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PASTORAL PSYCHOLOGY
customer a few coppers too much for a pound of bacon. On
grounds as flimsy as this, patients will insist that they have made
themselves responsible for all the wickedness in the world. They
will eagerly assure every listener that they have committed sins
more grave than anyone else that ever lived.
Such delusions are often extended to all the patient’s actions
and experiences. He has not only failed in the past but
continues to do so now. Because he eats others are compelled to go
hungry. He is to blame for the restlessness of the other patients
in his hospital ward. In everything that occurs about him, he
finds and seizes avidly an opportunity to increase his liabilities.
Sometimes these patients claim that reproaches and
accusations come from without. They hear their thoughts spoken or
whispered as if by someone else, although they may know that
it is their own thinking that is being uttered. This phenomenon
can be observed by asking a patient to read. He will then say
that other voices are speaking in unison with his own. It may
also happen that the patient discusses a topic with himself and
experiences one side of the argument as coming from without.
This ‘thought echo’ marks the beginning of pure projection,
when parts of the self have been transferred to the outer world.
The patient then affirms that he desires to be good and happy,
but that evil thoughts and feelings are being forced on him. He
is merely a medium or instrument of an external will. Someone
else talks through his mouth, writes with his hand. The self and
its environment, concepts and experiences, intermingle and
merge. As this process goes on the whole sense of reality
deteriorates. The self repudiates responsibility for the
accusations it makes. The patient hears voices that condemn him,
remind him of all his failures and sins, swear at him, laugh at
him, or describe the eternal torments to which he is to be
subjected. The feeling of guilt is projected and verbalised in every
way. The patient thinks he is the object of public conversation.
The newspapers write about him. Wireless announcers refer
to him. His crimes are proclaimed to the world. All his secrets
are known, but nobody can help him.
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