Complex Depression

Golan Shahar argues that the dynamic relationship between personality and social factors, which he terms "ecodynamics," is the root cause of complex depression and leads to severe consequences, including suicide. Dr. Shahar examines foundational psychoanalytic research on depression, particularly Melanie Klein's object relation theory and her depressive position. He elaborates upon these concepts with a transtheoretical lens that accounts for key factors, including affect (primarily self-criticism); affect regulation; schemas and scripts that reinforce self-criticism; projections of the self into the future; and externalization of depressive feelings that creates a vicious cycle. Shahar explores specific ecodynamic patterns that lead to complication like chronicity, heterogeneity, comorbidity with other disorders, health and legal problems, and suicidality. Methods and guidelines for assessing and treating depression that account for ecodynamic factors are provided, including three new measures developed by Shahar for this book. Case examples help readers understand the causes and consequences of complex depression, including Shahar's deeply personal investigation of his stepfather's suicide.