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Karpman attempts to 'submit proof that delusional elaborations of the psychotics are nothing more than attempts to create barriers against committing the two basic crimes of mankind; namely, incest and parricide'. In order to stimulate work along this line, Karpman intends to present case material from two hebephrenics. However, in a footnote he writes: 'Owing to the extreme limitations of space all of the textual material on which the discussions are based has been omitted… The discussions, however, are sufficiently explicit and suggest clearly the content of the omitted text.' Then for twenty-six pages he gives us very skilful and ingenious interpretations but very skimpy material.
The author also attempts theoretical formulations in differentiating neurosis from psychosis. Typical samples of his theoretical concepts are the following: in discussing the libidinal forces, he writes: 'One may picture' the neurotic 'as an eight-cylinder engine in a four-cylinder car', the psychotic, however, … 'a four-cylinder car with two cylinders', and: 'The sex life of the neurotic is persistently exuberant, certainly above the average; whereas in the psychotic one finds a rather conservative sex life. The psychosis results from the struggle between the primitive urge and the demands of culture. In the psychotic that urge is never strong and, even under normal circumstances, is likely to be below the average.'
In his introduction, Karpman states that it is possible to understand the mental content of a psychosis only if one accepts freudian ideas. Since he does not even mention such fundamental concepts as regression or failure of defense mechanisms, his formulations differ quite a bit from those of Freud.