Psychotherapy of severe depression

The author discusses his clinical experiences in treating severly depressed patients with psychotherapy. The psychotically depressed person cannot use normal mechanisms to recuperate from sadness because he is prevented from doing so by a preexisting life ideology that may include living for a dominant other or a dominant goal and that restricts his vision of alternative approaches to living. The therapist treating the severely depressed must initially assume a strong role; later, he helps the patient recognize depressive cognitive patterns and guides and motivates him to try other ways of living.