Abstract

Some years ago I was referred a 42-year-old woman who had become depressed after a hysterectomy for benign fibroids. Her name was Anna Corelli, and she was married and had four teenaged children. (The name of the patient has been disguised to ensure anonymity.) It was assumed that her depression was related to mourning for her lost womb and lost reproductive capacity. But I am getting ahead of myself. It was the 1970s, the era of long hair and short skirts, of turning on and dropping out. My office was, at the time, on 96th Street just off Madison Avenue, widely referred to as the "mental block," for all the psychiatrists who had their offices there. Mrs. Corelli entered my office embraced by a huge sable coat. She was intelligent, spoke with a refinement far beyond her limited schooling, and was moderately depressed. At the end of the session I outlined a treatment program of weekly sessions. She said it was "so expensive" and that she would have to speak to her husband, who made all decisions. I doubted poverty, because of the enormous diamond on her left ring finger. The next session, she spoke more of her