Paranoia has individual and institutional, social and cultural forms and determinants. There is probably at least a germ of paranoia in everyone which may be activated in regressive states with increased vulnerability. Clinically, paranoia may be found in mild transient forms, paranoid states of varying degree and duration, fixed paranoid traits and paranoid character, and borderline schizophrenia. The range of paranoid conditions doubtless depends upon constitutional, characterological, and experiential variables.{{Top}}paranoïa{{Bottom}}
Unlike other types of psychosis, a paranoid psychosis =====Psychosis=====[[Paranoia]] is usually well-defined, and more or less circumscribed in a delusional part [[form]] of the personality. The disturbance may remain encapsulated or systematized without generalized tendencies toward deterioration of the overall personality[[psychosis]] characterized principally by [[delusions]].
The paranoid personality is characterized by a number =====Sigmund Freud=====[[Freud]]'s [[experience]] of common traits: basic distrust; suspiciousness; readiness to feel slighted, injured or persecuted; a tendency to collect grievances and grudges; and vindictiveness. The paranoid personality either anticipates or fears being exploited and abused; is irrationally suspicious of hidden dangers or threats; and expects or believes in the infidelity of a spouse, the disloyalty of friends, and notions of hostile conspiracy. Betrayals are anticipated or assumed, so that for the paranoid friend may immediately become foe, and seeming affection may be replaced by an implacable animosity. Self-esteem issues are also apparent—connected with both the extraordinary sensitivity to narcissistic injury and humiliation, and concomitant grandiosity which may extend to megalomania[[treatment|treating]] [[paranoiacs]] was limited.
The psychoanalytic understanding of =====Shreber Case=====[[Freud]]'s most extensive [[work]] on [[paranoia was initiated by Freud (1911c) who, prior to the Schreber case, had already linked the defense mechanism ]] is an [[analysis]] of projection to the paranoia personality. Via projection, the paranoid defends against unacceptable impulses, especially hate and aggression, which are also related to paranoid defiance. The importance written memoirs of regression to narcissism, with attendant hypersensitivity to narcissistic mortification and grandiosity associated with infantile omnipotence, was highlighted in the a [[paranoiac]] -- a judge named [[Daniel Paul Schreber case]]. Grandiosity could also be a compensatory reaction to unconscious feelings <ref>{{F}} "[[Works of inadequacy and inferiority. However, Sigmund Freud shifted the dynamic understanding |Psycho-Analytic Notes on an Autobiogrpahical Account of paranoia at the same time to a core oedipal conflict. The paranoid defense constellation warded off unconscious homosexual wishes. In the paranoid male the unconscious proposition: "I, a man, love him, a man," is contradicted in the following ways: (1) delusions Case of jealousy: "It is not I who love the man; it is she," Paranoia (2Dementia Paranoides) delusions of persecution: ]]"I do not love him, I hate him1911. Because of this he hates and persecutes me," ([[SE]] XII: 3) erotomania: "I do not love him. I love her, and she loves me," (4) megalomanic disavowal: "I do not love anyone else, but only myself."</ref>
=====Homosexuality=====It should be noted is in this work that [[Freud's formulations in the Schreber case were based upon the utilization of the libido ]] puts forward his theory and an attempt to understand that [[paranoia in terms of psychosexual disturbance]] is a [[defence]] against [[homosexuality]], which reversed his earlier formulation of repressed hostility. Subsequent contributions have confirmed arguing that the importance different forms of malignant narcissism and the defense of projection, but also of hatred, aggression, and splitting [[paranoiac]] [[delusion]] are based on different ways of [[negation|negating]] the ego and of self and object representationsphrase "I (a man) [[love]] him."
This defensive splitting off (Klein, Melanie, 1932) is also recognizable in group processes, as in the tendency to idealize one=====Jacques Lacan=====[[Lacan]]'s own group and to distrust and project evil and hostility to those outside the group, especially against defenseless minorities unable to counterattack. Paranoid processes may be discerned interest in various sects and ideologies, where there is devaluation and persecution of those who are seen as opposed to the sect or group's narcissistically-invested belief system. In such dynamics, those who diverge may be scapegoated, and those who deviate or depart may be persecuted as heretics. Individuals with paranoid proclivities are far more readily attracted and susceptible to paranoid demagogues and groups. Paranoid leaders may foment and foster group paranoid reactions among vulnerable individuals. On the other hand, paranoid tendencies may contribute to individuals being vigilant guardians of civil liberty, ever-ready to detect a base of power and threats of exploitation. Feelings of being watched and scrutinized, so commonly seen with paranoid superego regression and externalization, may also have adaptive functions[[paranoia]] predates his interest in [[psychoanalysis]].
