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In an era when academic psychiatry has become dominated by biological models and related techniques, a dynamic psychiatrist faces a formidable challenge in finding practical, contemporary guides for treating psychopathology. This may be especially true for depression whose conceptualization has been purged of the rich dynamics observed through the psychoanalytic process. With each successive version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), depression has evolved to represent, what some would consider (Shorter, 2008), an artificial syndrome with consequent high heterogeneity. Despite clinical relevance, terms like neurotic-depression and depressive personality are now extinct. Fortunately, Psychodynamic Treatment of Depression fills this void in the psychodynamic psychiatrist's therapeutic armamentarium.
The book is broken up into three parts, with the first section introducing psychodynamic treatment of depression. It takes into account modern developments in psychiatric treatment, including DSM-5 (American Psychiatric Association, 2013) updates. Its transparency regarding the current evidence base and distinction among other depression-related treatments is essential for providing proper informed consent with patients. With considerable tact, the authors synthesize together various theoretical approaches to depression and provide a coherent conceptual model. Rather than advocate for one orthodox explanation, their model offers a practical starting point which most therapists can appreciate, regardless of training background. Their core dynamic formulation describes two cycles: narcissistic vulnerability and anger and low self-esteem, and idealization and devaluation. Throughout the book, numerous clinical vignettes provide clinical context.
The second section presents specific treatment techniques. The overall strategies and course of proposed treatment is very much like other modern psychodynamic psychotherapies (e.g., Busch, Milrod, Singe