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By a study of the Old Testament prophets, the author compares the type of thinking which goes into creative conscience formation with psychopathological cognitive processes. Strong personal anxiety and guilt, hallucinations, delusions, thinking in primitive modes, overconcern with oral themes of devouring and being devoured, and psychopathological anal and anal-oral associations, obsessive thinking, compulsive undoing behavior, and distorted sense of space and time are all found in the writings of the Old Testament prophets. Quotations amply illustrate these points. Cohen feels that 'the death decision'—the willingness to die in body in order to actualize one's nature, e.g., ethical convictions—is central to the understanding of the evolution of autonomous conscience.
The paradox of the prophet is that he shows all the evidence of psychopathological thinking but seemingly transcends this in his own lack of concern with social and physical rewards and punishments and is completely 'other-centered'. Rather than masochism, the 'death-decision' in the prophet is a result of continual self-analysis. The ego ideal, formed as it is from social learning, is not the crux of the prophet's creative conscience, nor is its formation entirely a secondary process phenomenon.