In highland Ecuador, pena refers to a state of mind characterized by a mixture of sadness and anxiety as well as to an illness state resembling depression. This paper attempts to illustrate, through an analysis of the discourse on pena, how the ideology in which it is embedded serves to interpret a bodily problem at the same time as it reflects a more global attitude toward life. In essence, the folk theory states that the physical complaints caused by suffering are the result of a disturbance of the heart, the central organ of man, and of the emotional life which it controls. Because this suffering is often attributed to the immediate family group of the victim, the community at large often formulates accusations against one of its members. Though the therapy is limited to a cure of the symptoms through herbal remedies, a formal request can be made to a perceived wrongdoer to amend his behavior. The pena is also a state which can lead to colerin, a dangerous and sometimes lethal illness which is characterized by a sudden explosion of anger or madness and which will follow an unattended state of pena. [ABSTRACT FROM AUTHOR]