When the depressive psychosis has become manifest, its cardinal feature seems to be a mental inhibition which renders a rapport between the patient and the external world more difficult.

A person who suffers from severe locomotor anxiety finds himself in an almost permanent state of mental tension. He wakes in the morning with the anxious expectation of having to go out somewhere in the course of the day.

Psychoanalysts have been occupied for a long time with the difficult question of what the psychological conditions are which determine the form of the neurotic disease to which the individual will succumb. It is as though he had a choice between different illnesses and led by unknown impulses selected one or other of them.

Even in my first analysis of a depressive psychosis, I was immediately struck by its structural similarity with obsessional neurosis.

In neurotics, worm phobias are usually found as well as snake phobias.

Whereas the melancholic exhibits a state of general inhibition, in the manic patient even normal inhibitions of the instincts are partly or wholly abolished.

The onset of mania occurs when repression is no longer able to resist the assaults of the repressed instincts.

A considerable number of persons are able to protect themselves against the outbreak of serious neurotic phenomena only through intense work.

Psychoanalytic investigation has shown that in mental patients excessive affection often turns to violent hostility.