Psychodynamic psychotherapy of depression

Abstract

Psychodynamic psychotherapy has a long tradition in the treatment of depression. Its effectiveness lies, according to previous studies on the same level as other bonafide therapies. The review first presents the guideline recommendations for the therapy od depression in Germany. Furthermore, classical and modern psychodynamic models of depression are introduced. From these, general and specific therapeutic aspects are derived. The presentation of the therapeutic approach begins with a section on how to deal with acutely depressive patients. In this regard, contextual factors such as medication and social support measures are described as well as how to deal with suicidal tendencies. In addition, typical pitfalls in dealing with these patients are described. In a further section, two particularly typical personality constellations in depressive patients are addressed (avoiding versus ambivalent-preoccupied patterns). These are derived from traditional models of depression as well as from clinical attachment research. Finally, measures for relapse prophylaxis and possible maintenance therapy strategies are presented.