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The author summarizes this rather complicated and somewhat repetitious paper fairly well when he states that drug dependent and psychosomatic patients suffer from: 1) a marked disturbance of affect development, and 2) and inability to exercise self-caring functions. Krystal traces these difficulties back to complicated situations during the early developmental period in which the defect is in the mothering process, or at least in the fantasies the developing individual has in respect to the care-taking object. The difficulties in treating such patients result primarily from the fact that they are unable to confront their own aggression without becoming either severely depressed or homicidal, particularly in reference to the therapist. But in a few selected instances, according to the author, intensive psychoanalytic psychotherapy has been able to produce dramatic results, although it demands an enormous amount of patience, tolerance, and empathy on the part of the therapist. Perhaps one of the most stimulating thoughts expressed in this paper is that an individual can no more affect his autonomically controlled organs than one can influence one's organs that are affected by "hysterical paralysis." Such a concept has far-reaching implications.