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Aftab: One thing I had not quite appreciated before reading your book was that the psychoanalysts were quite sympathetic to the notion of gene-environment interactions when it came to depression (the genetic factors being described in the language of their day as a constitutional factor or inborn tendency). It is rather unfortunate that we have this caricature of psychoanalysts in contemporary consciousness as psychological reductionists and dismissive of biologySadowsky: I have long thought that psychoanalytic hostility to biology was a caricature created by the critics of psychoanalysis—I wrote an article about it in 20065—but I was surprised by how right I was in the case of depression. The psychoanalysts who denied any role of biology in causing or treating depressive illness were defying the views of the most prominent theorists, including Freud; Karl Abraham, PhD; Otto Fenichel, MD; Edith Jacobson, MD; John Bowlby; MD; Silvano Arieti, MD; Julia Kristeva, PhD; Nancy McWilliams, PhD, ABPP; and Otto Kernberg, MD, FAPA. I am naming names here because they are so prominent, and they wrote such widely read books.
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Aftab: In a very memorable passage of your most recent book, you compare history with psychoanalysis: “One theory about how psychotherapy works is that patients are locked into repeatedly telling the same story about themselves – about their loneliness, or their victimization, for example. The therapy helps patients see that they do not have to repeat the same story. They can tell new stories of their lives. History can have a similar role . . . We do not have to live the same story, time after time” (page 133).4 Later in the epilogue you again refer to the study of history as a means of guarding against compulsive repetition. Can you summarize here what history tells us we can do differently going forward when it comes to our understanding and treatment of depression?
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