We all know patients who seem to be driven by a compulsion to awaken ever new hopes just to have them cruelly disappointed, to annihilate all expectations, to devalue everything good by action, though not by words, and all this just as much within themselves as in their relations with others: Th ey are most profoundly disappointed about themselves. In the following chapter, I shall try to get closer to an understanding of this phenomenon which is a central feature, I believe, of the negative therapeutic experience.