I present another case apparently “paranoidal,” a case interesting from our standpoint. The patient is a man of twenty-seven years; his parents are neurotic, religious revivalists. As far back as the age of eight he suffered from agonizing fears of perdition and scares of tortures in hell, impressed on his sensitive, young mind during the revivals. He is very religious, obsessed with the fear of having committed an unpardonable sin. He thinks he is damned to suffer tortures in hell for all eternity. He keeps on testing any chance combinations, and if his guesses turn out correct, he is wrought up to a pitch of excitement and panic. For to him it means a communication coming from an unseen world of unknown mysterious powers. With his condition diagnosed as “paranoidal dementia praecox,” the patient was committed to an insane asylum, from which he was subsequently released. The attack comes in pulses of brief duration, followed by long periods of brooding, depression, and worry. The primitive fear of pain, of danger and death, and the sense of the mysterious cultivated by his religious training, reached here an extraordinary degree of development. Among the earliest memories that have come up in the hypnoidal state was the memory of a Sunday school teacher, who cultivated in the patient, then but five years of age, those virulent germs which, grown on the soil of the primitive instinctive fear and the highly developed sense of the unknown and the mysterious, have brought forth poisonous fruits which now form the curse of his life. The case is a typical _psychoneurotic phrenophobia_ with its characteristic recurrent states. “It is difficult,” the patient writes, “to place the beginning of my abnormal fear. It certainly originated from doctrines of hell which I heard in early childhood, particularly from a rather ignorant teacher who taught Sunday school. My early religious thought was chiefly concerned with the direful eternity of torture that might be awaiting me, if I was not good enough to be saved.” After a couple of years of persistent treatment by means of the hypnoidal state and by methods of association and disintegration of the active subconscious systems, the patient recovered. He entered a well known medical school and took the foremost rank among the medical students.[9] _In the investigation or psychognosis of psychopathic cases I invariably find the psychopathology to be a morbid condition of the fear instinct, rooted in the primordial impulse of self-preservation._ The psychognosis of this underlying pathological state and disintegration of the latter are of the utmost consequence in the domain of psychopathology and psychotherapeutics. FOOTNOTE: [9] A full account of the cases is published in my volume “The Causation and Treatment of Psychopathic Diseases.” CHAPTER XX FEAR CONFESSIONS