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Reading this 1936 paper today takes one back to a contentious, fertile period in psychoanalytic history. Karen Horney touches on or alludes to a number of subjects that continue to engage our interest and stimulate controversy: the mystery of therapeutic action; the impacts of a relationship between analyst and patient on the intrapsychic lives of both and on the psychoanalytic process; the mutual influences of biological factors, cultural traditions, and social attitudes on the psychology of individuals and groups; and impacts on the profession and its practitioners of wider world events and narrower psychoanalytic politics.
Beyond noting Horney's theoretical and technical additions to Freud's discussions of negative therapeutic reaction (Freud 1919, , ), we are reminded afresh in reading the paper of the intergenerational tensions that smoldered in an era when many of the pioneer figures in psychoanalysis had been forced to emigrate from their homelands in the wake of the ever more terrible cataclysm in Europe. Transplanted as refugees in the new and strange American world, they must have found a compelling need to conserve the allegiances and beliefs they held in common, central among them, their bonds to Freud and his psychoanalysis. In this same period, Freud's patriarchal authority was necessarily weakening because of age and illness, and was being passed on to others —especially to his daughter, who firmly secured her place as his heir by publishing in this same year her landmark classic, The Ego and the Mechanisms of Defense (A. Freud 1936).