Psychotherapy of The Depressive Character

Since the earliest psychoanalytic investigations, disturbance in human relations has been consistently stressed in describing depressive reactions. Despite this interpersonal emphasis the majority of psychoanalytic works on the theory and therapy of depression have focused on intrapsychic dynamics. A good number of psychoanalytic authors have taken Freud's early work on melancholia (1917) as a paradigm and have encouraged an “outward” deflection of the alleged retroflected anger in their patients. This continued utilization of a pioneer work (that today appears as a transitional theoretical phase between the topographic hypothesis and the structural theory), seems unfortunate since in depression, perhaps more than in any other pathologic condition, the patient's relationships (and especially the relationship to the therapist) are of prime importance. During certain stages of treatment, for example, the actual content of sessions may be relatively irrelevent while the tenor of the therapeutic relationship is crucial. It is my opinion that the depressive requires a specific type of psycho-therapeutic intervention, and I will attempt to offer some guidelines which I have found helpful. Some excellent contributions have already appeared on the psychotherapy of depression, such as publications of Arieti , Beck , Bonime (1960-1962b), Cohen et al. , Jacobson (1971), and Kolb (1956) and my debt to these authors will be evident in my frequently quoting from their works. I plan to present a fairly detailed program for the therapy of the depressive character which is relatively