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.
Unlike other types of psychosis, a paranoid psychosis [[Paranoia]] ([[French]]: ''[[paranoïa]]'') 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]] characterised principally by [[delusions]].
The paranoid personality is characterized by a number 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.==Sigmund Freud==
The psychoanalytic understanding of paranoia was initiated by Freud (1911c) who, prior to the Schreber case, had already linked the defense mechanism 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 of regression to narcissism, with attendant hypersensitivity to narcissistic mortification and grandiosity associated with infantile omnipotence, was highlighted in the Schreber case. Grandiosity could also be a compensatory reaction to unconscious feelings of inadequacy and inferiority. However, Freud shifted the dynamic understanding 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 of jealousy: "It is not I who love the man; it is she," (2) delusions of persecution: "I do not love him, I hate him. Because of this he hates and persecutes me," (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."===Projection===
It should be noted that Freud's formulations in Prior to the [[Schreber ]] [[case were based upon the utilization of the libido theory and an attempt to understand paranoia in terms of psychosexual disturbance]], which reversed his earlier formulation of repressed hostility. Subsequent contributions have confirmed the importance of malignant narcissism and [[Freud]] linked the [[defense mechanism]] of [[projection, but also of hatred, aggression, and splitting of the ego and of self and object representations]] to [[paranoia]].
This defensive splitting off The [[paranoiac]] [[defends]] against unacceptable impulses (Klein, Melanie, 1932) is also recognizable in group processes, as in the tendency to idealize one'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 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 [[hate]] 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[[aggression]]) through [[projection]].
Contemporary understanding ==Schreber Case==[[Freud]]'s experience of the paranoid personality sometimes relates to circumstances in which a traumatic reality is embedded in fantasytreating [[paranoiacs]] was limited, and historical truth in delusion (Freud, 1937d; Blum, 1994). There his most extensive work on the subject is often not the record of a history course of childhood paranoia[[treatment]], so that pronounced narcissistic and paranoid features are already present in childhood. Feelings but the [[analysis]] of mistrust, suspicion, and susceptibility to feelings the written memoirs of insult and injury may have been lifelong. The nightmares of paranoid patients may leave a hangover effect, so that [[paranoiac]] man (a judge by the paranoid nightmare and terror name of attack invades reality[[Daniel Paul Schreber]]).<ref>Freud, 1911c</ref>
Traumatic experience with It is in this work that [[Freud]] puts forward his [[theory]] that [[paranoia]] is a [[defence]] against [[homosexuality]], arguing that the terror different forms of helplessness and inevitable narcissistic mortification may also be associated with severe and enduring vulnerability to narcissistic hurt and humiliation. Some cases involve selective identifications with paranoid parents. Paranoid dispositions may be anchored in familial styles [[paranoiac]] [[delusion]] are based on different ways of paranoid suspicion and scapegoating, or blaming and vengeful familial attitudesnegating the phrase "I (a man) love him."
Furthermore, the paranoid often not only detects the latent envy and hostility of others, but tends to activate and evoke hostile reactions as well. The paranoidIt should be noted that [[Freud]]'s expectation of social slights and hurts becomes a self-fulfilling prophecy as their own suspiciousness and hostility arouses similar mistrusts and hostility formulations in others. Freud (1922b) observed the tendency [[Schreber]] [[case]] were based upon the utilization of the paranoid personality [[libido]] [[theory]] and an attempt to recognize but exaggerate the imagined infidelity present understand [[paranoia]] 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 terms of a defensive counterattack. Any narcissistic frustration, disappointment, or traumatic [[psychosexual]] [[disturbance may regressively activate a paranoid persecutory system. All levels of personality development may contribute to the paranoid persecutory system]].
Current explanations of paranoia involve recognition of diffuse developmental disturbance without a single point of developmental fixation or deficit, appreciating the possibility of complex overdetermination. In paranoia, murderous hostility is now considered far more important than repressed homosexual love. 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).==Oedipal conflict==
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 [[psychoanalytic]] understanding of representations, there is a regressive failure of object constancy with incomplete separation-individuation (Mahler, Margaret, 1971), and a desperate effort [[paranoia]] shifted 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 narcissismcore [[oedipal]] [[conflict]].
In national and social paranoia, concern with ego boundaries and narcissistic injury is reflected in concerns about national boundaries and enemy betrayal. The nation'[[paranoid]] [[defend]]s integrity, and its boundaries, must then be defended because of fear of destructive invasion and engulfmentagainst [[unconscious]] [[homosexual]] [[wish]]es.
The In the [[paranoid personality, depending upon the degree and fixity of ]] [[male]] the underlying disturbanceunconscious proposition: "I, may be variably amenable to psychoanalytic treatment. Mistrust and lack of confidence in the analyst or therapista man, fear of humiliation and abuselove him, coupled with an entrenched and entitled narcissism make the paranoid patient a major therapeutic challenge. For those patients amenable to psychoanalysisman, consistent interpretation of paranoid transference manifestations, management of paranoid regression, and awareness of " is contradicted in the patient's ego fragility and extreme ambivalence are of critical importance.following ways:
# [[delusions]] of [[jealousy]]: "It is not I who love the man; it is she,"
==new==# delusions of [[persecution]]: "I do not love him, I hate him. Because of this he hates and persecutes me,"
# [[erotomania]]: "I do not love him. I love her, and she loves me,"
# [[megalomanic]] [[disavowal]]: "I do not love anyone else, but only myself."
==Jacques Lacan==
[[Lacan]]'s interest in [[paranoia]] predates his interest in [[psychoanalysis]].
It is the subject of his first major work, his doctoral dissertation.<ref>Lacan, 1932</ref>
In this work, [[Lacan]] discusses a [[psychotic]] [[woman]] whom he calls '[[Aimée]]', whom he [[diagnose]]s as suffering from '[[self-punishment paranoia]]' (''[[paranoïa d'autopunition]]'') - a new [[clinical structure]] proposed by [[Lacan]] himself.
[[Lacan]] returns to the [[subject]] of [[paranoia]] in his [[seminar]] of 1955-6, [[Seminar III|The Psychoses]] 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 [[foreclosure]] the specific [[mechanism]] of [[psychosis]].
Like all [[clinical structure]]s, [[paranoia]] reveals in a particularly vivid way certain basic features of the [[psyche]].
The [[ego]] has a [[paranoiac]] [[structure]]<ref>{{E}} p.20</ref> because it is the site of a [[paranoiac]] [[alienation]].<ref>{{E}} p.5</ref>
==Paranoiac Knowledge==
[[Knowledge]] (''[[connaissance]]'') itself is [[paranoiac]].<ref>{{E}} p.2, 3, 17</ref>
==Analytic Treatment==
The process of [[psychoanalytic treatment]] induces controlled [[paranoia]] into the [[human]] [[subject]].<ref>{{E}} p.15</ref>
paranoia (paranoÔa)
[[Paranoia]] 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 [[Woman]] 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 [[Foreclosure]] the specific mechanism of [[Psychosis]].
Like all clinical structures, paranoia reveals in a particularly vivid way certain basic features of the psyche. The ego has a paranoiac structure (E, 20) because it is the site of a paranoiac alienation (E, 5). Knowledge (connaissance) itself is paranoiac (E, 2, 3, 17). The process of psychoanalytic treatment induces controlled paranoia into the human subject (E, 15).
==See Also==
* [[Narcissism]]
* [[Knowledge]]
==References==
# ——. (1937d). Constructions in analysis. SE, 23: 255-269.
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