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I cannot overemphasize the importance of this volume towards better psychotherapeutic work with depressed patients. We have to keep up with progress in psychiatry. Naturally, both authors focus on psychotherapy, but they do not ignore the other aspects of treatment and very consistently point out the importance and relevance of somatic therapies such as electroconvulsant therapy for involutional melancholia and antidepressant medication such as the tricyclics and the monomine oxidase inhibitors in the treatment of severe depressions. Even in these discussions, there is a diversity which is refreshing. This is not a monolithic structure towards a Procrustean treatment of depressed patients; on the contrary, it is a refreshing approach using current scientific knowledge towards better patient care. It is my impression that they emphasize the principle of flexibility as did Franz Alexander.
Especially noteworthy is the admirable inclusion by Bemporad of the physiological approaches. He uses the scientific evidence for and against the catecholamine hypothesis concerning depression. Not only is this an extraordinary inclusion of physiological data, but an acknowledgment of the importance of brain chemistry in the treatment of patients. To quote Bemporad, “Before describing these theories, it should be clarified that the physiological approach to depression does not necessarily contradict a psychodynamic approach. Certainly, neurological events accompany psychological phenomena, and experience of depression is no exception. The two views are particularly congruent if depression is conceptualized as a basic affect that automatically arises in certain situations, as exemplified in the theories of Sandler and Joffe and Bibring.” Adding to these contributions by Jules Bemporad, Arieti points out, “Four major therapeutic approaches or combinations of them are presently available for the treatment of severe depression. Psychotherapy, drug therapy, shock therapy, and hospitalizat