The advent of multiple effective psychopharmacologic interventions and targeted psychotherapeutic treatments has led to remarkable progress in the treatment of depression. Yet despite this progress, the treatment of depression often continues to be a struggle. Psychodynamic psychotherapy -- often used in combination with cognitive-behavioral, interpersonal, or medication treatments -- is one approach to reducing the neurophysiological and psychological vulnerabilities that may predispose patients to persistent symptoms or recurrence of depression. Though books on other treatment approaches to depression abound, this insightful volume is unique because it offers a psychotherapeutic approach to the dynamics observed in patients with depression that can sharpen clinicians' skills in treating this disorder. Intended for use by students, residents, or clinicians who are trained in the practice of psychotherapy and in the diagnosis of depression, the book describes how to tailor the psychodynamic psychotherapeutic approach to the treatment of patients with depression. The authors use many vivid clinical case vignettes based on their clinical work to illustrate common dynamic constellations and techniques for engaging patients in depression-focused psychodynamic psychotherapy. Because a major disparity exists between the widespread use of psychodynamic psychotherapy in clinical practice and the few systematic studies of this treatment, the authors recommend using this approach mainly in patients with mild or moderate major depression and dysthymic disorder. Using a structure that facilitates learning how to apply psychodynamic psychotherapy, the authors - Begin with an introduction placing psychodynamic psychotherapy within the context of current treatments for depression, including indications and contraindications highlighted by two case vignettes.- Review psychoanalytic theories and research on depression to develop a core set of depressive dynamics.- Focus on the techniques of psychodynamic psychotherapy as they specifically apply to treating patients with depression.- Highlight techniques to help patients recognize their vulnerability to the dynamics that form the core of the depressive experience, and illustrate how to work with these dynamics to help patients better manage their vulnerability.- Address topics of special concern in the psychotherapy of depression, including complex cases, treatment impasses, suicidality, and issues to consider when combining treatments. Useful for practitioners, students, and residents as a clinical guide for learning about psychodynamic psychotherapy and its adaptation for treatment of a specific disorder, this practical volume, with its fascinating clinical case vignettes, is also an invaluable text for courses on psychodynamic psychotherapy and psychotherapeutic treatment approaches to depression.
Fredric N. Busch, M.D., is Clinical Associate Professor of Psychiatry at Weill Medical College of Cornell University and on the faculty at the Columbia University Center for Psychoanalytic Training and Research in New York, New York. Marie Rudden, M.D., is Clinical Assistant Professor of Psychiatry at Weill Medical College of Cornell University, Training and Supervising Analyst at Berkshire Psychoanalytic Institute, and on the faculty at the New York Psychoanalytic Institute in New York, New York. Theodore Shapiro, M.D., is Emeritus Professor of Psychiatry in Pediatrics at Weill Medical College of Cornell University, and Training and Supervising Analyst at the New York Psychoanalytic Institute in New York, New York.
Part I: Introduction and Overview. Introduction. Development of a psychodynamic model of depression. Overview of psychodynamic psychotherapy for depression. Part II: Techniques in Psychodynamic Treatment of Depression. Getting started with psychodynamic treatment of depression. The middle phase of treatment. Addressing narcissistic vulnerability. Addressing angry reactions to narcissistic injury. The severe superego and guilt. Idealization and devaluation. Defense mechanisms in depressed patients. The termination phase. Part III: Special Topics. Managing impasses and negative reactions to treatment. Psychodynamic approaches to suicidality. Use of psychodynamic psychotherapy with other treatment approaches. Index.
