The question is raised as to whether peculiar forms of motor activity in schizophrenia are symbolic expressions, organically conditioned symptoms, or unconsciously motivated escape or substitute phenomena. No general answer is given but Devereux offers certain suggestive data from a case studied before and after insulin treatment. This patient, prior to treatment, had a rich fantasy life with some postural and motor disturbances. After treatment the postural and motor symptoms were far more pronounced, with a concomitant increase in apathy and emotional deterioration; at the same time the output of fantasy decreased sharply. A possible explanation is that there had been a 'shift from the cortical to the motor level' with primacy of the latter over the former. It is also suggested that the symptoms in a given schizophrenic derive from the level of integration at which the patient adjusts to reality.