In this empirical yet deeply humanistic work, Golan Shahar investigates the dynamic relationship between personality and social factors in complex depression, identifying avenues for research and offering hope for sufferers and treatment providers.
 
Shahar synthesizes research and clinical wisdom to enhance our understanding of complex depression, a mental illness defined by its chronicity, heterogeneity, and serious consequences including suicide. He focuses on Melanie Klein's object relations theory and depressive position, reconceptualizing both from a transtheoretical perspective, with an emphasis on four key factors: demeaning affect; affect regulation; maladaptive schemas and scripts; and a time axis consisting of past, current, and projected future experiences. Shahar also explores how individuals externalize self-critical feelings, in turn creating a malignant social environment and a vicious cycle of self-recrimination. To explain this toxic relationship, Shahar presents ecodynamics, a novel theory examining relationship patterns between the self and their social contexts.
 
The book offers tools and procedures for assessing complex depression and guidelines for integrative psychotherapy. Case examples, including the author's profound personal investigation into his stepfather's suicide, vividly demonstrate the causes and consequences of complex depression.