Declaration of interest None.
Cognitive therapy for depression is common practice in today's National Health Service, yet it does not work well. Aaron Beck developed it after becoming disillusioned with the psychoanalytic theory and therapy he espoused and practised. But Beck's understanding of psychoanalysis appears to have been seriously flawed. Understood rightly, the psychoanalytic approach offers a cogent theory and therapy for depression which, unlike the cognitive approach, takes us to its emotional-motivational roots. A clinically successful therapy can afford to eschew theory and rest on its pragmatic laurels. This is not the case for cognitive therapy. The time is right to re-examine the psychoanalytic theory and treatment of depression.
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