SEVERAL studies have shown that the affective response of "giving-up," when it follows real, threatened, or symbolic loss of a highly valued form of gratification, tends to precede the onset or exacerbation of somatic as well as psychic disease.^1-4 The "giving-up" reaction does not cause disease to occur but allows or facilitates whatever disease potential or predisposition exists in the individual or environment to become manifest. As described elsewhere, we think the term "giving-up" is expressive of more than what is usually subsumed under the heading of a feeling. In our work we have come to view feelings as indicators of general intrapsychic adaptation. On this basis, "giving-up" indicates not only an unpleasant feeling but includes a loss of self-esteem, a disruption in object relationships, a decrease in motivation, and an expectation that such a state may be enduring. Such intrapsychic phenomena appear to be based in part on