Paranoia (next to, around, deviation from something, + to think) — at present, most domestic psychiatric schools are considered in the syndromological aspect as paranoid symptom formation in the form of the formation of a systematized interpretive delirium within the framework of various mental nosologies (see paranoid syndrome). K. Kahlbaum (1863) was first singled out as an independent mental illness with a predominant disorder of rational activity. In a number of Western psychiatric schools paranoia retains its nosological independence.
This mental disorder is characterized by long periods of unreasonable distrust of others, as well as increased susceptibility. Although this disorder is not classified as a psychosis, people affected by it often have great difficulty in relationships. They, as a rule, are very critical of others, however, they do not accept criticism in their address.
A mental disorder characterized by suspicion and a well-founded system of overvalued ideas, which, when overexpressed, become delusional. This system usually does not change; it would be perfectly logical if the original pathological ideas were correct. Because paranoid patients most often degrade only in the final stages of the disease (they often manage to give the appearance of reality to their delusional thinking by getting involved in lawsuits or other litigious activities), they rarely end up in psychiatric hospitals. Patients with paranoia do not have the frivolous behavior, emotional instability, grotesque hallucinations, and unusual ideas noted in other psychopathological conditions. Many of them are able to support, at least superficially, economic and social adaptation. It is only when their motives come into conflict with the public welfare that it becomes obvious that hospitalization is necessary. On the other hand, there are cases of paranoia when the patient expresses strange ideas: for example, one patient claimed to be married to God.
History is rife with paranoids. Several theories have been put forward to explain the mechanism of paranoia. One of them is Freud’s theory, which suggests that the basis of paranoia is fixation, or delay, at a certain stage of the child’s sexual development. We are talking about the stage of homoerotica — the period when boys play with boys, and girls play with girls (between approximately 4 and 11 years). When a boy who has been fixed in the homoerotic stage reaches adult freedom, an unsatisfied attraction to little boys weighs over him, and he is forced either to become involved in homosexual activity or, subject to social pressure, seek compensation in such forms of behavior as alcoholism or male aggression. This behavior becomes a kind of cloaca of unconscious desires for homoerotic contacts.
If paranoia arises as a compromise, then the delusion of persecution turns out to be a projection of an internal fantasy desire: the problems associated with homosexuality, as it were, are not contained in the person himself, but are imposed on him from the outside. Indeed, paranoid men are usually «chased» by men or male organizations, and paranoid women by females. Sexual adaptation, including marriage, is most often absent. Patients with paranoia who enter into marriage to meet the requirements of heterosexuality have poor adaptation to family life or home discord. The paranoid individual, no matter what socio-economic stratum he belongs to, forever devotes himself to aggressiveness, fighting imaginary enemies and displaying emphasized masculine behavior that borders on heroism. The cycle never comes to an end: as soon as one enemy is defeated, another even more dangerous appears.
Paranoia must be distinguished from other delusional disorders called paranoid; they are often associated with organic pathology (cerebral atherosclerosis, senile psychoses) or with functional psychoses, in particular schizophrenia. Delusions in paranoid disorders are variable and not as logically worked out as in paranoia. In addition, it may be accompanied by hallucinations, changes in emotional states and socially unacceptable behavior.
Treatment for paranoia remains unsatisfactory. The main reason is that people with paranoia rarely seek help. As a result, research based on observation and treatment is not possible. There are currently no specific treatments for these conditions in medicine.
references
- Paranoia — Encyclopedia Around the World
- Psychoanalytic Notes on an Autobiographical Description of a Case of Paranoia (Schreber’s Case) Z.Freud. 1911 — Psychoanalysis