What Is Paranoia And Why Does It Hurt Us

Paranoia has been interpreted differently in psychiatry and in psychoanalysis. The concept initially arose in psychiatry and was initially assumed simply as a form of dementia.

Over time, psychiatry discarded this concept as a diagnostic entity; in part, because paranoia became part of some mental disorders, particularly schizophrenia. Thus, it ceased to be a separate entity and became almost a symptom of other pathologies. Currently, what is most similar to it, according to the DSM, is the “delusional syndrome.”

In psychoanalysis something very different happened. At first, Sigmund Freud approached it as a form of neurosis derived from obsession. Later, particularly with the Schreber case, he realized that it was a psychosis. Lacan, for his part, made his doctoral thesis on the Aimée case: a cured paranoia.

Some history

The word paranoia comes from the Greek root “para”, which means “next to” or “along”; and from the word “noev”, which means to think or understand. So because of its etymology,  paranoia is something like “having a parallel thought. ” The first to speak of it was Hippocrates.

For a long time the word paranoia was used as a synonym for insanity. The German Kahlbaum is the first to speak of it as a differentiated entity, in 1863. Kraft-Ebing developed the concept a little further and in 1879 he defined it as a ” mental alienation that mainly concerns judgment and reasoning .”

There were other attempts to describe this problem, but the concept of Kraepelin finally prevailed, in 1889. From that moment on, it took the meaning of a type of disorder in which there are delusions, without other significant psychopathology. In the DSM it was present until 1987, when it was replaced by “Delusional disorder” or “Paranoid disorder”.

Paranoia in psychoanalysis

Sigmund Freud initially spoke of paranoia, without fully conceptualizing it, in his work The Neuropsychosis of Defense (1894). Freudian psychoanalysis was mainly concerned with neuroses. Freud associated paranoia with the projection mechanism initially; then, he did not progress on it conclusively.

Neisser defined a fundamental aspect of the way in which psychoanalysis deals with the paranoid phenomenon. He noted that this is, in essence, ” a unique way of interpreting. ” The paranoid feels that everything he observes and hears, in one way or another, refers to him.

Jacques Lacan, for his part, went much deeper into the subject. In a 1958 text, in which he refers to the Schreber case, addressed by Freud, Lacan defined paranoia as the “ identification of one jouissance in the place of the other ”.

Lacan is cryptic and is not easily understood. Let’s just say that his statement amounts to the slogan of paranoia: ” The Other enjoys me. ” Jacques Lacan literally says it this way: ” He himself [the paranoid] offers himself as a support for God or the Other to enjoy his passivized being .”

Elucidating the concept of paranoia

Paranoid in psychoanalysis is not only a suspicious person, as is used to think in popular culture. The person affected by this problem starts from two assumptions: one, that some kind of “evil” or “cruelty” has been unleashed and he would be the victim of that. And two, that what happens in the world somehow has to do with him.

The paranoid interprets the world from these two assumptions and on the basis of a delusion. Delirium is an unreasonable story. In paranoia, that story has to do with a form of evil that wants to make the person a victim. “Evil spirits take over my mind,” for example. Either the Martians or the devil.

In this state, a person interprets the facts from the story that his mind has brought to life. Thus, losing an object, for example, would be proof that those spirits, Martians or demons, or whatever, are playing with it or tormenting it.

As Lacan points out, the slogan appears: ” The Other enjoys me .” And in the face of this, he feels completely “passivated.” He attributes what happens in his life to him: ” It wasn’t me, it was the Other. ” This belief and this delusion range from relatively simple situations, such as celotype, to states that lead to more serious consequences, as in the Aimée case.