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.
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