Eissler considers the creative process in genius to be psychopathological and related to paranoid schizophrenia in the sense that the creative product is a new reality which he compares to a delusion. It further resembles paranoid schizophrenia in that the ego is confronted with an overwhelming conflict between repressed and forbidden strivings and the superego. The difference lies in how the preconscious wish is handled. Commonly it leads to the formation of a delusion or the taking of some action, or a topical regression takes place leading to a dream hallucination. In the creative act a further possibility, which partakes to some extent of the other three, is realized: symbolic action which combines a near hallucinatory vision of an artistic goal, a near delusional feeling of reality toward the created content, and access to the motor system since the created work has a perceptible form.