Psychotherapy as such has two aspects, a reality (here-and-now) aspect and a transference (distortion-of-reality) aspect, which, in the clinical setting, should be distinguished even more clearly than is done in individual therapy. The reality aspect, crystallized in the process of decision-making, is made more explicit when democratization (a process of delegation of power and responsibility) is introduced into the mental hospital. Problems concerning various types of resistance to democratization (descended from patients, staff or the clinical setting per se) are further discussed.

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SUMMARY In his daily work, guilt and shame and, consequently, punishment and penance do not pass over the psychoanalyst unobtrusively even if the ‘ideal’ basic psychoanalytic attitude demands that he/she be above this kind of human triviality. After all, through his own training analysis and through education he can be (or become) conscious of feelings contrary to the high psychoanalytic expectations of the person behind the couch: to listen patiently, not to react emotionally or aspire after direct gratification, be always understanding and unselfish, never offended, always aiming at insight and, in the end, to make himself redundant. That is the ideal, but what is it like in reality? There is obviously a field of tension, caused not only by one's personal impediments, including one's personal motives to choose this profession, but also evoked by the conventions within one's professional group as a socially defined professional superego. How tolerant are psychoanalysts of each other, is this much aspired inner awareness, for example, actually facilitated or rather impeded, owing to the rigidity of the rules? In any case, the personal superego and especially the ego ideal, in psychoanalysis partly transposed to a professional superego and a professional ideal image, play an important part and contribute to the ultimate result. Inner awareness still seems to be the main thing.