Certain forms of the negative therapeutic reaction can be understood as manifesting a more basic feeling of not having a right to a life of one's own, that is, to a separate existence. In one case, the woman was dominated by an unconscious fantasy of having in infancy robbed the two siblings who followed her of all of her mother's love (milk). Her basic attitude to life was that if she had anything, it meant someone else was deprived; more specifically, that her family would starve. In the transference a therapeutic alliance could only be established after it was discovered she unconsciously felt she had no right to live and, therefore, to the treatment. Such attitudes are especially intense in more disturbed cases but are present to some extent in less severe ones. The disturbance may be called separation guilt and relates to a failure in the phase of self-object differentiation with the mother. The guilt appears to relate to genetic elements in the superego rather than to the superego itself.