Download Author: Arieti, Silvano, M.D.

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American Handbook of Psychiatry: Volume 4

Covers a broad range of psychiatric topics dealing with Organic Disorders and Psychosomatic Medicine. Download the entire Volume (2240 pp.) or download individual chapters by clicking the titles below.

The Basic Questions and the Psychological Approach

The major themes of this book will be the psychopathology and psychotherapy of the individual patient—child, adolescent, and adult. When we go beyond the study of manifest symptomatology and make our first acquaintance with the history of the depressed patient, we feel as if an invisible force, running throughout his life, has brought him to his present predicament. One of the main aims of this book is to make visible that invisible force, by showing how it came into existence and sustained itself on many facts, internal and external, individual and sociocultural; most of them unconscious and others conscious, but with unconscious ramifications.

The Manifest Symptomatology of Depression in Adults

A depression is called primary when it constitutes an essential component of a syndrome. An endogenous depression is based on organic factors. A reactive depression is precipitated by an event perceived by the patient as harmful. The differentiation between psychotic depression and depressive neurosis depends on wether the reaction affects the reality testing enough to be considered a psychosis.

The Psychobiology of Sadness

  • Introductory Remarks
  • Sadness
  • Other Aspects of Sadness
  • Transformation of Sadness
  • Unresolved Sadness and Depression

Psychodynamics of Severe Depression

In practice we find that many states of sadness leading to severe depression have a long course, either chronic or subchronic, liminal or subliminal. We also find that in many cases in which a specific occurrence was the obvious and major precipitating factor, a subliminal state of sadness resulting from previous contingencies preexisted. Thus it is important to study the longitudinal psychodynamic history of each patient.

Psychotherapy of Severe Depression

For major therapeutic approaches are available for the treatment of severe depression: psychotherapy, drug therapy, shock therapy, and hospitalization milieu therapy. Indications for psychotherapy exist in every case of primary severe depression. The intensity should not deter the therapist from making psychotherapeutic attempts. Concomitant drug therapy does not make the patient less accessible to psychotherapy.

  • Choice of Treatment
  • Beginning of Psychotherapy
  • Therapy of the Patient with a Pattern of Submission to the Dominant Other
  • The Treatment of Claiming Depression
  • Treatment of Depression Following Failure to Reach the Dominant Goal, and of Depression with Mixed Patterns
  • Advanced Stage of Treatment

Postpartum Depression

The more we study each case psychodynamically, the more we realize that the experience of giving birth to a child was an episode of such magnitude as to require a complete psychological readjustment on the part of the patient.

  • Introductory Remarks
  • Psychodynamic Developments
  • Case Report

Psychotherapy of Depression During the Middle Years

What sooner or later emerges is the symbolic importance of having reached the middle years, the menopause, or the climacterium. A recurring theme is that life has come, or is about to come, to an end.

  • Specific Psychodynamics in the Middle Years
  • Psychotherapy
  • Case Reports

Sociocultural Factors, Sociology of Knowledge, and Depression

  • Introduction
  • Greater Incidence of Depression in Women
  • Affective Psychoses and Inner-Directed or Other-Directed Society
  • Literature and Depression: Tragedy
  • Our Era As the Age of Depression
  • Socio-Philosophical Premises of the Psychotherapist of Depressed Patients