Contemporary understanding =====Case of Aimée=====It is the paranoid personality sometimes relates to circumstances in which a traumatic reality is embedded in fantasy, and historical truth in delusion (Freud, 1937d; Blum, 1994). There is often a history subject of childhood paranoiahis first major work, so that pronounced narcissistic and paranoid features are already present in childhoodhis [[doctoral dissertation]]. Feelings of mistrust<ref>{{1932}}</ref> In this work, suspicion[[Lacan]] discusses a [[psychotic]] [[woman]] whom he calls "[[Aimée]]", and susceptibility to feelings of insult and injury may have been lifelong. The nightmares of paranoid patients may leave whom he diagnoses as [[suffering]] from "[[paranoia|self-punishment paranoia]]" (''[[paranoïa d'autopunition]]'') - a hangover effect, so that the paranoid nightmare and terror of attack invades realitynew [[structure|clinical structure]] proposed by [[Lacan]] himself.
Traumatic experience with =====Seminar III=====[[Lacan]] returns to the terror [[subject]] of [[paranoia]] in his [[seminar]] of helplessness and inevitable narcissistic mortification may also be associated with severe and enduring vulnerability 1955-6, [[Seminar III|The Psychoses]] which he devotes to narcissistic hurt and humiliationa sustained commentary on the [[Schreber]] [[case]]. Some cases involve selective identifications with paranoid parents. Paranoid dispositions may be anchored in familial styles [[Lacan]] finds [[Freud]]'s [[theory]] [[about]] the [[homosexual]] roots of paranoid suspicion [[paranoia]] inadequate and scapegoating, or blaming and vengeful familial attitudesproposes instead his own [[theory]] of [[foreclosure]] the specific [[mechanism]] of [[psychosis]].
Furthermore, the paranoid often not only detects the latent envy and hostility of others==Paranoiac Structure==Like all [[clinical structure]]s, but tends to activate and evoke hostile reactions as well. The paranoid's expectation of social slights and hurts becomes a self-fulfilling prophecy as their own suspiciousness and hostility arouses similar mistrusts and hostility in others. Freud (1922b) observed the tendency of the paranoid personality to recognize but exaggerate the imagined infidelity present [[paranoia]] reveals in both partners. Since blame and guilt are projected, the paranoid remains indignant about innocent victimization and may become litigious. Narcissistic rage over feelings of injury and compensatory aggrandizement serve to undo and reverse traumatic helplessness and avenge prior narcissistic hurts and humiliations (Kohut, 1972). The paranoid's own urge toward betrayal becomes a means of vengeance, vindication, and mastery. A preemptive strike may be related to the paranoid's expectation of attack, betrayal, and the rationalization of a defensive counterattack. Any narcissistic frustration, disappointment, or traumatic disturbance may regressively activate a paranoid persecutory system. All levels particularly vivid way certain basic features of personality development may contribute to the paranoid persecutory system[[psyche]].
Current explanations of paranoia involve recognition of diffuse developmental disturbance without ===Paranoiac Alienation===The [[ego]] has a single point of developmental fixation or deficit, appreciating [[paranoiac]] [[structure]]<ref>{{E}} p. 20</ref> because it is the possibility site of complex overdetermination. In paranoia, murderous hostility is now considered far more important than repressed homosexual lovea [[paranoiac]] [[alienation]]. There is a stress on preoedipal roots, leading to failure of oedipal resolution, and to the patient's vulnerability to malignant narcissistic regression (Kernberg, 1975)<ref>{{E}} p.5</ref>
Freud's proposition of the delusional reconstruction of the lost object world is still accepted by many analysts, while others have proposed different views concerning impaired reality testing and paranoid object relations. Reality testing, cognition, and affect regulation may be constitutionally fragile and further impaired by projection, traumatic injury, and ego regression. The paranoid personality may have many areas of intact ego, but it has been proposed (Blum, 1981; 1994) that the persecutor is a narcissistic object or a part object (Klein, 1932), incompletely differentiated from the self representation. In addition to the splitting of representations, there is a regressive failure of object constancy with incomplete separation-individuation (Mahler, Margaret, 1971), and a desperate effort to reestablish object constancy within a constant persecutory relationship. The persecutory narcissistic object is sought, followed, or is imagined to be following the paranoid patient. The split-off dangerous object is the lesser evil when compared to objectless disorganization and fragmentation. Extreme ambivalence prevails, with the dominance of hate over love and with predominant projection of destructive rage, hatred, and self-hatred. Fear of being attacked by an invading or engulfing object is readily fused and confused because of unstable self-object differentiation, intrapsychic representation, and ego integration. Masochistic wishes to be attacked are less unpalatable to the paranoiac than the potentially malignant