLIPP AND NISSENFELD

whereby self-punishment preserves the good mother introject. In

addition to preserving this internalized object relationship, this
maneuver is acted out interpersonally. Arieti (1959) has stressed
how the depressive submits to the "dominant other," usually a
witholding and controlling mother, hoping to sustain a dependent
relationship. This becomes acted out later with an external mater-
nal transferential figure. Bemporad (1953) also noted that the de-
pressive establishes a bargaining relationship with the "dominant
other" to sustain dependency gratification, and is unable to pro-
vide self-gratification.
The senior author's theory of depression (Slipp, 1976) inte-
grates both the intrapsychic, developmental aspects of the child
with interpersonal relations in the family, using object relations
theory as a bridging concept. In studying depressives and their
families, it was found that the family interaction plays a role in
arresting normal development and contributes to a fixation at the
symbiotic phase of development. Jacobson (971) has postulated
that the child employs splitting of the love object, with the ideal-
ized, powerful parental image incorporated in the superego and
the deflated parental image incorporated in the self. Jacobson
considers this process purely from an intrapsychic vantage point
and does not explain the environmental contribution to the fixa-
tion. In the families we have studied, it was found that in actuality
one parent was overly powerful and dominant and the other par-
ent was deflated and weak. 2 The senior author (Slipp, 1981) has
hypothesized that the developmental fixation in depressives can be
attributed to the fact that the external reality in the family corre-
sponds to and reinforces the child's internal psychic reality. The
family does not provide a corrective external reality, and thus
fantasy, through which the child experiences the world, is not dif-
ferentiated from reality. Integration of the split object does not
occur developmentally, and the powerful parental superego intro-
ject remains unmodified in its domination of the ego.
A specific type of relationship occurs within the depressive's
family, which the senior author has termed a "double-bind over
achievement." The patient is expected to enhance the diminished
self of the dominant parent, who lives vicariously through the
patient's achievement. In overt communications, pressure is ex-
erted by the dominant parent on the child for social performance.
If the child does not succeed, he will not be loved and will suffer

2 This was also found in studies by Lewis et aJ. (1976) of families with a depressive.
 AN EXPERIMENTAL STUDY / 587

rejection. However the dominant parent is jealous of and does not

gratify the child's success when it does occur. The achievement is
exploited to enhance only the dominant parent's self-esteem and
social image. The child learns that no matter what he does, it is
not enough or is taken for granted. This is experienced as a cov-
ert message not to be too successful and to remain submissive and
dependent on the dominant parent. If the child complies to the
overt pressure for success or to the covert message for failure, he
loses love. The child's submission and self-diminution serve to
preserve the self-esteem and validate the power of the dominant
parent. The pressure for achievement of the dominant parent be-
comes internalized in the ego ideal and the power of the dominant
parent incorporated in the punitive part of the superego. If the
child does succeed and becomes strong and independent, he fears
the loss of the dominant parent's love. Thus separation and indi-
viduation are blocked by this interaction. For the depressive,
autonomy becomes equated with abandonment and threatens sur-
vival.
Bibring (1953) and others have emphasized the helplessness of
the depressive. It is hypothesized that because the child is im-
mobilized by the conflicting messages of the "double-bind over
achievement," a pervasive sense of trapped helplessness and a nega-
tive cognitive set are developed. The depressive's self-esteem and
security remain dependent on his parents. To preserve the sym-
biotic dependency, the depressive submits to the power of the
dominant parent incorporated in the superego and projects this
image externally onto a transferential figure. 3
To preserve some autonomy and prevent self-annhilation, a
compromise solution of partial compliance and rebellion is acted
out interpersonally. This results in an inability to complete pro-
jects, to make genuine commitments, to take risks, and results in
half-hearted performances that are self-defeating. This frustrates
the dominant parent's exploitation of his performance by with-
holding gratification, and insures also against abandonment. This
had been termed an "oppositional symbiosis" which is a form of
interpersonal defense providing the depressive with (I) control
over omnipotent magical destructive fantasies, (2) a means of con-
trolling and manipulating external relationships, (3) a means of
sustaining dependent relationships with the dominant parent or
transferential figure, (4) a means of sustaining some autonomy,

