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It was the title of this book that made me want to read and review it for the journal. Psychiatry is learning fascinating things about depression, about the limitations of our knowledge, and about the contributions of genes and environment to depression. I hoped to learn how an erudite and thoughtful psychiatrist might put it all together. Indeed, Ghaemi does a creditable job of making his case for how to understand these issues, but he omits important recent information that undercuts his position, and rarely misses an opportunity to take a swipe at, misunderstand, or misrepresent Freud and psychoanalysis. From my work in organized psychiatry I am familiar with such swipes at psychoanalysis from those often untrained in it, though I am pleased that such swipes seem to be fading in light of emerging evidence of the efficacy of psychoanalytic treatments, but not so from Ghaemi.
Despite his swipes at psychoanalysis, Ghaemi extols the virtues of some psychoanalytic concepts without recognizing them. An example of this is in a late chapter on Leston Havens, surely a gifted clinician or “guide” as Ghaemi calls him, to whom Ghaemi properly assigns credit for emphasizing in his work with patients the importance of being able to hold simultaneously two conflicting ideas. Ghaemi fails to recognize that here Havens is speaking a basic developmental notion from