Neurotic Guilt and Healthy Moral Judgment

That severe and intractable guilt feelings can operate as a serious block to progress in analytic therapy is well known by experienced psychoanalysts. One would assume that a sense of wrong doing would open the way to reorientation of values, constructive efforts, and realistic strivings toward healthier ways of life, but experience shows that we must reckon with a sense of wrong doing which is not only totally unproductive, but which tends to drive the patient toward chronic and unremitting self-torture, despair, and sometimes self-destruction. If this kind of guilt has been accurately understood and if the problems associated with it have been well analyzed and worked through, we find that the patient comes to experience a sense of wrong doing which has a totally different quality. There is no plunge into a hell of gloom and self-recrimination, but a sense of relief, of cleanness, a sustained facing of the issues, and the beginning of real hope and interest in remedying matters. We must conclude that we have to deal with two kinds of guilt feelings—one unproductive, obstructive, and potentially or actually destructive; and the other potentially productive and constructive. The title of this paper indicates this differentiation—neurotic guilt and healthy moral judgment.

A careful and serious study of Horney's theory of neurosis helps to clarify the serious technical difficulties encountered in dealing with problems of neurotic guilt and also points to the value of observing and utilizing the patient's true and constructive moral judgment. According to Horney's theory, neurotic or destructive guilt feelings are the outcome of neurotic developments. Neurosis inevitably entails impairment of moral integrity. This is expressed in a variety of ways. In some individuals, there is an intense conscious concern with moral problems, with right and wrong. But when we study the individual's moral values in detail, we encounter many glaring distortions and paradoxes. What is rea