Psychotherapy of self-criticism in a case of mixed anaclitic-introjective depression

Jeanne A. Layne, John H. Porcerelli, Golan Shahar

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


In this case study, the year-long psychotherapy of a depressed and self-critical 34-year-old women is described. Her depression was conceptualized as a "mixed" anaclitic and introjective type according to the model of Sidney Blatt. Anaclitic depression involves a preoccupation with the integrity of interpersonal relatedness (e.g., issues of dependency and abandonment), whereas introjective depression involves a preoccupation with autonomy and self-esteem (e.g., self-criticism and feelings of worthlessness). Given the potentially destructive nature of self-criticism, the therapist systematically confronted the patient's use of this trait in a supportive manner. Changes in the patient's functioning were assessed at the beginning and at the end of treatment using the Shedler-Westen Assessment Procedure and the Diagnostic and Statistical Manual of Mental Disorders (4th edition) Global Assessment of Functioning Scale. After 1 year of psychotherapy combining both cognitive and psychodynamic interventions, the patient evidenced significant changes in both anaclitic and introjective personality dimensions and showed significant improvements in adaptive functioning.

Original languageEnglish
Pages (from-to)421-436
Number of pages16
JournalClinical Case Studies
Issue number5
StatePublished - 1 Oct 2006
Externally publishedYes


  • Anaclitic depression
  • Cognitive psychotherapy
  • Depression
  • Introjective depression
  • Psychodymanic psychotherapy
  • Self-criticism

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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