'Arieti (1959) bas termed this transferential fIgUre "the dominant other."
588 / SLIPP AND NISSENFELD

(5) the binding of castration and separation anxiety, and (6) a

passive-aggressive means of expressing hostility without taking
responsibility and risking abandonment.
Intrapsychically during the depressive episode, the patient's
main identification is with the submissive, depressed parent incor-
porated in the self-image. This results in self-punishment to undo
hostility and to sustain a dependent relationship with the domin-
ant parent incorporated in the superego. During mania, the main
identification is with the dominant parental image in the superego,
and the masochistic self-image is projected into another who is
then demeaned and punished.
In treatment, these patients often become "help-rejecting com-
plainers" who entice the therapist into offering support and sug-
gestions, but then reject whatever help is offered. Whatever the
therapist does it is never enough, leaving the therapist helpless,
frustrated, and angry. These patients use the manic defense of
identification with the dominant parent incorporated in the super-
ego, and through projective identification place their helplessness,
frustration, and anger into the therapist. Thus the therapist exper-
iences in the countertransference 4 the same feelings the patient
experienced as a child with the dominant, pressuring, but ungrati-
fying, parent.

EXPERIMENTAL PROCEDURES

The study reported in this paper was designed to experimentally

test this "Double-Bind over Achievement" hypothesis as well as
the two critical hypotheses concerning symbiosis and aggression
utilized in many theories of depression. The subjects in this study
were 48 nonschizophrenic, female depressives, all of whom were
patients at New York University - Bellevue Medical Center. They
were both in- and outpatients, between the ages of 18 and 55, and
all native English speaking. Subjects were identified as depressed
utilizing the Beck Depression Inventory (Beck, ]974) as a screen-
ing measure. (See Nissenfeld, ]979 for details.)
Previous investigators who used subliminal aggressive messages
with depressives found an intensification of depressive feelings in
the subjects. The population for these studies, however, was

4 Countertransference is used in the broader sense as defmed by Winnicott (1965) and

Racker (1957).
 AN EXPERIMENTAL STUDY /589

suicidal schizophrenics (Rutstein and Goldberger, 1973), psycho-

tic depressives (Cox, 1973), and normals prone to depression
(Miller, 1973 and Varga, 1973). The same aggressive message used
in some of these previous studies, "Destroy Mother," was chosen
for our study to determine if their findings could be replicated
with our population. This verbal stimulus was accompanied by a
picture of a younger woman holding a knife over her head, menac-
ing an older woman.
In previous studies with schizophrenics, phobics, alcoholics,
obese patients, and other populations (summarized in Silverman,
1978a, 1980) a subliminal stimulus designed to activate a gratify-
ing fantasy of symbiotic merging with mother produced adapta-
tion-enhancing effects. The subliminal message used in these pre-
vious studies, "Mommy and I are one," was used in our study,
accompanied by a picture of two women merged together at the
shoulders like Siamese twins. This picture was adapted from the
picture described by Silverman et a1. (1971) that had been used
with male subjects. No previous study of depression using Silver-
man's methodology had employed symbiotic stimuli. A therapeu-
tic effect was predicted in the current study since certain theories,
including our own, stress the need to maintain dependent ties with
the good internalized mother image.
In addition, we wished to explore the role of parental demands
for achievement in depression. A "Succeed-Fail Scale" was de-
vised which was administered to all subjects to determine which
was the dominant parent pressuring for success, as well as whether
success was rewarded. This test determined which subliminal mes-
sage would be used, "Succeed for Mother" or "Succeed for
Father." This verbal message was termed the "Exploitative Suc-
ceed" message, and was accompanied by a picture of an older
woman or man standing behind and looking over the shoulder of a
young woman seated at a desk. It was hypothesized that this stim-
ulus would lead to an increase in depression, since it implied ex-
ploitation and loss of autonomy. However, the alternative possibil-
ity was considered that the stimulus would lead to a decrease in
depression, since it went along with the adaptive style that guaran-
tees against abandonment. A second success-related stimulus was
considered adaptation-enhancing, Le., "Succeed for myself," and
was hypothesized to lead to a lessening of depression. This stimu-
lus was termed the "Autonomous Succeed" message and was
accompanied by a picture of a woman standing on a platform
alone speaking before an audience. This message was intended to
590 I SLIPP AND NISSENFELD

