A thirty-year-old man became able, after ten months of treatment, to voice hostile feelings and 'still carry on in a polite way' with the analyst. He had been in psychotherapy with another analyst for almost a year, terminated because the therapist left town. The patient had felt unliked and actually despised. This attitude was felt in almost every situation, with his boss, mother, brothers, and customers. He repressed his feelings, projected them, or fled from the scene. The ego could react only with anxiety and flight when confronted by hostile feelings, which existed as an autonomous component.

Treatment was directed to enabling the ego to tolerate the hostility. Only when this was achieved could the patient proceed to analyze the hostility against which he had hitherto merely defended himself.