A young woman hospitalized during a severe depressive episode told me, ''No one could possibly care about me because I'm such an awful person. I'm a complete loner. Not one person on Earth gives a damn about me.'' When she was discharged from the hospital, many patients and staff members expressed great fondness for her. Can you guess how she negated all this? ''They don't count because they don't see me in the real world. A real person outside the hospital could never care about me.'' I then asked her how she reconciled this with the fact that she had numerous friends and family outside the hospital who did care about her. She replied, ''They don't count because they don't know the real me. You see Dr. Burns, inside I'm absolutely rotten ''.