But not all cases are like Kathy's by any means. There are many other patterns, some also quite common. Marcia was one of the very first of my long-term-therapy cases. She was a quite wealthy young woman in her mid-twenties who sought my attention because of a generalized anhedonia. While she could not put her finger on anything wrong with her existence, she found it inexplicably joyless. Certainly she looked joyless. Despite her wealth and her college education she looked like an impoverished, bedraggled and aged immigrant woman. Throughout the first year of therapy she invariably dressed in badly fitting clothes of blue, gray, black or brown, and carried with her an enormous, filthy and ragged carpetbag of similar hue. She was the only child of intellectual parents, both highly successful university professors, both socialists of a sort who believed that religion was "pie in the sky by and by." They had made fun of her when, as a young adolescent, she had attended church with a girl friend.

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