The patient represents his ego to us as worthless, incapable of any achievement and morally despicable; he reproaches himself, vilifies himself and expects to be cast out and punished...
It would be equally fruitless from a scientific and therapeutic point of view to contradict a patient who brings these accusations against his ego.
He must surely be right in some way and be describing something that is as it seems to him to be.
Indeed we must at once confirm some of his statements without reservation.
He really is as lacking in interest and incapable of love and achievement as he says...
He also seems to us justified in certain other self-accusations; it is merely that he has a keener eye for the truth than other people who are not melancholic.
When in his heightened self-criticism he describes himself as petty, egoistic, dishonest, lacking in independence, one whose sole aim has been to hide the weaknesses of his own nature, it may be so far as we know, that he has come pretty near to understanding himself...
We only wonder why a man has to be ill before he can be accessible to truth of this kind.
in, “Mourning and Melancholia”