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Balint starts from his thesis, evolved twenty years ago from clinical observations, that some patients toward the end of analysis make a 'new beginning', they begin to demand of the analyst simple gratifications which cannot be satisfied autoerotically. The treatment goes well if the primitive nature of these wishes is worked through. However, in some patients with deeply disturbed ego development the problem of such demands makes for great difficulty. An insatiable greediness and addictionlike state appear if these gratifications are given; on the other hand, pent-up sadistic tendencies are aroused if their demands are not met. Nevertheless, if analysis can proceed the patient begins anew to love and hate in a primitive way, which then is followed by the development of a mature, well-adapted, nonneurotic way of loving and hating. Balint considers this period, of a primitive or archaic object love which the patient is allowed to 'regress' to, to be the fons et origo of human libido development.
In his second section the author discusses the fate of the new beginning in those of his cases who are improved but not 'cured'. One group remained in the state of being unable to relax or to abandon their suspiciousness or ideas of reference. They improved after analysis and are able to get along without symptoms, but remain unattached, somewhat independent and suspicious, hypercritical and overbearing. If analysis progressed further this state of suspicion changed to one best described as depression. Balint here describes the relationship of these paranoid and depressive syndromes to Melanie Klein's 'paranoid and depressive positions' and differentiates depression in this sense from the syndrome known as melancholia.
The third section explains why Balint considers the sequence of paranoid attitude-depression-archaic object love as being significant in the end phases of analyses. He believes Melanie Klein correct in supposing that the persecutory phase is followed by