ABSTRACT In considering the hopeful rhetoric that pervades the “nothing but” psychopharmacological approaches to depression—a contemporary version of what William James calls medical materialism—this article argues that only a thorough-going pluralist account of hope is a hope worth wanting. Medical materialist hope is better conceptualized as a variation of optimism, which assumes a single universe that is already the best of all possible universes, and thereby only promotes optimization of the status quo, rather than encourage a wider undertaking of a (...) variety of experiments in living. A pluralist hope, as opposed to optimism, cannot logically infer what the future will bring from a reigning scientific model of the brain. Rather, a pluralist hope is a passionate belief that a not-yet unimagined, and therefore indeterminate, future will meliorate current human ills should humans strenuously work toward achieving it. (shrink)