Oliver Kamm suffered a hideous bout of depression that he recovered from through a combination of medication, CBT and the then virtuous circle of re-engaging with what nourishes him: art and literature. It’s a hopeful story – littered with literary quotes – as his conviction is that depression is treatable, if treated correctly. An unsuccessful – and in fact, damaging – course of psychodynamic psychotherapy quite rightly angered and obviously still angers him, but it also sadly seems to taint his view of the whole psychotherapy profession which gets a hefty weight of un-nuanced attack.
Psychodynamic psychotherapy has little evidence to support it for successfully treating severe depression, but Kamm seems to resist the worth of examining his past . We learn very little about the stresses that could have contributed to his illness, nor anything of his life pre-adulthood. That’s fine of course, as depression doesn’t always correlate to a previous trauma, but in so doing, he does ignore depressions that are, and the well established link between adverse childhood experiences and mental health problems. As a therapist treating depression, I always concentrate first on alleviating symptoms and offering evidence-based tools but the compassion-focused work he describes also rests upon exploring the possible legacies of unprocessed trauma too.
There are a few claims in the book that jar, such as ‘the underlying conviction that mental disorder has an occult origin is not rare in western societies in the twenty first century and is held even among medical professionals.’ He quotes one psychiatrist writing about demonic possession that sounds deeply alarming, but in all my years of talking to medical professionals in mental health I haven’t encountered one suggesting mental ill-health is anything other-worldly. I’m not so sure it is ‘not rare’ in the West either. He also writes, “Modern Britain does not have a ‘therapy culture’. Nor does any other advanced industrial economy I’m familiar with. Does Argentina or (ok not all) USA count? Parisians are open to therapy too and we are far more open to talking therapy than when I began practising 15 years ago.
But as I say, it’s hopeful: depression is treatable and I entirely agree that medication and talking therapy combined is a good course of action. The former can help forge the headspace necessary for the latter.