In this group of patients, it was determined that aggression, which we took as a criterion for differentiating the mechanisms of formation of anxiety-depressive states, manifests itself most clearly and can be easily isolated. The triggering factor for this mechanism was the moment when the patient was treated, in his opinion, unfairly, not in the way he deserved by all his previous actions, or the people around the patient did not take into account any special interests that were of great importance to him or desires. At such moments, the patient found himself in the role of a passive object over which, in his opinion, a kind of psychological violence was being committed. At the moment of the triggering factor, the patients’ condition usually deteriorated very quickly and such deterioration proceeded very rapidly, and at this first stage the patient felt himself in the role “victims”, and therefore the immediate painful manifestations at this stage were expressed to the maximum. This maximum degree of severity of painful symptoms was quite quickly reduced, and a second period began when, behind relative external adaptation, there was a subconscious search for a “way of punishment” for the party guilty of “violence.” Moreover, a mandatory aspect of the developed method had to be the infliction, in one form or another, of “damage” to the punished party. The duration of this period is usually short and ranges, as a rule, from one week to several months. Then comes the third period, when psychological mechanisms find a justified (in the patient’s value system that has developed at that moment) method of punishment in the form of re-manifestation of the disease state. Moreover, its manifestations in this group are especially vivid and the less amenable to correction on the part of the “punished”, the more efforts he shows in trying to help the patient. It should be mentioned here that during intra-family “punishment” the patient most often uses elements of the so-called. “castration”, when the “victim”, usually the husband or wife of the patient, is deprived of a full-fledged sexual life through the latter’s illness, and sometimes, by passively agreeing to it, their behavior makes the partner feel sexually inferior. Patient G., born in 1969 ., Was treated in a specialized neurosis department with a diagnosis of “hysterical personality disorder, decompensation.” ICD-10 code F60.42. Heredity is not burdened with mental illness. She was the only child in the family. The mother always knew how to get “her way,” and more often “quietly and imperceptibly,” but “she could throw a tantrum.” In addition, as the patient says, her family developed a “punishment system” for various “offenses,” and this system applied to both her and her father, whom the patient characterizes as kind, gentle, and pliable. He says that he loved his daughter very much when she was little, and allowed her a lot, sometimes covering things up in front of her mother. She says that she always liked the relationships that were established in their family, and she considered them exemplary and “the only correct one.” The patient went to school at the age of seven, studied well, was actively involved in social work, participated in amateur performances, even organized together with young class teacher of the school theater. She studied piano at a music school. After school I wanted to go to study to “be connected with art”: either to a music school or to a theater institute, but my mother insisted on enrolling in a polytechnic institute at the economics department. She got married in 1995, mainly because her husband “adored her” and demonstrated this attitude towards her in every possible way. She herself did not feel “special love” for him. She said that she constantly changed jobs, and after marriage, she and her husband tried to start “their own business,” but at first this also did not bring any serious income. Her husband blamed her for everything, saying that she was too frivolous about the matter. INEventually, he decided that she should take care of the house, and it was at this point that things gradually began to look up. At the end of 1998, her husband forced her to have an abortion, citing the fact that “they can’t have children yet” because they are poorly financially secure. He did not pay any attention to her requests, to the fact that “it was at that moment,” in her words, that she “wanted a child as never before and probably never will.” “Almost by force he brought” her to a doctor he knew, where she had an abortion. She believes that “gross violence was committed against her at that time.” After leaving the hospital, she moved from her husband to her parents and wanted to divorce him, but her husband and parents persuaded her to return. The relationship with her husband remained very tense, she quite often argued with him, she could shout “throughout the whole house,” break dishes, etc. At the same time, her mood dropped sharply, she didn’t want to do anything, she could lie on the sofa all day long or “loiter around.” ” around the city, while missing work, which is why they were fired from one job after another. Then came weakness, very rapid fatigue, a feeling of palpitations, dizziness, and a feeling of unformed anxiety. Intimate relationships with her husband continued, but were completely passive on her part, which often resulted in additional scandals. Then she lost her appetite, her weight dropped by 20 kilograms within six months, and in the end, her husband brought her to the neurosis department of the Regional Clinical Clinical Hospital. Somatic condition: asthenic constitution and noticeably low nutrition, pale skin, vesicular breathing in the lungs, no wheezing, clear heart sounds , rhythmic heart rate 88 beats per minute, blood pressure 100/66 mm Hg. Art. Consultation with a therapist: chronic gastroduodenitis without exacerbation, chronic pancreatitis without exacerbation. Consultation with a neurologist: vegetative-vascular dystonia, cervical osteochondrosis without exacerbation. EEG: no focal pathology was detected, there are signs of a decrease in the threshold of convulsive readiness. REG: pulse filling in the carotid and vertebrobasilar basins is sufficient. Vascular tone is not impaired. Venous outflow is not difficult. Mental state: at the appointment the patient was with her husband, who brought her to a psychotherapist. At the beginning of the conversation, the husband asks for a preliminary conversation with the doctor without the patient. At the same time, he says that his current life with the patient has become “unbearable” for him; she constantly throws scandals at him, finding the most insignificant reasons for this. In addition, some time ago she insisted that she “needed” to work, got a job herself, then began to skip work for no apparent reason, as a result of which she was fired. The husband accused the patient that she was “putting him at risk.” He was surprised at her behavior and condition, saying that everything was completely normal between them until recently. The patient herself also demanded a conversation separately from her husband. During the conversation in the department, the mood is low, and he emphasizes and tries to demonstrate this low mood in every possible way: he sighs heavily, speaks in a quiet, pained voice, covers his eyes with his hand. Sometimes she starts crying, but she can be distracted from crying quite easily by changing the topic of conversation. She immediately spoke about the situation with abortion, which she considered key to her condition. By telling the story, she makes it clear to the doctor how important it was for her then to give birth to a child, how callously and cruelly her husband acted, forcing her to have an abortion. During the conversation, she asks questions aimed at understanding how the doctor feels about her situation and whose actions he considers correct. When it seems to her that the doctor agrees with her interpretation of events, she tries to “encourage” him, becoming flattering, starting to flirt slightly and expressing confidence that it is “such a doctor” who is able to understand and cure her. During treatment in the department, she was very conflictual, with at the slightest disagreement with her vision of the problem or failure to fulfill her desires, she demonstrated a “sharp” deterioration in her condition, expressed blackmail.