The foregoing is a minor example of what those people with the courage to call themselves patients must go through in more major ways, and often many times, in the process of psychotherapy. The period of intensive psychotherapy is a period of intensive growth, during which the patient may undergo more changes than some people experience in a lifetime. For this growth spurt to occur, a proportionate amount of "the old self" must be given up. It is an inevitable part of successful psychotherapy. In fact, this process of giving up usually begins before the patient has his first appointment with the psychotherapist. Frequently, for instance, the act of deciding to seek psychiatric attention in itself represents a giving up of the self-image "I'm OK." This giving up may be particularly difficult for males in our culture for whom "I'm not OK and I need assistance to understand why I'm not OK and how to become OK" is frequently and sadly equated with "I'm weak, unmasculine and inadequate." Actually, the giving-up process often begins even before the patient has arrived at the decision to seek psychiatric attention. I mentioned that during the process of giving up my desire to always win I was depressed. This is because the feeling associated with giving up something loved -- or at least something that is a part of ourselves and familiar -- is depression. Since mentally healthy human beings must grow, and since giving up or loss of the old self is an integral part of the process of mental and spiritual growth, depression is a normal and basically healthy phenomenon. It becomes abnormal or unhealthy only when something interferes with the giving-up process, with the result that the depression is prolonged and cannot be resolved by completion of the process.

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