activate the individual's wish to own his own success without hav-
ing an exploitative bind with the parents. Again, however, the
alternate possibility was considered that this condition might lead
to an increase in depression. The depressive might be unable to
gratify self, since it would go against the "bargaining agreement"
(Bemporad, 1953) or it might imply that autonomy is equated un-
consciously with abandonment by the dominant parent (Slipp,
1976).
To summarize, it was hypothesized that (I) the Symbiotic mes-
sage, "Mommy and I are one," would provide a safe gratification
and therefore lead to a decrease in depression; (2) the Aggressive
message, "Destroy Mother," would lead to an increase in depres-
sion; (3) the Exploitative Succeed condition, "Succeed for Moth-
er" or "Succeed for Father," would lead to an increase in depres-
sion; and (4) the "Autonomous Succeed" condition, "Succeed for
myself," would lead to a decrease in depression.
The method is presented in greater detail in Nissenfeld (1979).
Here the most salient aspects will be described.
The 48 subjects were divided into two groups of 24 each and
came for three testing sessions. Each subject was exposed to one
stimulus in each session. One group received the following three
stimuli: (I) Symbiosis, (2) Exploitative Succeed, and (3) a neutral
control stimulus - the message, "People are walking" accompa-
nied by a picture of two bland-looking men side by side as if walk-
ing. The other group received the following three stimuli: (I)
Aggressive, (2) Autonomous Succeed, and (3) neutral control.
Subjects were randomly assigned to one of the two groups. The
following measures were used in the initial interview: (I) the
Structured Clinical Interview (Burdock and Hardesty, 1969), used
to screen out schizophrenics; (2) the Beck Depression Inventory
(Beck, 1974) for a measure of the baseline level of depression; (3)
the Adjective Rating Scale (Silverman et al., 1971) provided a
measure of differentiation level; and (4) the Succeed-Fail Ques-
tionnaire. This last scale was devised by us for this study to meas-
ure the subjects' conscious experiences of their own and parental
attitudes towards achievement, and the level of parental and self-
gratification obtained for achievement.
The following measures were used before and after tachisto-
scopic stimulation for each condition to test for changes in depres-
sive symptomatology: the Multiple Affect Adjective Check List
(Zuckerman and Lubin, 1965) scored for depression, hostility, and
feelings of well-being; and the TAT, scored for depression and feel-
 AN EXPERIMENTAL STUDY I 591

ings of well-being. In addition, posttest measures of self-object dif-

ferentiation and level of self-esteem were obtained from the Adjec-
tive Rating Scale in each of the testing sessions.
The subjects were seen for three testing sessions, following an
initial screening session. All three testing sessions were conducted
by the same experimenter (S.N.). Each session was comprised of a
"baseline" assessment of functioning followed by one of the three
stimulus conditions listed above, followed in turn by a "critical"
assessment of functioning. Each baseline assessment was preceded
by the subliminal presentation of "baseline stimuli," Le., neutral
verbal messages and pictures, though different from those used as
control stimuli (see Nissenfeld, 1979 for details).
After the baseline stimulation, two TAT cards were presented
using standard TAT instructions. The TAT responses were used to
measure mood, utilizing the scales developed by Welch, Schafer,
and Dember (1961). Following the TAT, four pairs of refresher
flashes of the baseline stimuli were presented, followed by admin-
istration of the Multiple Affect Adjective Check List (Zuckerman &
Lubin, 1965). (The MAACL was modified from a checklist to a
50-point scale for the purposes of this study; see Nissenfeld,
1979.) Following the baseline measures, one of the three "critical"
pairs of stimuli was presented as described above. The subjects
were then given a "critical" presentation of the TAT. This was fol-
lowed by four pairs of refresher flashes of the "critical" stimulus,
followed by administration of the "critical" MAACL. Each session
then ended with administration of one of three equivalent forms
of the Self-Concept Scale. This measure consisted of a list of adjec-
tives, positive and negative, with the subject being asked to rate
herself on the extent to which these adjectives applied to her. This
measure was previously shown to yield an increase in level of posi-
tive self-concept, in response to the Symbiosis message, in schizo-
phrenics (Silverman et al., 1971; Kaplan, 1975).
All subliminal presentations were for 4 milliseconds. (In the
presentation of the verbal and pictorial stimuli pairs, the verbal
stimuli followed the pictoral stimuli after three seconds.) There
were four presentations of each pair of stimuli, and ten-second in-
tervals between each presentation. The stimuli were presented
through a two-channel tachistoscope manufactured by Scientific
Prototypes.
The experimenter was blind to stimulus conditions. This was
accomplished by having the stimuli coded in advance by someone
else, so that the experimenter could insert the stimuli guided only
592 / SLIPP AND NISSENFELD

