Yeah, let’s work through each level, just to make sure.
I’d say conceiving is the Concern. Everyone is trying to get John to concieve that he has a problem? Or to stop conceiving of Charles et al as real? Something like that. And attempts to get him to concieve of that are met with resistance. His failure to properly concieve have running off thinking he’s on secret missions, etc, running out of lectures and punching doctors. Having a hard time coming up with his math ideas and feeling alive has him not taking his meds and falling back into delusion.
What about Issue? Does Need feel right, or do we need to look at a couple?