That there was in fact a subconsciously functioning process derived from this complex would seem to be almost conclusively shown by another phenomenon manifested. I refer to the vivid _visualization of herself in a convulsion, struggling for air and manifesting fright_, which she experienced in each attack. We have seen that such a visualization (i.e., a modified vision) is the expression (secondary images?) of a subconscious process (co-conscious ideas?). As a matter of fact this particular visualization was a pictorial representation of antecedent thoughts organized with thoughts of death and insanity and still conserved in the unconscious. We must believe, then, that it was these antecedent thoughts (in the first place her apprehension of inheriting Bright’s disease and convulsions from her father, and in the second place her conception of the unreality syndrome as a state which might possibly end in convulsions) which, functioning subconsciously, induced the quasi hallucinatory expression of themselves.[194] It is difficult to get away from the conclusion that the remainder of the setting from which the ideas of insanity and death were derived also functioned as a subconscious process. Whether this process was conscious or unconscious is a secondary question which we need not consider. In weighing the probabilities of this interpretation we should bear in mind that there were two conscious beliefs of which the patient was fully aware and which were very real to her; namely, the liability of becoming insane and to convulsions and death. The conative force of the instinct of fear linked to such ideas is quite sufficient to drive them to expression when out of mind and subconscious. Or expressed differently we may say that the fear was a reaction to these ideas which the patient dared not face. We ought not, however, to be too sweeping in our generalizations and go further than the facts warrant. We are not justified in concluding that the linking of an affect to an idea always includes a subconscious mechanism. On the contrary, as I have previously said, probably in the great majority of such experiences, aside from obsessions, no such mechanism is required to explain the facts.