This book is for clinicians of all 'denominations.' It is an extremely clear, concise, and well written exposition that focuses on every aspect of the psychodynamic treatment of depression, including the sometimes concomitant need for medication. Written in an accessible style and studded with excellent case vignettes, the book addresses the different dynamics in depression with remarkable clarity and panache, and it presents the whole trajectory of a psychodynamic treatment of depression from beginning to end. First rate. Ethel Spector Person, M.D., Professor of Clinical Psychiatry, Columbia University, Training and Supervising Analyst, Columbia University Psychoanalytic Center for Psychoanalytic Training and Research This timely volume reminds us that in our era of psychopharmacological triumphs, the optimal treatment of our patients requires psychodynamic understanding and psychotherapeutic skill. Busch and his colleagues have written a remarkably concise, clear and yet comprehensive volume outlining what the psychodynamic model of pathology is, its usefulness in the treatment of depression, and how one conducts a brief psychodynamic psychotherapy. While their focus is on depression, and they provide a detailed map for the treatment of this disorder; however, everyone with an interest in psychopathology will profit from this work. The authors provide numerous clinical illustrations that make core concepts crystal clear and that illustrate the techniques required for successful conduct of psychodynamic psychotherapy. I believe that everyone who accepts responsibility for the treatment of a depressed patient will be grateful for the increased knowledge and enhancement of their skills that this book provides. I know of no better introduction to psychodynamic psychotherapy. Arnold M. Cooper, M.D., Stephen P. Tobin Professor Emeritus in Consultation-Liaison Psychiatry, Training & Supervising Analyst Columbia University, Past President, American Psychoanalytic Association A well-balanced volume that educates the new and informs the experienced. A valuable addition to the library of clinicians doing psychodynamic psychotherapy or using psychodynamic techniques in their treatment settings -- inpatient, consultation, partial and outpatient settings. Teaches as you learned during training, using cases to illustrate and develop examples of technique and theory. Robert J. Ursano, M.D., Professor & Chair, Dept of Psychiatry, Uniformed Services University of Health Sciences; Director, Center for Study Traumatic Stress Uniformed Services Univ School of Medicine This is a much needed addition to the literature on treatment of depression. The book aims to improve the clinical skills of clinicians at every stage of their career and from any mental health discipline, but it should be especially useful for those early in their careers. I highly recommend it. Allan Tasman, M.D., Professor and Chairman, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Louisville, Louisville, Kentucky
"This book is for clinicians of all 'denominations.' It is an extremely clear, concise, and well written exposition that focuses on every aspect of the psychodynamic treatment of depression, including the sometimes concomitant need for medication. Written in an accessible style and studded with excellent case vignettes, the book addresses the different dynamics in depression with remarkable clarity and panache, and it presents the whole trajectory of a psychodynamic treatment of depression from beginning to end. First rate." - Ethel Spector Person, M.D., Professor of Clinical Psychiatry, Columbia University, Training and Supervising Analyst, Columbia University Psychoanalytic Center for Psychoanalytic Training and Research; "A well balanced volume that educates the new, and informs the experienced. A valuable addition to the library of clinicians doing psychodynamic psychotherapy or using psychodynamic techniques in their treatment settings - inpatient, consultation, partial and outpatient settings. Teaches as you learned during training, using cases to illustrate and develop examples of technique and theory." - Robert J. Ursano, M.D., Professor and Chair, Department of Psychiatry, Uniformed Services University of the Health Sciences; Director, Center for the Study of Traumatic Stress, Uniformed Services University, School of Medicine, Bethesda, Maryland; "This is an exceptionally timely book and is a much needed resource in helping our patients in their recovery from depression and not simply in their symptom reduction. The authors present one of the most concise descriptions of the psychodynamic treatment process that I know of. Those clinicians wishing to learn about this type of treatment for depression will find this book invaluable. Residents will embrace this book because Psychodynamic Treatment of Depression provides an excellent overview to all of psychodynamic treatment including patient assessment for this modality, the establishment of the therapeutic relationship, patient responses to medication and combined treatment, precise interpretive techniques, the role of psychoeducation, the helpfulness and utilization of dreams, and the characteristics and objectives of the specific phases of treatment with this modality. They will also enjoy the extensive use of illustrative clinical vignettes." - Jerald Kay, M.D., Professor and Chair, Department of Psychiatry, Wright State University School of Medicine, Dayton, Ohio"
