The author discusses how normally positive circumstances in the treatment process—family, therapist, and hospital—can unite to obstruct the progress of the intractable female patient. This patient's hospitalization should be comparatively brief; her therapy supportive and aggressively reality oriented, but not intensive; and her attention firmly fixed on home, family, and adult obligations. There should be early, aggressive work with the spouse, concentrating on his passivity and lack of dominance. Control, maturity, and independence should be emphasized.Abstract Teaser