There are many psychological issues uncovered in this book and many problems suspected, although not all diagnosed. Each of the characters in the family has psychological problems, and together they are in a muddle of difficulty and problematic communication.
There are at least three separate treatment situations. First, there is the treatment of Conrad at the mental hospital, which involved both talk therapy and ECT. Then, there is the treatment of Conrad by Dr. Berger, which relied on talk therapy. Finally, there is brief mention of Conrad's father, Cal, beginning to work with Dr. Berger on his own issues. The focus of this paper is the second course of treatment, with reference back to the first.
The major difficulty being treated is depression. In the book, the statement was made that Conrad's original diagnosis at the hospital was of Severe Depressive Episodes, with High Risk of Suicide (p. 33). His suicide attempt was a significant one and he was treated in the hospital for a period of eight months.
Although released to the community and living at home, there is indication throughout the early part of the book that Conrad still struggled with depression. In addition, anxiety, or even panic, seemed to be part of the constellation of symptoms he struggled with. There is some indication even of panic disorder, and some indication of claustrophobia. However, the main diagnosis of depression seemed an accurate one.
During the course of the book, it appeared that this depression was grief-based, but extended and extreme. It seemed to have elements of survivor's guilt as part of it, as well as contributing cognitions of inadequacy and failure. The condition was exacerbated by the boy's feeling that his mother did not love him at all and wished that he had died, rather than his brother.
The treatment this second time was exclusively based on talk therapy. In the book, it stated that Dr. Berger was a psych...