Depression with its thousand faces continues to present us with considerable challenges. The case that was put to us by Dr Kantrowitz serves as a good example to illustrate how wide a span there is in situating our views when we try to share them although, thanks to non-specific or relational factors, this distance does not seem to carry such radical consequences in the long-term treatment of an afflicted patient.

The case presented is of an 11-year analysis with a man whose affect was frozen. Dispositional, environmental and developmental factors all contributed to his depression. He was stuck in a painful psychological place in which he could not achieve success, yet he could never stop wishing for success - while