A highly instructive case history is presented as the focus for discussion of the reciprocal relationships between unconscious guilt, pain, and success. The patient was 'wrecked by success'—success in this instance being medical relief from pain and suffering. Remission of physical suffering was followed by a progression of emotional difficulties resulting in social and professional failure and culminated in a severe accident. Brain injury caused by the accident left the patient socially and intellectually crippled but at peace with his psychological conflicts.