Ethel Schwabacher, best known as a painter, turned to writing when she became incapacitated with arthritis. In her journal, The Tortoise and the Angel, she wrote extensively of her experience in psychoanalysis. Schwabacher suffered from low self-esteem and depression, attempting suicide several times. She was in treatment for two and one half years with Helene Deutsch, and then for nearly thirty years with Marianne Kris. Berman documents similarities between Schwabacher and the patient described in Deutsch's published case titled "Hysterical Fate Neurosis." Psychoanalysis enabled Schwabacher to discover many of the causes of her conflicts and offered her an explanatory system that she used in her artistic work. Berman believes the benefit of treatment was due not primarily to insight, but to the therapeutic alliance with Kris.