After the sad death of our colleague Ilse Grubrich-Simitis, one aim of this paper is to revisit one of her groundbreaking works, “Drive or Trauma – Drive and Trauma” (1987) after almost 40 years. Grubrich-Simitis integrated drive and object relational aspects on the one hand and trauma-specific perspectives on the other in a creative way, as we discuss regarding some conceptual developments in contemporary psychoanalysis. A short case example illustrates the conceptual richness for treating chronically depressed patients with early trauma available to clinicians today. Considering both drive and trauma belongs to the strengths of modern psychoanalytic treatment techniques, which we would like to discuss alongside recent findings of the LAC1 depression study [Comparative outcome study of psychoanalytic and cognitive behavioral long-term psychotherapy with chronically depressed patients], indicating that these difficult-to-treat patients profit especially well from psychoanalysis.