The therapeutics, then, consisted in showing that the alleged facts upon which the patient’s logical conclusions had been based were false. The setting thereby was altered, and a new and true meaning given to the real facts. The result was towers and steeples no longer excited fears, the phobia ceased at once—an immediate cure.[191] _Type D._ In this type _the conscious psychosis consists of idea, meaning, affect, and physical disturbance_. F. E. suffered from attacks of so-called “unreality” accompanied with intense fear. She was unable to give an intelligent explanation as to why she was afraid of the attacks—harmless in themselves—until it was brought out that there was in the _background of her mind_ the thought that the attacks spelled insanity (or that she was likely to go insane) and also death. Following the attacks there was amnesia for these thoughts. Her fear really, then, was of insanity and death. The content of consciousness in the attacks contained the perception of herself as an insane person, thoughts which expressed the meaning of her attacks, and fear. (The usual physical disturbances of course accompanied the fear.) No amount of explanation of the harmlessness of the unreality syndrome sufficed to change her point of view, i.e., its meaning to her. But going further it was discovered that her self-regarding sentiment and her ideas of insanity and death were organized with a large number of fear-inspiring antecedent experiences which explained why she regarded the attacks as dangerous to her mentality and life; and why the biological instinct of fear was incorporated with the self-regarding sentiment. These experiences had long passed out of mind and there was no conscious association between them and her phobia, but they could be recalled as associative memories.[192] The unreality attacks had for her two meanings which were within the content of consciousness, viz., 1, insanity, and 2, death. The first was derived from (a) antecedent girlhood and later experiences which had engendered the unsophisticated belief that having the mind fixed on one subject, as was obtrusively and painfully the case at one time, meant insanity: and (b), from the fact that the bewildering, irreconcilable, absurd thoughts, conflicts, and emotions in which the unreality attacks culminated meant insanity.