A neurotic patient tells me that he suffers from fatigue, insomnia, dullness, inability of concentration of attention, failure in studies, slowness of comprehension, and so on; and yet he gives his opinion with papal infallibility on every conceivable subject, and hints at being an undeveloped, unappreciated genius. The psychopathic, neurotic patient rarely, if ever, suffers from a complaint of inferiority. His real fear is that his superiority may be humbled. Obsessed by the impulse of self-preservation and fear instinct, and with utter disregard of others, the patients are convinced of their extraordinary kindness, gentleness, sympathy, martyrdom, and even saintliness. It is from this class that neurotic philanthropists are recruited. Psychopathic patients are always ready “to sacrifice themselves for the good of humanity.” They talk endlessly about goodness, and may even devote themselves to charity and instruction of the “poor and degraded.” A patient of mine worked for three years for the “good of the poor,” had “high ideals and a sensitive conscience,” according to his accounts, but abandoned readily his wife and children. Another young woman, a typical psychopathic, full of high ideals, ran away with a married man, had a child that died of exposure. This patient was interested in modern education and improvement of humanity. In reality she never cared to do anything for anybody, and without any hesitation took advantage of others in order to satisfy the least whim that might have crossed her mind, especially those whims that relate to health. She had all kinds of directions, prescriptions, exercises, requisite for the strength and health of the body and the nerves. One of my patients used to be anxious about my going and coming. Was it love or devotion? I found out that he was afraid that I might be killed. This fear was developed in him by an actual accident in which his brother had died, but the same fear associated with me was due to the fact that the patient was sure that my treatment was requisite for his health and welfare. He was in fear lest I might be killed, he would be unable to get his treatments, and thus lose time in getting back his health. For the sake of his “health” the patient will not stop at anything. Neurotics may well name their troubles “Health and Science.” _The psychopathic, neurotic patient makes of health his science and religion, because self-preservation and fear are at the bottom of the psychopathic, neurotic constitution._ CHAPTER XVI NEUROTIC PARASITISM The psychopathic patient may be regarded as a case of parasitism. The parasite, living on his host, gradually loses all active functions, a condition followed by atrophy of organs no longer necessary to the life existence of the organism.