Work with patients with severe neuroses very often has to cope with the phenomenon that every progress in the analytic or therapeutic work is followed paradoxically by a clinical deterioration. There are a number of dynamic factors that converge to bring about this negative therapeutic reaction, including many-layered guilt and shame, aspects of envy and jealousy, attachment to negative affects, turning trauma from passive to active, conflicts within the superego, and the defensive use of omnipotence of responsibility. In Nothing Good Is Allowed to Stand, Wurmser, Jarass, and their colleagues...