Toward a New Understanding of Self , Relationship , and Experience

T book Interpersonal Psychotherapy of Depression was the original statement of interpersonal psychotherapy of depression (IPT). As someone who has conducted IPT for several years, I have carefully read and reread the 1984 IPT book. It is a refreshingly clear, clinically friendly outline of why and how to conduct IPT. The fact that the book has been in print in one form or another for the last 15 years attests not only to the increasing popularity of IPT but also to the quality of the book itself. In short, it’s a classic. Can a classic be improved? Comprehensive Guide to Interpersonal Psychotherapy is an effort to supplement the 1984 IPT book. Its authors are Myrna Weissman, one of the originators of IPT, and John Markowitz, a leading practitioner and researcher of IPT. The new book is a blend of the 1984 IPT book and an updated version of New Applications of Interpersonal Psychotherapy. The latter was a review of research and clinical efforts to implement IPT with a wide variety of patient populations and psychiatric diagnoses. Is the Comprehensive Guide more than an updated sum of these two books? Section I, “Conducting Interpersonal Psychotherapy of Depression,” is the expanded version of the 1984 IPT book. What I best liked about this section is that the authors added information on how to conduct IPT that will be especially useful to clinicians who are learning this modality for the first time. Suggested scripts for inquiring about interpersonally relevant issues are included, as well as possible ways of explaining IPT concepts and issues to patients. As an IPT supervisor, I find that clinicians new to IPT thirst for practical, howto ways to conduct the therapy. Suggested scripts were available in the 1984 IPT book, but the addition of others enriches this section as a training manual. The Comprehensive Guide also provides more clinical vignettes than the 1984 IPT book. Again, the vignettes provide concrete examples of how specific issues are handled with real patients at different stages of the therapy. I surmise that the new vignettes are drawn from Markowitz’s and Weissman’s own experience of conducting IPT in the last 15 years. Some of the clinical material reflects contemporary issues in conducting IPT in psychotherapeutic practice, such as the psychological ramifications of HIV infection. Section I also provides updated efficacy data on IPT. Section II, “Adaptation of IPT for Mood Disorders,” and Section III, “Adaptation of IPT for NonMood Disorders,” correspond to the last two sections of New Applications. The variety of problems to which IPT has been applied testifies to the therapeutic versatility of this modality. Problems include recurrent major depression, dysthymic disorder, adolescent depression, late-life depression, bipolar disorder, depression in primary care patients, depressed HIVpositive patients, and others. These sections of the Comprehensive Guide offer more clinical vignettes than found in New Applications and, of course, provide contemporary summaries of research pertaining to each of the problem areas discussed. Clinicians will find the research updates brief and straightforward, with relevant references for those who wish to pursue the details. Section III also contains a chapter on “Applications in Progress,” which gives a glimpse of novel and cuttingedge IPT interventions such as IPT for borderline personality disorder and for body dysmorphic disorder. Section IV, “IPT Resources,” reports on the remarkable spread of IPT to other countries and of its flexible adaptation to new formats. The book concludes with a look at “The Future of IPT” and an extensive discussion of the conduct of an IPT case that appeared in the 1984 IPT book. Can a classic be improved? Is the Comprehensive Guide more than an updated sum of two previously published IPT books? I believe so. With the wealth of both research and clinical knowledge possessed by Weissman and Markowitz, the book is indeed comprehensive. It adds texture and depth to the 1984 IPT book and to New Applications. Sections II through IV benefit from the authorship of only two individuals (in contrast to New Applications, which was an edited compilation), who bring a common format to these sections enriched with clinical examples. It is notable that Weissman and Markowitz included the late Gerald Klerman as one of the co-authors of this book. Clearly he was the nucleus of IPT and had a major hand in writing the 1984 IPT book. Klerman was one of those rare individuals in psychiatry who combined a clinician’s sensitivity and intuition with a researcher’s hard-headed search for the facts. I found the dedication of the book particularly touching: “To Gerald L. Klerman, loving and wise, a mind of crystal clarity.” And indeed, in both the 1984 IPT book and the Comprehensive Guide one finds love, wisdom, and clarity.