Fear, Self, Reserve Energy, and Fatigue are the main factors in the formation of the psychopathic or neurotic condition. Janet, in a recent article of his, lays stress on the fear states in psychopathic affections and refers these conditions to the levels of vital energy. There is no doubt that Janet lays his finger on the very heart of the psychopathic diathesis. In my work I come to a similar conclusion only I lay more stress on the fear states, being referred to the fundamental instinct present in all animal life as a primordial condition of existence. This instinct is intensified and extended in the psychopathic diathesis. The level of energy and the fear instinct are vitally interdependent. A low level of energy, especially a dissociation or inhibition of the store of reserve energy, arouses an excess of reaction of the fear instinct, and _vice versa_ the excessive reaction of the fear instinct locks up the stores of reserve energy, thus intensifying and extending the psychopathic states with their fear-fatigue conditions. Janet refers indirectly to the impulse of self-preservation which is of the utmost consequence in psychopathic affections. On the whole, I may say that my work and clinical experience are in accord with that of the great French psychopathologist. Where the fear instinct, self, and inhibition of reserve energy are present, then any emotion, even that of love, and devotion, will give rise to psychopathic states. This psychopathic state is not produced, because of the intensity or repression of the emotion, but because of the underlying subconscious predisposition to fear-instinct, self-preservation, and inhibition of reserve energy. The feelings of inhibited reserve energy produced by fear and self, make the individual hesitate in decision, in action, and finally demoralize and terrorize him. These conditions take away from him all assurance and security of life and action, and hold him in a perpetual state of anxiety until he becomes completely incapacitated for all kinds of action and reaction. Events that threaten the impulse of self-preservation of the individual, such as misfortunes, shocks, losses, tend to bring about psychopathic states, on account of the aroused fear instinct, on account of the impulse of self-preservation, and sudden inhibition of the stores of reserve energy. Events that may lead to dissolution of personality are, hence, attended with intense anxiety. As we have seen, an intense state of fear, conscious or subconscious, produces a state of aboulia, a state of indecision, a state of incompletion of action, a state of insufficiency, a paralysis of will power, and a sense of unreality, all of which are intimately interrelated. For the fear instinct, when intense, inhibits and arrests the will and paralyzes action. _The patient fears, not because he is inactive, but he is inactive, because he fears._