" Already in the preliminary interview one may get an impression of the patient's hopelessness. He will be unwilling to make the smallest sacrifice, to undergo even a minor inconvenience, to take the slightest risk. He may give the appearance then of being too self-indulgent. But the fact is that he sees no compelling reason to make sacrifices when he expects to gain nothing from them. Similar attitudes can be seen outside analysis. People remain in thoroughly unsatisfactory situations which with a bit of effort and initiative could be bettered. But a person may be so completely paralyzed by his hopelessness that moderate difficulties seem to him insurmountable obstacles. "

― Karen Horney , Our Inner Conflicts: A Constructive Theory of Neurosis