Rowe's books are interesting and they occasionally contain some pearls of wisdom but they all seem to suffer from the same weakness. She's very good at giving detailed explanations as to why we might hold certain ideas, where these ideas came from (childhood) and why these ideas might be detrimental to us, but she devotes little or no time to solutions.
Instead, she provides an unnecessarily lengthy and unfocused book in which she attempts to put down on paper everything she can think of about depression - this includes numerous poems about depression sprinkled liberally throughout the book, excerpts of 'dark writing' produced by patients and writers, and anecdotes about patients. The problem with this, and particularly with her approach (which is largely psychoanalytical), is that it tends to encourage the reader to brood on their problems, and churn things over in their minds again and again. As a part of a treatment model, this isn't something that should be encouraged as it tends to exacerbate rather than reduce the symptoms of depression.
The descriptions of depression that Rowe adopts are taken from her patients - dark places, prisons, nothingness, bleakness, etc. People seems to relate to these descriptions and I have to admit that this is what got me to buy the book in the first place. Whilst I don't have any problem in people sharing experiences, provided it is appropriate, there is a considerable danger that the use of such descriptive and emotionally evocative language emphasises the power of the very 'prison' that people are trying to get out of. Depression is a frightening and difficult experience at the best of times, and if Rowe is going to take the reader to such a 'dark place' through emphasis and re-emphasis, she has an ethical responsibility, in my opinion, to lead them of out it through a structured and focused practical treatment programme. This she patently does not do.
Even when she does (briefly) talk about solutions, she gives the impression that it's simple to change deeply rooted ideas that have built up over a lifetime - if you feel angry don't, if you're afraid have courage, if you're feeling negative, don't because it's causing your depression. It's very condescending. If you're at your lowest ebb, it's the last thing that you'll want to hear. She spends almost the entire book analysing psychological causes and ideas, and its not until the very last chapter that she finally divulges what she believes to be the solution - that it's the depressed person that has the built the prison of depression around them through the ideas that they hold and it's therefore the depressed person's choice as to whether they want to deconstruct the walls of that prison. No further explanation. No practical or structured treatment programme of behaviour led change. No mapping of daily routines and behavioural target setting. No depression inventories or depression scoring techniques to measure progress (and encourage further progress). No consideration of physiological contributors to depressive symptoms (Rowe simply doesn't believe that there is any biological basis for depression). Nothing. Which wouldn't be so bad, if she showed more warmth, empathy, encouragement and understanding throughout the book. I don't feel that she does this very well or at all. She uses the word 'we' alot but she shows nothing of herself and the style is cold and clinical in my view. However, it's the complete absence of a solution based focus and its emphasis on psychological rumination, which makes the book fundamental flawed, in my opinion, particularly, if it is to be taken as a form of treamtment for depression.
Rowe has a number of entrenched views which crop up as recurring themes in her books. As far as Rowe is concerned, the field of psychiatry is irrelevant and there is no biological component to depression (serotonin / norepinephrine levels, atrophy of neurons, disrupted sleeping patterns, physiological contributors etc). Whilst I don't have any problem with her expressing unusual or controversial views or providing a socialogical or philosophical, I don't believe that a book that is likely to be read by a person suffering from depression is the most appropriate place in which to do so. Depression can be a hugely debilitating condition and most people who read this book will simply not be in position to question what she says becuase of vulnerabilty, fear, difficulty in making decisions or lack of knowledge.
When I suffered from depression, the things that would have helped would have been warmth, empathy, understanding, encouragement, hope and most of all, someone or some method to pull me out of depression. In my opinion, a book that is focused on those aspects, is far more appropriate than the restrictive and limited approach taken by Rowe which focuses on introspective rumination. If this book is simply one of many on the subject that you're going to read, then fine, but have a think about what sort of position you're in with regard to depression before diving in. It's interesting hearing the views of others who have read this book - one person I met said that after they had finished reading the book, they were 'cured' of depression, which I find difficult to believe. Another person described the book as 'not for the depressed'. Personally, I can't recommend this book to anyone suffering from depression (particularly those with moderate to severe depression). There are far better books on treating depression or its surrounding causes. The David Burn's book is a good one and its also worth having a look at the NHS depression reading list.
