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We cannot expect that psycho-analysis as a method of investigation will uncover facts that are entirely new. Our contributions, such as they may be, will consist of bringing older observations into accord with newer theoretical formulations
Psycho-analysts have long observed individuals who feel that they cannot justify their existence, and who must destroy every opportunity for happiness (Freud, 1916). Freud applied the term 'moral masochism' to such behaviour and he considered that the negative therapeutic reaction was the sign by which it could be recognized. In The Ego and The Id Freud (1923) says:
There are certain people who behave in a quite peculiar fashion during the work of analysis. When one speaks hopefully to them or expresses satisfaction with the progress of the treatment, they show signs of discontent and their condition invariably becomes worse. One begins by regarding this as defiance, as an attempt to prove their superiority to the physician, but later one comes to take a deeper and juster view. One becomes convinced, not only that such people cannot endure any praise or appreciation, but that they react inversely to the progress of the treatment. Every partial solution that ought to result, and in other people does result, in an improvement or a temporary suspension of symptoms produces in them for the time being an exacerbation of their illness; they get worse during the treatment instead of getting better. They exhibit what is known as 'negative therapeutic reaction'.
The existence of this phenomenon testifies to the presence of an unconscious sense of guilt, and the problem as a whole has long been known to be a manifestation of superego pathology. I wish here to review these observations in the light of more recent notions of superego formation.
Psycho-analysis is at present experiencing a revival of interest in the concept of the superego. This is shown by the appearance of several extensive and excellent reviews (Beres, 1958); (Sandle