ABSTRACT
Sixteen-year-old Thomas had been admitted to our clinic on account of a paranoid psychosis. Since spending a two-week holiday overseas staying with an aunt, he had developed a marked obsession with washing based on the fear that he might have infected himself with BSE. Paranoid and compulsive thoughts dominated his thinking and experience. He was in fear of going to Hell: “I’m scared that because of a fault or an omission I will go to Hell,” he had said to the doctor who admitted him. He said he received signals to which he had to react, otherwise punishment threatened. Compulsive thoughts, in the form of feelings of guilt and fear of punishment, had started when he had masturbated at around the age of 11. On the ward Thomas developed the notion that he might have infected himself with AIDS through homosexual contacts at the ages of 7 and 14. He was preoccupied with fears that the women on the ward might become pregnant from his sperm. When he masturbated, sperm might be left on the door handles, which would then be touched by the women. His father was described as being under great pressure at work, socially isolated, and depressive and suicidal in phases. The marriage had been difficult for a long time, and the mother was thinking of separating. The boy and his mother largely excluded the father from their relationship, and in particular the father was not allowed to hear of Thomas’ problems.
