You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In glancing over the title of this volume the reader will note that the author avoids the use of the two terms readily available to psychotherapists; of these terms Dr. Ostow states, “Unhappiness which is pathologically intense is called depression. When depression is severe, it is called melancholia.”
The author recognizes depression as a complex condition consisting of different components of psychic pain, anxiety, guilt, worry, and agitation. He states that in most instances the first step in the genesis of depression is the loss of love of some important individual. He also points out that “the patient was originally unable to separate from his mother.” Thus, while Ostow is aware of childhood (and adolescent) episodes of depression and sets the highest incidence in the latter half of the fifth and during the sixth decades of the life of the individual, in the opinion of this reviewer it is one of the minor flaws of this study that it does not stress the childhood roots of depression sufficiently and explicitly. This remark is made even in the face of the fact that the author does mention Karl Abraham's suggestion “that clinical depression in adult life repeats an initial and very early childhood depression.”
Furthermore, whereas the author does not stress the feeling of loneliness as a potent factor of depression in later life, one may well deduce this from his original definition of depression as originating in the loss of some important individual. Overlooked, it seems, is the anxiety-producing suppressed rage at the person who has abandoned the depressed individual and the latter's fear to give vent to this rage.
While anxiety is mentioned as an essential component of depression, specific fears are not explicitly mentioned. In the opinion of this reviewer, these fears play a significant role; outstanding among these are the fears of self-alienation (using Karen Horney's concept of a shift in a person's energies and consciousness away from his real self), of depe