Cognitive Evolutionary Therapy for Depression

A Rwandan man once described the Rwandan treatment for depression to the 2001 National Book Award winner Andrew Solomon in these words: “You know, we had a lot of trouble with Western mental health workers, especially the ones who came here right after the genocide. They came and their practice did not involve being outside in the sunshine… which is, after all, where you begin to feel better. There was no drumming or music to get your blood flowing again – when you’re depressed and low you need to have your blood flowing. There was no sense that everyone had taken the day off so that the entire community could come together to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out of you again. Instead, they would take people one at a time into these dingy little rooms and have them sit around for an hour or so to talk about bad things that had happened to them. We had to ask them to leave the country.”While this description of a psychological intervention for depression is in stark contrast with the standard weekly therapy sessions so common in the Western cultures, it would not make an evolutionary therapist surprised. This chapter presents the theoretical underpinnings of Cognitive Evolutionary Therapy for Depression and the differences between it and Cognitive Therapy.