narcissism. In national and social paranoia, concern with ego boundaries and narcissistic injury is reflected in concerns about national boundaries and enemy betrayal. The nation's integrity, and its boundaries, must then be defended because of fear of destructive invasion and engulfment. The paranoid personality, depending upon the degree and fixity of the underlying disturbance, may be variably amenable to psychoanalytic treatment. Mistrust and lack of confidence in the analyst or therapist, fear of humiliation and abuse, coupled with an entrenched and entitled narcissism make the paranoid patient a major therapeutic challenge. For those patients amenable to psychoanalysis, consistent interpretation of paranoid transference manifestations, management of paranoid regression, and awareness of the patient's ego fragility and extreme ambivalence are of critical importance. HAROLD P. BLUM See also: Narcissism; Paranoid position; Paranoid-schizoid position.Bibliography * Blum, Harold P. (1994). Paranoid betrayal and jealousy: the loss and restitution of object constancy. In J. Oldham, S. Bone (Eds.), Paranoia: New psychoanalytical perspectives. Madison: International Universities Press, p. 97-114. * Freud, Sigmund. (1911c [1910]). Psycho-analytic notes on an autobiographical account of a case of paranoia (dementia paranoides). SE, 12: 1-82. * ——. (1922b [1921]). Neurotic mechanisms in jealousy, paranoia and homosexuality. SE, 18: 221-232. * ——. (1937d). Constructions in analysis. SE, 23: 255-269. * Kernberg, Otto. (1975). Borderline conditions and pathological narcissism. New York: Jason Aronson. * Kohut, Heinz. (1972). Thoughts on narcissism and narcissistic rage. The search for the self. (Vol. 2.) New York: International Universities Press, p. 615-65. Further Reading * Auchincloss, Elizabeth L., and Weiss, Richard W. (1992). Paranoid character and the intolerance of indifference. Journal of the American Psychoanalytic Association, 40, 1013-1038. * Blum, Harold P. (1980). Paranoia and beating fantasy: psychoanalytic theory of paranoia. Journal of the American Psychoanalytic Association, 28, 331-362. * Kernberg, Otto F. (1992). Psychopathic, paranoid, and depressive transferences. International Journal of Psychoanalysis, 73, 13-28. * Meissner, William. (1986). Psychotherapy and the paranoid process. Northvale, NJ: Jason Aronson. * Oldham, John M., and Bone, Stanley. (Eds.). (1994). Paranoia: New psychoanalytic perspectives. Madison, CT: International Universities Press. ==new=Paranoiac Knowledge=== paranoia (paranoÔa) [[ParanoiaKnowledge]] is a form of [[Psychosis]] characterised principally by [[Delusions]]. Freud's experience of treating paranoiacs was limited, and his most extensive work on the subject is not the record of a course of treatment, but the analysis of the written memoirs of a paranoiac man (a judge by the name of Daniel Paul Schreber) (Freud, 1911c). It is in this work that Freud puts forward his theory that paranoia is a defence against homosexuality, arguing that the different forms of paranoiac delusion are based on different ways of negating the phrase 'I (a man) love him'.Lacan's interest in paranoia predates his interest in psychoanalysis; it is the subject of his first major work, his doctoral dissertation (Lacan, 1932). In this work, Lacan discusses a psychotic [[Womanconnaissance]] whom he calls 'AimÈe', whom he diagnoses as suffering from 'self-punishment paranoia' (paranoÔa d'autopunition) - a new clinical category proposed by Lacan himself. Lacan returns to the subject of paranoia in his seminar of 1955-6, which he devotes to a sustained commentary on the Schreber case. Lacan finds Freud's theory about the homosexual roots of paranoia inadequate and proposes instead his own theory of itself is [[Foreclosure]] the specific mechanism of [[Psychosisparanoiac]].Like all clinical structures, paranoia reveals in a particularly vivid way certain basic features of the psyche. The ego has a paranoiac structure (<ref>{{E, 20) because it is the site of a paranoiac alienation (E, 5)}} p. Knowledge (connaissance) itself is paranoiac (E, 2, 3, 17). The process of psychoanalytic treatment induces controlled paranoia into the human subject (E, 15).</ref>
===Analytic Treatment===
The [[process]] of [[psychoanalytic treatment]] induces controlled [[paranoia]] into the [[human]] [[subject]].<ref>{{E}} p. 15</ref>
==See Also==
{{See}}
* [[Defence]]
* [[Defense mechanism]]
* [[Delusions]]
||
* [[Foreclosure]]
* [[Knowledge]]
* [[Narcissism]]
||* [[Projection]]* [[Paranoid positionPsychosis]]* [[Paranoid-schizoid positionStructure]]{{Also}}
==References==
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# Blum, Harold P. (1994). Paranoid betrayal and jealousy: the loss and restitution of object constancy. In J. Oldham, S. Bone (Eds.), Paranoia: New psychoanalytical perspectives. Madison: International Universities Press, p. 97-114.# Freud, Sigmund. (1911c [1910]). Psycho-analytic notes on an autobiographical account of a case of paranoia (dementia paranoides). SE, 12: 1-82.# ——. (1922b [1921]). Neurotic mechanisms in jealousy, paranoia and homosexuality. SE, 18: 221-232.# ——. (1937d). Constructions in analysis. SE, 23: 255-269. [[Category:New]]</div>
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