In this letter to the editor, the author comments on a case reported by Schwartz et al (see SIEC #970018). Schwartz & her colleagues discussed the symptoms & treatment of a 32-year-old Latina woman repeatedly hospitalized for depression & suicidal ideation. Silberman argues that the patient made poor progress because she was poorly understood. Her caregivers failed to appreciate how much of her behaviour was a meaningful response to life events in the context of a particular personal history.