People in depressions are submitted to a suffering which always necessitates, in addition to pharmacotherapy, a psychotherapeutic approach. In all the psychotherapies known, a certain attitude of the therapist, which includes an unconditional openness for the patient, is necessary. Depressives cannot bear banal optimism, but need the therapist’s confidence in their future. This human participation helps to fill up, at least to a certain degree, their lack of narcissism. Special points of psychotherapy of depressives are described: 1. positive emotional attention, empathy, 2. unconditional listening, 3. asking questions (to give the patient’s word and attitudes a meaning and to activate cognitive processes), 4. more orientation than interpretation (during depressive phases), 5. giving advice: Whereas in most psychotherapies it is counterindicated to counsel the patient, in major depressions it can be necessary to formulate recommendations, 6. getting conscious about what happened during the therapeutic session in the patient and in the therapist, since otherwise the therapist may get too involved in the depressive’s unrealistic expectations or too defensive against him. – Psychotherapy with depressives does not only mean individual treatment, but can include – possibly in addition – their social environment: Partner therapy, family therapy, of the use of a social system as a milieu for psychotherapy (group psychotherapy). Whereas psychotherapy in the depressive phases consists mainly in the named procedure, in the intervals, the experiences of the depressive phases and the emotional and cognitive life and behavior patterns should be worked through focally, in an analytically oriented short-term psychotherapy. A long-term analytic treatment is only indicated in depressive neurotics. Depression, whatever its cause, always represents a suffering which leads, especially because of a more or less total lack in the realm of the self, to isolation, anxiety and pain. Even major depressions, parallel to typical biochemical findings, are characterized by specific psychodynamics like narcissistic emptiness respectively depletion and overwhelming dependance on a strict archaic conscience (superego) with corresponding behavior patterns, such as the need always to observe law and order (Battegay, 1985, 1, 2, Tellen-bach, 1961).