The abnormal ideas, impulses and actions are in nowise equally potent in individual forms and cases of compulsion neurosis; it is the rule, rather, that one or the other of these manifestations is the dominating factor and gives the name to the disease; that all these forms, however, have a great deal in common is quite undeniable. Surely this means violent suffering. I believe that the wildest psychiatric phantasy could not have succeeded in deriving anything comparable, and if one did not actually see it every day, one could hardly bring oneself to believe it. Do not think, however, that you give the patient any help when you coax him to divert himself, to put aside these stupid ideas and to set himself to something useful in the place of his whimsical occupations. This is just what he would like of his own accord, for he possesses all his senses, shares your opinion of his compulsion symptoms, in fact volunteers it quite readily. But he cannot do otherwise; whatever activities actually are released under compulsion neurosis are carried along by a driving energy, such as is probably never met with in normal psychic life. He has only one remedy--to transfer and change. In place of one stupid idea he can think of a somewhat milder absurdity, he can proceed from one precaution and prohibition to another, or carry through another ceremonial. He may shift, but he cannot annul the compulsion. One of the chief characteristics of the sickness is the instability of the symptoms; they can be shifted very far from their original form. It is moreover striking that the contrasts present in all psychological experience are so very sharply drawn in this condition. In addition to the compulsion of positive and negative content, an intellectual doubt makes itself felt that gradually attacks the most ordinary and assured certainties. All these things merge into steadily increasing uncertainty, lack of energy, curtailment of personal liberty, despite the fact that the patient suffering from compulsion neurosis is originally a most energetic character, often of extraordinary obstinacy, as a rule intellectually gifted above the average. For the most part he has attained a desirable stage of ethical development, is overconscientious and more than usually correct. You can imagine that it takes no inconsiderable piece of work to find one's way through this maze of contradictory characteristics and symptoms. Indeed, for the present our only object is to understand and to interpret some symptoms of this disease.