by the code letters on the back of the cards. Thus, the experimen-
ter was never aware of the content of the cards he was inserting.
Since each subject was to receive three critical stimulus condi-
tions, there were six possible sequences in which these conditions
could be administered. Four subjects in each group were given
each of these sequences.

RESULTS AND DISCUSSION

The results of this study are presented in detail in Nissenfeld

( 1979) and here are only summarized·.
Only the hypothesis regarding the Symbiotic condition re-
ceived clear-cut support. This condition (when compared with the
control condition) produced a significant increase in feelings of
well-being, as measured by the TAT (p < .03) and a trend toward
heightened self-esteem as measured by the Self-Concept Scale
(p < .10). Moreover, when the five measures of mood utilized in
this study (TAT Feeling of Well-Being, TAT Depression, MAACL
Feelings of Well-Being, MAACL Depression, Positive Self-Image on
the Self-Concept Scale) were combined into a unitary, global meas-
ure of depression, which was termed the Manifest Depression In-
dex, there was a significant decrease in depression after the Sym-
biotic stimulation as compared to the control condition (p < .03).
The finding that the Symbiotic condition produced an ameliora-
tive response in the depressed subjects is in keeping with the thera-
peutic effect found by previous researchers with other diagnostic
groups. It can be viewed as supportive of those theorists, such as
Mahler (1952) and Jacobson (1971), who stress arrest in develop-
ment of the self, and fixation prior to resolution of the Symbiotic
phase. Activation of the symbiotic tie with the internalized good
mother image can be seen as gratifying and conflict-alleviating for
the depressive.
Correlational data were obtained to shed further light on these
results. Such correlational data are only suggestive of certain
trends, and as such must be more directly investigated in future
studies. However, it may be useful to speculate about such data to
stimulate further research.
The maternal symbiosis message appeared to be most ameliora-
tive for those depressives who experienced their mothers as reia-
 AN EXPERIMENTAL STUDY / 593

tively nonpressuring towards achievement and relatively gratifying

and reinforcing of achievement on their part. (This was derived
from data obtained on the Succeed-Fail Questionnaire.) When,
however, mother was experienced as a source of pressure and con-
flict in the area of achievement, then the maternal symbiosis mes-
sage tended not to alleviate the depression.
The correlational data also suggested that the individual's spe-
cific experience with and memories of Father may also affect the
extent to which a maternal symbiosis fantasy is gratifying. It was
found that the maternal symbiosis condition was more ameliora-
tive for those depressives who experienced their fathers as more
pressuring towards achievement and as less gratifying of success.
Thus the correlational data suggest that the individual's specific
experience with both parents is relevant to whether the activation
of a symbiotic fantasy will be ameliorative for a depressed person.
This is in keeping with the senior author's (Slipp, 1976) clinical
observation that reality factors in the family reinforce or diminish
the potency of symbiotic and other intrapsychic dynamics. For
example, it was noted that when one parent was the dominant and
pressuring one, the depressive turned to the other parent for nur-
turance and support; thus the latter became the good symbiotic
object. This finding also is in keeping with Silverman's (1978) view
that the ameliorative effects of symbiotic fantasy are most likely
when the symbiosis fantasy involves the love-object with whom a
sense of oneness is most gratifying. Thus, for depressives for whom
the mother is not the yearned-for nurturant object, the activation
of a symbiotic fantasy involving father may be ameliorative. It
would therefore be interesting to examine the effect of a paternal
symbiosis message, "Daddy and I are one," with depressives. This
stimulus was found to have an ameliorative effect with schizo-
phrenic women (Cohen, 1977), whereas the "Mommy and I are
one" stimulus left them unaffected. Interestingly, as Cohen points
out, Lidz has described schizophrenic women (in contrast to
schizophrenic men) as more apt to be symbiotically tied to their
fathers than to their mothers. The senior author (Slipp, 1977) also
found this symbiotic tie to the father with borderline women.
The absence of significant effects for the other three experimen-
tal messages could cast doubt on the applicability of the theoreti-
cal formulations concerning the "double-bind over achievement"
and the role of aggression for the subjects studied, or imply
that the stimuli presented did not accurately reflect the hypothe-
594 / SLIPP AND NISSENFELD

