It is amazing how obtuse otherwise intelligent patients can become when it is a matter of seeing the inevitability of cause and effect in psychic matters. I am thinking of rather self-evident connections such as these: if we want to achieve something, we must put in work; if we want to become independent, we must strive toward assuming responsibility for ourselves. Or: so long as we are arrogant, we will be vulnerable. Or: so long as we do not love ourselves, we cannot possibly believe that others love us, and must by necessity be suspicious toward any assertion of love. Patients presented with such sequences of cause and effect may start to argue, to become befogged or evasive.

Neurosis and Human Growth (1950), Chapter 2, Neurotic Claims