In my clinical experience, several patients in psychotherapy and one in psychoanalysis have revealed themselves to be willing and eager for treatment because of genuine distress, well-motivated, capable of the development of transference, insight with affect, and working-through, but incapable of the use of action to implement their professed goals. In point of fact, when action was called for, they responded either by flight from treatment or by an intense increase in distress.
Discussions with colleagues have confirmed that this type of case is frequently found in the practice of psychiatry. Such individuals are usually lonely people who suffer acutely from their neurotic conflicts and the resultant symptoms, are active, often aggressive, capable of hard work, able to see what tasks can or should be done to bring them closer to social and work adjustments, but are unable to exert their activities in what they
GRINKER RR. Ego, Insight, and Will-Power. Arch Gen Psychiatry. 1961;5(1):91-102. doi:10.1001/archpsyc.1961.01710130093011