Dr Martin Kantor sent the following response on July 21, 2008, published July 25, 2008.
I raise the following questions about James K. Luiselli's review of my book Lifting the Weight.
Why is a behaviorist who works for an institute mainly involved with treating autistic children and writes about their treatment assigned to review my book, a general psychiatric book on depression in men, in the first place?
What is wrong with being an eclectic? As the mainstream psychiatrist John Oldham, an eminent psychiatrist affiliated with the New York Psychoanalytic Institute and Columbia-Presbyterian Hospital, writing with Joan Morris, says, "very often a therapist will combine many different approaches to achieve the optimal treatment for his or her patient1 (p. 403) Clearly Oldham and Morris disagree with Luiselli who says, "most practitioners adopt a singular treatment modality that is theoretically consistent and integrated conceptually."
As for "mindfulness-based interventions such as Acceptance and Commitment Therapy (ACT), and learning-theory strategies such as behavioral activation," sure, I overlooked them; they aren't in any of my medical books or journals or seminars. And why should I give behavioral therapy, which I believe doesn't always generalize well outside of the treatment room, and isn't the only approach applicable to depressed men, precedence over therapeutic modalities such psychodynamic psychotherapy and supportive therapy, which I advocate in the belief that they are eminently effective for treating depression in men?
What's wrong with speaking in English and using simple analogies to bring points home for the general clinician and layperson? Too simple for the clinician yet too abstruse for the layperson? That's a hard line to walk. I believe in getting real, not in remaining ivory-tower rarefied. Two of the best books on depression, by Andrew Solomon2, who speaks of the man's depressing attitude of "I am an unworthy, inadequate, unmasculine man" (p 205) and Terrance Real3, who speaks of problems with "images of masculinity" deal with the subject on a very similar conceptual and expressive level. The clinicians I spoke to found my language revealing, containing words that started a conversation with themselves. In contrast they had some trouble relating to "Mindfulness-based interventions such as Acceptance and Commitment Therapy (ACT), and learning-theory strategies such as behavioral activation."
Why should a general book on depression in men that specifically sets out to describe the human dimension of the disorder have a section on the latest pharmacotherapy of depression? Have there been any big breakthroughs since I wrote my text? I must have missed something big even though I read the latest psychiatric and medical journals every month.
Alas, missing something big I fear would put me in a place I wish not to go: in league with my reviewer.
1. Oldham, John and Lois B. Morris. 1995. New Personality Self-Portrait: Why You Think, Work, Love and Act the Way You Do. New York: Bantam
2. Real, Terrence. 1997. I Don't Want to Talk About It: Overcoming the Secret Legacy of Male Depression. New York: Scribner
3. Solomon, Andrew. 2001. The Noonday Demon. New York: Scribner
Dr James Luiselli was offered the opportunity to reply to Dr Kantor's response, but declined.