What Is Paranoia And Why Does It Hurt Us?

Paranoia has been interpreted differently by psychiatry and psychoanalysis. The concept first appeared in psychiatry, and at first it was simply assumed to be a form of dementia.

Over time, psychiatry discarded this concept as a diagnostic entity; in part, because paranoia has become 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, according to the DSM, is the “delusional syndrome”.

In psychoanalysis something very different happened. In principle, Sigmund Freud approached it as a form of neurosis derived from obsession. Later, particularly with the Schreber case, he understood that it was a psychosis. Lacan, on the other hand, did his doctoral thesis on the Aimée case: a paranoia cured.

A little of history

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

For a long time the word paranoia was used as a synonym for madness. The German Kahlbaum was the first to speak of it as a separate entity in 1863. Kraft-Ebing further developed the concept and, in 1879, described it as a “mental alienation which concerns essentially judgment and reasoning” .

There have been other attempts to describe this problem, but eventually Kraepelin’s concept was imposed in 1889. It has since taken on 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 being able to conceptualize it completely, in his work The neuropsychosis of defense (1894). Freudian psychoanalysis dealt mainly with neuroses. Initially, Freud associated paranoia with the projection mechanism; so, it has not progressed conclusively.

Neisser defined a fundamental aspect of the way 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, is about him.

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

Lacan is enigmatic and not easily understood. Let’s just say that his statement is equivalent to the slogan of paranoia: “The Other takes advantage of me” . Jacques Lacan literally says this: “He himself [the paranoid] offers himself as a support so that God or the Other can enjoy his passive being” .

Diluting the concept of paranoia

The paranoid person in psychoanalysis is not just a suspicious person, as popular culture often thinks. The person affected by this problem starts from two assumptions: one, that some kind of “evil” or “cruelty” was triggered and that he would be the victim of it. And two, that what happens in the world has something to do with it in some way.

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

In this state, a person interprets the facts of the story to which his mind has given life. So losing an object, for example, would be proof that these spirits, Martians or demons, or whatever, are playing with or tormenting her.

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