The conscience instance of our patients, their superego, is often significantly stricter, more prohibitive, or more devaluing than in other people. It then forbids any kind of positive change, joy, pride, or personal will. As soon as the patient achieves a small improvement, the superego intervenes and forbids it. The superego primarily triggers feelings of guilt. The ego ideal contains the image of how we would like to be in order to be recognized and perhaps even admired by ourselves and others. If the patient’s self-image is very far from the ego ideal, she experiences shame and feelings of inferiority. In many patients, the ego ideal is so exaggerated that it would be unattainable even with the greatest effort. It then mocks any change as small, insignificant, and ridiculous, so that the patient ultimately abandons all efforts to change. The ego ideal also mocks the therapist as a simple-minded, undemanding being if she is pleased about or acknowledges a small change in the patient. In this way, any change is nipped in the bud.