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him to do certain things which he had been unable or unwilling to do, when the suggestions had emanated from us. His responses to Dr. Yoder’s letters were manifold and complicated, and although we were sometimes able to anticipate them, at other times we were not. Moreover, in his reactions to the communications, he often revealed himself in ways he never did with us, thus affording us new insights into his character and into the nature and magnitude of the problem of identity which he faced in daily life.

The exchange began when, in the middle of July 1960, Joseph wrote to Dr. Yoder asking if he could be transferred back to England, his “native” country, the country he loved so much. The reply sent in Dr. Yoder’s name noted that, according to the hospital records, Joseph had been born in Canada, had never been to England, and was a naturalized citizen of the United States. It was therefore unlikely that the English would be willing to have him back or that the American authorities would be able to initiate action for deportation. To this letter, Joseph replied, in part:

Dear Dr. Yoder:

I must say that I have not felt any too well over it, but since you state so, I am unable to do anything about going back to England. I am God, however, and I must wait for my power, so I may be back in England one beautiful day. As God, I am a citizen of the world, there is no doubt.

I have consulted Dr. Rokeage and Mr. Spivak as you write in the letter and they were at one as to what you state.

For the next three months there were no further communications between Joseph and Dr. Yoder. Yet the result of the initial exchange was dramatic. While previously Joseph’s delusions about England had made up a large portion of his conversation, he now dropped all references to it and no longer spoke of having been born in England or wanting to be deported there.

On September 19, 1960, I interviewed Joseph to find out to what extent he still held to his delusions about England, and to his other grandiose delusions about himself. When I asked him where he was born, he said Canada; of what country he was a citizen, he said the United States; whether he had ever been to England: “No, I never have! I was born in Quebec.” If he left the hospital, what sort of a job would he take? He would be a janitor, he replied, or work for the railroad, or be clerk in a bank or a department store, or work on the assembly line at Ford. He did not, as had been his usual practice, lapse into dreams of more grandiose jobs, such as bank president or owner of a department store.

I pursued the idea of his working in a bank, to see whether he would end up owning it. He said instead that if he brushed up on his mathematics he might eventually become a teller.

Joseph also said he now realized it was useless for him to try to go back to England. It was clear, however, that he had not really given up his grandiose delusions, but had decided simply not to talk about them. “If Dr. Yoder says I am God, then I can’t get out of the hospital. I have the right thing in mind. Nobody bothers you if you say you’re a laborer. I’m trying to be myself, Joseph Cassel.” He went on to talk about being deported to Canada, saying that maybe he could take over Prime Minister Diefenbaker’s job. Then suddenly he pulled back. “That’s a nice dream. One does dream about things too high.”

All in all, an impressive, insightful performance. I had never seen Joseph more realistic. The communication from his authority referent had indeed produced marked changes in his behavior. By inhibiting his delusional speech, it gave him a more realistic posture vis-à-vis other people in his daily environment. But at the group meeting he “backslid” a bit. “The last time I was born it was in Quebec. But I am originally English—no doubt about it.”

A few days later I asked Joseph once again if he had been born in England. He hesitated, then grinned: “I’m supposed to be born in Quebec.” When I asked why he was smiling, he evaded my question. I then asked him who John Michael Ernahue was. “Myself,” he answered.