The discussion emphasizes that one of the major energies that underlies long-term inmates' resistance to treatment is their morbid attitude about existence. The inmate in the case example is 60 years old and was a latchkey child. His mother was a prostitute whose constant absence forced him to learn how to survive for himself. He did not experience the normal developmental process that should have occurred during his youth. He now describes his existence as being similar to being buried in the sand from the head down. He feels imprisoned in the sand (the institution), which does not allow him movement. Many times his nose itches (injustices) and he cannot scratch it. The efforts of the inmate during therapy are similar to freeing an arm that can now be exercised both to correct its atrophy and to scrtach the nose, in that the inmate now has some power to choose. The author concludes that without psychotherapy, behavioral qualifications for a commuted sentence may be ineffective, in that work skills will be worthless if the inmate cannot stand the stress of a daily job routine. Discussion of therapeutic techniques and 9 references.