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There are four types of these and many forms. I can only make a comparison between hysteria, obsessional neurosis and one form of paranoia. They have various things in common. They are pathological aberrations of normal psychical affective states: of conflict (hysteria), of self-reproach2 (obsessional neurosis), of mortification (paranoia), of mourning (acute hallucinatory amentia). They differ from these affects in that they do not lead to anything being settled but to permanent damage to the ego. They come about subject to the same precipitating causes as their affective prototypes, provided that the cause fulfils two more preconditions-that it is of a sexual kind and that it occurs during the period before sexual maturity (the preconditions of sexuality and infantilism). About preconditions applying to the individual concerned I have no fresh knowledge. In general I should say that heredity is a further precondition, in that it facilitates and increases the pathological affect-the precondition, that is, which mainly makes possible the gradations between the normal and the extreme case. I do not believe that