For example, my patient's snippy reply spurred my reflection, "I went out of my way to show I thought of you, someone who complains of loneliness, by getting you a card I thought you'd find helpful, and that's the response? I'm starting to understand why it's difficult for you to keep peaceful family relationships or make friends." She had nowhere to look but the mirror for why she was unfulfilled, and a more productive course began to unfold as she realized she repelled that which she desired. Rather, it will be much more relational, because chances are the person is having significant interpersonal relational issues in their life. Focus will not be on categorically improving various symptoms like in depression.Despite trials of various therapies and anti-depressants, the depressive picture remains "treatment-resistant.".Sleep, appetite, and energy disturbances may be present but tend to be secondary complaints.They appear depressing but are not necessarily depressed per se. The person is not entirely incapacitated, remaining functioning, albeit not optimally.As Millon noted, this may be a mechanism designed to receive recognition from others and thus feel they do matter, despite their feelings towards themselves. They feel they can’t do anything right, and view themselves as helpless, giving up, and often summons others to take care of them.
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