Convergences among psychoanalytic and cognitive-behavioral theories of depression

This article reviews three contemporary psychoanalytic theories that articulate two types of depression, based on disruptions (a) of interpersonal relatedness or (b) of self-esteem, and that consider the nature, etiology, and treatment of depression based on the phenomenology of the issues that cause individuals to become depressed. The work of Arieti and Bemporad from an interpersonal perspective, of Bowlby from an ethological and object relations perspective, and of Blatt from the perspective of psychoanalytic ego psychology and cognitive developmental theory, are compared and contrasted with each other and with recent formulations of Beck, who approaches this topic from a cognitive-behavioral perspective. This article reviews these four theoretical positions with the goal of deriving a unified theory of depression that has implications for the treatment process. Areas of agreement and overlap as well as disagreements and differences among these four theoretical positions are articulated and discussed particularly in terms of their implications for treatment. In addition, suggestions are made about possible investigations that should be directed toward resolving some of the divergences and contradictions.