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Repressive material and unconscious conflicts are not considered of much importance compared with 'existential problems which are the real basis of the illnesses which we are treating.' Leaving aside Brull's inconsistency with his own advice to treat patients, not illnesses, it must be admitted that great tragedies can enter a person's life. Who is to say what a person might do when his back is against the wall? One patient's younger brother was captured by Nazis and executed before her eyes for a deed which she had carried out, but could not summon the 'courage' to admit. Certainly this could cause a traumatic neurosis and I doubt that any human being ever fully 'recovers' from such an experience. But whether it precipitates a psychoneurosis with the return of repressed internal conflict is another matter—a matter never really elucidated because of the author's interest in existential problems. He focuses on guilt as the central issue in two very disturbed patients who had made serious suicidal attempts. Besides guilt in terms of psychic structure—i.e., tension between ego and superego—claim is made for a second guilt: acts of omission or commission which are a betrayal of everything one holds dear.