sis. S Only future research can confirm or refute these possibili-

ties.
In the aggressive condition, we did not replicate previous studies
which found an increase in depression following aggressive stimu-
lation. These previous findings had been cited as supportive of the
retroflexion of aggression theory. However, it is important to note
that these previous studies were done with seriously disturbed
patients, schizophrenics and psychotic depressives (Rutstein and
Goldberger, 1973; and Cox, 1973) or individuals whose aggressive
fantasies were primed and considerably strengthened prior to tach-
istoscopic stimulation (Miller, 1973; and Varga, 1973). It may be
that there was no increase in depression following aggressive stim-
ulation in the current study because our population was less dis-
turbed and the level of intensity of their unconscious aggressive
fantasies was not sufficiently strong to be activated by subliminal
aggressive stimulation without prior priming. This corresponds to
the findings of Cox (1973), who found that subliminal stimulation
of aggressive fantasies without priming did produce an increase in
self-directed aggression and a lowering of self-esteem in a psycho-
tic group but not in a nonpsychotic group that was similar to the
population utilized in this study. His finding was explained as be-
ing due to a higher level of aggressive fantasy toward the internal-
ized mother image in the psychotic group than in the neurotic
group.6
With schizophrenic and psychotically depressed patients, one
can speculate that the "Destroy Mother" message produced in-
creased pathology because the higher level of aggression, when
triggered by the aggressive stimulus, leads to destruction of the
maternal image. Historically, Abraham, in 1911 (1953), was the
first to consider that in the psychotic depressive, regression to the
anal sadistic stage occurred, with destruction of the internalized
• The wording of the "Autonomous Succeed" message was changed in a recently
completed study (Greenberg, 1980) in such a way as to try to neutralize the threat of
autonomy. That is, since autonomy may represent feared loss of the dominant (bad)
parent and thus abandonment, a success message that gives permission for success while
maintaining the relationship with the needed objects was thought of as more optimal for
bringing about positive behavioral change. Interestingly, Greenberg found that the new
message, "My success is O.K.... improved functioning for a group of underachieving
female subjects.
• A clinical research study by Horowitz et al. (1980) of patients suffering pathologi-
cal grief after bereavement found. rather than ambivalence, that the reemergent needy
and helpless self-images, previously stabilized by reliance on the lost object, were more
pathogenic.
 AN EXPERIMENTAL STUDY /595

