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Psychodynamic Treatment of Depression, Second Edition

Fredric N. Busch, M.D., Marie Rudden, M.D., and Theodore Shapiro, M.D.

  • ISBN 978-1-61537-035-1
  • Item #37035

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Psychodynamic Treatment of Depression addresses the use of psychodynamic psychotherapy, both alone and in combination with cognitive-behavioral, interpersonal, and medication treatments, as a method for reducing the psychological vulnerabilities that may predispose patients to persistent symptoms or recurrence of depression. Thoroughly revised and with new material, the second edition reflects changes codified in the DSM-5 classification and is intended for use by students, residents, or clinicians who are trained in the practice of psychotherapy. The authors' extensive clinical experience is thoroughly mined to provide techniques for tailoring the psychodynamic psychotherapeutic approach to patients with depression, and important topics such as narcissistic injury and vulnerability, guilt, defense mechanisms, and suicidality are addressed. The book is written in an accessible style and structured logically to support the acquisition and enhancement of psychotherapeutic skills through the systematic exploration of the psychodynamic model of depression.

The volume's noteworthy content and features are many:

  • Just as patients' responses to medications vary, responses to particular therapeutic interventions are different in different patients. Accordingly, the authors locate psychodynamic psychotherapy within the context of current treatments for depression, including indications and contraindications.
  • A multitude of detailed and compelling clinical vignettes clearly illustrate the dynamics and techniques and facilitate learning across diverse clinical roles and practice settings.
  • A chapter on psychodynamic approaches to depression with comorbid personality disorder has been added to the new edition, because these disorders have been found to have an adverse effect on treatment outcome, including diminished response to antidepressants, reduced adherence to treatment, and longer time period to achieve remission.

There is a growing evidence base for the effectiveness of psychodynamic psychotherapy, both alone and in tandem with other treatment modalities. Psychodynamic Treatment of Depression offers a robust model of psychodynamic therapy for depression and the detailed strategies and techniques clinicians need to improve outcomes with this significant patient group.


  • PART I: Introduction and Overview
  • Chapter 1. Introduction
  • Chapter 2. Development of a Psychodynamic Model of Depression
  • Chapter 3. Overview of Psychodynamic Psychotherapy for Depression
  • PART II: Techniques in Psychodynamic Treatment of Depression
  • Chapter 4. Getting Started With Psychodynamic Treatment of Depression
  • Chapter 5. The Middle Phase of Treatment
  • Chapter 6. Addressing Narcissistic Vulnerability
  • Chapter 7. Addressing Angry Reactions to Narcissistic Injury
  • Chapter 8. The Severe Superego and Guilt
  • Chapter 9. Idealization and Devaluation
  • Chapter 10. Defense Mechanisms in Depressed Patients
  • Chapter 11. The Termination Phase
  • PART III: Special Topics
  • Chapter 12. Psychodynamic Approaches to Depression With Comorbid Personality Disorder
  • Chapter 13. Managing Impasses and Negative Reactions to Treatment
  • Chapter 14. Psychodynamic Approaches to Suicidality
  • Chapter 15. Use of Psychodynamic Psychotherapy With Other Treatment Approaches
  • Index

About the Authors

Fredric N. Busch, M.D., is Clinical 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 the Berkshire Psychoanalytic Institute.

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.

Depression is the most common cause of referral to psychodynamic therapy, and this book remains the best guide therapists have to effectively address this pernicious problem. It stands alone as a clear, technical, research-informed guide for experts as well as beginning therapists. It should be on the shelf of all clinicians practicing psychotherapy of any modality.—Peter Fonagy, Freud Memorial Professor of Psychoanalysis and Head of Research Department of Clinical, Educational and Health Psychology, University College London; Chief Executive, Anna Freud Centre

The authors succeed in crafting a book that is as approachable and relevant as it is educational and progressive. Their balanced approach invites readers to examine their own interactions with patients and think critically about how applied psychodynamic principles could improve depressive symptoms. Of equal utility is the authors' inclusion of relevant areas of special concern, such as patients with comorbid personality disorders — a cohort with whom it can be exceedingly frustrating and difficult to work. As a psychiatry resident, I found the case vignettes extremely useful as a practical way to explore the concepts of psychodynamics. While the authors obviously emphasize a psychological approach, they have a balanced view of mental illness and treatment. They clearly espouse the en vogue biopsychosociospiritual approach. Indeed, such a respectful and balanced view certainly builds a healthy bridge between psychiatry and psychology. I will continue to highly recommend this book to my colleagues, as it has already proven to be a valuable tool for my training.—Cameron J. Risma, M.D., Doody's Book Review

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