The Will to Recovery1

The question why the neurotic patient has the desire to get well and comes for treatment is not so paradoxical as it appears at a superficial glance. We know that neurosis is an indication of unsuccessful repression, which gives rise to symptoms, and in his symptoms every patient tries to attain pleasure in some disguised form, if it be only symbolically. So it is not obvious why the neurotic, in spite of all the resistances of the ego, should forthwith renounce this pleasure.

It would be possible to answer the question by saying that it is the suffering accompanying illness (that is, 'pain') which of itself rouses the endeavour to get well. But when we reflect that suffering in and by itself may be a source of pleasure we shall attach less importance to the pain of illness as the sole motive in the desire to get well. And if, further, we consider that the ego is passive and simply carries out the will of the id and the super-ego, we are bound to look carefully for unconscious motives of the will to health.

We can never calculate the probable duration and success of analytic treatment from the conscious wish to get well. Every psycho-analyst knows that the neurotics who are so impatient that they can hardly wait for the beginning of the treatment are not the easiest to treat. But it is amazing how obstinately these very patients cling to analysis, in spite of the enormous resistances which they oppose to the treatment from the very beginning. We might perhaps account for this phenomenon by the transference. But these patients generally begin the treatment with a negative transference, which surely would be likely to alienate them from the physician rather than attach them to him. Moreover, some patients have not even had time at the beginning to form a transference at all; for quite a long while they adopt a waiting attitude, that of tranquil observation—and yet they go on with the treatment.

How then are we to explain the contradiction that, in spite of the c