love object. According to modern ego psychology and object rela-

tions theory (Jacobson, 1971), a developmental arrest exists in the
psychotic, and there is a lack of differentiation of the self-object.
One could speculate that because of the very lack of differentia-
tion of the self-image from the maternal image (Le. the self-
object), destruction of the maternal image would cause annihila-
tion of the self, and result in psychosis.
The achievement-related conditions failed in the study to yield
any significant changes in mood. It had been hypothesized that a
diminution of depression would result from the "Autonomous
Succeed" message. As was described previously, the "Autonomous
Succeed" message was accompanied by a picture of a woman
alone on a stage in front of an audience to convey achievement
and success for oneself. However, it is possible that this picture
triggered associations relating to external pressure to achieve or a
sense of aloneness, abandonment, and vulnerability. Such feelings
and associations would counteract any positive associations related
to autonomous achievement for oneself.
It was found that the "Exploitative Succeed" condition, when
compared to the control condition, showed a trend toward height-
ened feelings of well-being. This finding, which contradicted one
of our hypotheses, might be explained as reflecting the depres-
sive's need to comply. That is, this condition may have reinforced
the depressive's compliance, which in turn preserved the depend-
ent relationship to which the patient is accustomed (Bemporad,
1953; Slipp, 1976). No personality change (giving up the bad,
dominant object image) is demanded and the depressive can con-
tinue in her accustomed manner of functioning and feel an in-
creased sense of well-being. Interestingly, correlational data sug-
gested that it was the more differentiated depressives who showed
this effect while those who were less differentiated responded to
the "Exploitative Succeed" condition with increased depression.
This raises the possibility that the "double-bind over achievement"
is most conflictual for individuals with a more profound lack of
differentiation of self from other. Future research on such a
specific subgroup of depressives could shed light on the question
of whether less differentiated depressives are more vulnerable to
exploitative parental demands because of their already diminished
sense of self. It is interesting that in studies of poorly differentia-
ted schizophrenics (Silverman, 1978), the ameliorative response to
symbiotic stimulation did not occur as with the more differentia-
ted schizophrenics. In those schizophrenic patients who were
596 / SLIPP AND NISSENFELD

poorly differentiated, further merging of self and object stimula-

ted by the symbiotic condition was seen as threatening total loss
of sense of self. One can speculate that with our poorly differen-
tiated depressives, a similar explanation might be entertained as
causing the deepening of depression in response to the "Exploita-
tive Succeed" message. With these less differentiated patients, a
further taking over of the self by the dominant parental image
might be experienced as also overwhelming the sense of self. How-
ever, with more differentiated patients, the "Exploitative Suc-
ceed" message was not overwhelming. It served simply to protect
symbiotic dependency, with the depressive giving up only part of
the self in performing for others, and thus it led to an increased
sense of well-being.

SUMMARY

This study involves an application of a new methodology, subli-

minal psychodynamic activation, which can be used to experimen-
tally test psychoanalytic "dynamic" propositions. It was found
that with a sample of neurotically depressed female patients, there
was a significant decrease in depression-related responses following
the stimulation of a symbiotic gratification fantasy ("Mommy and
I are one"). Subliminal symbiotic stimulation had been shown pre-
viously in studies with different populations (schizophrenics,
homosexuals, phobics, alcoholics and overeaters) to have similar
ameliorative effects. The current results point to the importance
of symbiotic dynamics and the relationship dependent on a dom-
inant other, rather than to the retroflexion of aggression in neu-
rotic depression. This is in keeping with the formulations of Arieti
(1959), Bemporad (1953), Horowitz (1980), and the senior author
(Stipp, 1977). Hypotheses regarding the effects of stimulating fan-
tasies involving success were not supported by the primary data,
although secondary data (from correlational analyses) did provide
some indirect support for the senior author's hypothesis. The
"Autonomous Succeed" message ("Succeed for myself') did not
reverse the depressive mood, possibly because autonomy was equa-
ted with abandonment. Relatively differentiated depressives
tended to respond to the "Exploitative Succeed" ("Succeed for
Father or Mother") messages with a decrease in depression, while
depressives with a low level of self-object differentiation tended to
respond with an increase in depression. For more differentiated
 AN EXPERIMENTAL STUDY / 597

depressives, performing for and giving over a part of the self to

another is an adaptive style that insures the dependent relationship
and bolsters the patient's weak self-image. However, with poorly
differentiated depressives, giving over to another raises the threat
of total annihilation, since the self is already diminished. These
secondary data can be viewed, however, as only suggestive and
need to be pursued in future studies.
The results on symbiosis in this study add to the growing litera-
ture (summarized in Silverman, 1976, 1980) indicating that sub-
liminal psychodynamic activation is a useful technique for investi-
gating psychoanalytic formulations in the laboratory. It was
Freud's overriding hope that psychoanalysis be firmly rooted as a
behavioral science and this technique seems most promising as
contributing toward that end.

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