Discussion

AS I REVIEWED this interesting, clearly presented, and instructive paper I came to realize that I could not do the author justice in a

few minutes of discussion. Throughout the presentation run several themes, each deserving consideration by itself, and their interrelationships lending themselves to study in a seminar. Among these themes are the psychodynamics of depression, the roles of aggression and hostility, the phenomenon of homosexuality, the so-called "negative therapeutic reaction," the concept of anxiety, the problem of transference, the function of change in psychotherapy, and the unique aspects of the particular case presented. I shall report here a few of the ideas provoked by this variety of subjects, making no attempt to develop any thesis in detail.

Dr. Bonime speaks of depression as a "practice"—an active mode of interpersonal relationship. As he uses the term it refers to a wide range of behavioral expressions—"from sulk to psychosis."

In a general sense we use the word depression to refer to an affect, experienced as unpleasant, painful, inhibiting of thought and act, and undesirable. I should guess that "most people"—in our culture, at least—have some idea of what is meant by depression; "it" has been spoken of as a fundamental human emotion and as integral to psychic life. If we refer to depression as a process—rather than as an entity or a disease in the classical sense—the disorder will be seen to have beginnings in early life experience, multiple functions in interpersonal relationships and the social field, a course variably predictable, and a resistance to change that is noteworthy.

The depressive experience—common if not ubiquitous—may be manifest in various ways:

• a.as a "mood"—passing, persistent, recurrent, noted, or unobserved;

• b.as an accompaniment of other disorders;

• c.as a relative of grief reflective of loss;

• d.as a way of life—seemingly learned;