Discussion

Dr. Chrzanowski:

Our panelists have given us much stimulating food for thought—particularly Dr. Bonime's comment which calls to mind an irreverant attack on psychiatry depicted in a cartoon appearing in the New Yorker. Here, the patient is seen brushing something off himself and the psychiatrist says, "For heaven's sake, don't brush it off on me." Thus one could say that depressions are highly contagious and they evoke a host of defenses including those of the psychiatrist. We find, in some depressions, a mixture of helplessness and anger. If anything has been made clear tonight, it is that we are not justified in thinking in terms of a stereotyped concept. Some patients are undoubtedly willing to suffer the pains of hell for the privilege of tormenting others, and some people, as we know, always like to be tormented.

Now, since we would like to have as many comments and questions as possible, I would ask that you give your name and where you are from, and make your questions or comments as brief as possible.

Dr. Lester Gelb, New York:

I would like to address my remarks to the entire panel. However, I have been most provoked by Dr. Bonime's discussion of the psychopathological features of the depressive. What has been plaguing me for many years is an attempt to differentiate the morbid—the so-called morbid depressive—from the so-called normal depressive. And I believe there are normal depressions. We have heard of children being abandoned, people in concentration camps, old people being abandoned by their children and by society, people who have very few resources with which to function. We know that some people have severe organic illnesses and have a very difficult time. The question then is: Is there such a thing as a normal depression? If it is normal, then where is the psychopathology that we have been hearing about?

For example, a patient came to me after having been referred for shock treatment because she was depressed and did not want to take care o