[A introduction to despair as a psychopathological phenomenon].

Despair as a phenomenon has not received much attention from psychopathologists, which is difficult to grasp in the clinical context. This paper is an attempt to elaborate upon despair as a key concept and thus open up a new field in psychopathology. The historical approach leads to a twofold view on despair, namely as an affect and as a cognitive structure. The paper therefore follows both the affect theories developed since the onset of the modern era and the cognitive theories on doubt at risk of progressing into despair. Using current approaches of cognitive emotional psychology, despair is defined as an oscillating, affective-cognitive process: the oscillation of doubt is reflected in the alternation of various single affects such as hope, fear, anxiety, anger, shame, guilt, and sadness and then moves towards the negative pole of increasing affect diffusion, loss of object relation, hopelessness, and suicidality. On the basis of this model it is possible to elaborate specific types of despair in individual psychiatric disorders, assessments of the stage of the process, and possible therapeutic strategies.