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Observing two cases whose clinical type changed from melancholic (identification) to paranoid (projection) and then to obsessional (displacement) the author argued that the various defence mechanisms correspond to different degrees of ego-cathexis, the greater the aggression and anxiety the weaker the ego, weakest in the identification phase, strongest in the obsessional-displacement phase; the particular defence employed by the ego against the aggression of the super-ego depending both on the intensity of the free-floating anxiety to be mastered and on the libidinal tension within the organism.
A new theory of Grave's disease hypothecates a weakening of the gonad endocrine as well as hyperfunction of thyroid, witness the frigidity, anxiety and psychical manifestations of bisexuality; these two cases also shew that the anxiety caused by direct organic stimulus evokes in the mind the manifestations of the aggressive impulse, but which is primary, anxiety or aggression, is not shewn. In brief, the anxiety and aggression released by the thyreotoxin is worked over in the mind, the liberated aggression increasing the severity of the super-ego bringing about depression.