Even Paranoids Have Enemies

New Perspectives on Paranoia and Persecution

Joseph H. Berke, Stella Pierides, Andrea Sabbadini, Stanley Schneider, Joseph H. Berke, Stella Pierides, Andrea Sabbadini, Stanley Schneider

• Publisher: Routledge
• Year: 2006
• Topic: Psychology
• eBook ISBN:
  9781134731534
• Subtopic: History & Theory in Psychology
• Index: Psychology

'Even paranoids have enemies' is the reply Golda Meir is said to have made to Henry Kissinger who, during the 1973 Sinai talks, accused her of being paranoid for hesitating to grant further concessions to the Arabs. It is used as part of the title of this book to highlight the complex relationship between paranoia and persecution.The politics of the Middle East, the pressures within Japanese society, the dynamics of the drug scene, racism, and the effects of mechanical thinking in institutions and cultures all serve to illustrate in this book the intimate connections between paranoia and persecution. Contributors examine the ways in which paranoia and persecution are experienced at the individual, institutional and macrosocial level. They draw on theoretical perspectives from a range of disciplines in an exploration of both the psychological impact of paranoid processes and the extent to which these processes are rooted in political and cultural exigency.

Part I

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Psychological

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Introduction

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We have collected into this first part five chapters which, in their diversity, emphasize how persecutory phenomena develop and are experienced. We are aware, of course, that alongside such psychological components we always find interpersonal, social and cultural dimensions as well, and indeed Parts II and III of the book analyse such perspectives in more detail. Here, however, the authors have concentrated their attention on how different individuals face the pain of being threatened or attacked by internal (or better, internalized) objects and how they attempt to protect themselves from them.

The authors of this section come from different cultural, ideological and professional backgrounds. The first three chapters are by psychoanalysts from different parts of the world: Salomon Resnik is an Argentinian working in Paris and Venice; Andrea Sabbadini is an Italian who works in London; and Ilany Kogan is an Israeli. Robert Jay Lifton is an American psychiatrist and psychosocial historian and David Edgar a British playwright. The themes they cover in their respective chapters, and the angles from which they approach them, are somewhere at the crossroads between experiential and clinical, but are also radically different. Yet they have so many elements in common that it is possible to identify themes running through all of them which provide a rich and complex unity to the whole section.

In ‘Being in a persecutory world: the construction of a world model and its distortions’, Salomon Resnik refers to the concept of projection as Freud first applied it to the case of Frau P., a paranoid woman. In working with such patients Resnik finds it important to make use of the climate of the transference situation and the specific tonality of the atmosphere created in the therapeutic relationship. After providing an original review of the history of the concept of paranoia in psychiatric and psychoanalytic literature—from Kraepelin to Freud, Bleuler and Money-Kyrle—Resnik moves on to present some detailed analytic material from his work with four of his severely paranoid schizophrenic (as distinguished from Kraepelin's ‘lucid paranoid’) patients. He concludes that in the contemporary western world even the ‘normal basic personality’ has paranoid components.

In chapter 2, ‘From wounded victims to scarred survivors’, Andrea Sabbadini considers his psychotherapeutic work with refugees who have undergone severe persecution and torture in their countries of origin. He looks at these patients' predicament from the perspective of their traumatic experiences of permanent loss, which he contrasts to the fundamental impermanence of their condition as refugees, and argues for the centrality of mourning as part of the therapeutic process. He also considers the problem of the recovery of painful memories, in that those who have been severely traumatized are often trapped in the paradoxical need to remember what they only wish to forget. As illustration, he offers analytic material from his work with survivors of torture who present with symptoms of anxiety states, sleeplessness and terrifying nightmares. He concentrates on issues of transference and countertransference, as such processes, common in all analytic work, become significantly intensified (often in the sense of displaying paranoid connotations) in relation to victims of persecution.

In the third chapter, entitled ‘The black hole of dread: the psychic reality of children of Holocaust survivors’, Ilany Kogan provides an original framework to the experience of the Nazi genocide by focusing on its effects on survivors' offspring, thus introducing a multigenerational perspective to our understanding of the mechanisms of persecution and paranoia. She believes that the commonly observed persecutory anxieties of children of Holocaust survivors stem from their collective memory of it, and are coloured by its imagery. The mechanism of identification with either perpetrators or victims is of crucial importance, and of course it is repeated in the transference situation with the analyst, as Kogan aptly demonstrates through her clinical work. More specifically, she suggests that it is what she calls ‘primary identification’ that facilitates the creation of a psychic hole in the reality of these children, which then becomes the source of persecutory anxieties and fantasies, often revolving around themes of death and survival. Kogan believes that work with these patients should involve a modification of more traditional psychoanalytic technique, to include holding, both as ‘holding relationship’ and as ‘holding interpretations’, of which she gives here numerous and vivid examples.

Robert Jay Lifton further expands the analysis of such phenomena by considering in his chapter, ‘The “end-of-the-world” vision and the psychotic experience’, three different levels of experience: the external event (for example, the bomb at Hiroshima); the shared theological imagery (that organizes the event into an acceptable structure); and the internal derangement (the personal Armageddon of psychosis). Mostly with reference to the well-known case of Judge Schreber, Lifton re-examines our theories of schizophrenia, looking both at Freud's emphasis on narcissism in his understanding of paranoid mechanisms and at alternative interpretations, such as those of Macalpine and Hunter, Searles, Sullivan, Laing and others. He concludes that the schizophrenic's self, flooded with death anxiety, disintegrates into ‘a lifeless life’, where existence itself is equated with the constant threat of annihilation.

Finally playwright David Edgar, in this section's concluding chapter ‘Only pretend: the dramaturgy of paranoia’, reminds us that acting implies pretence, or even deceit, and that all drama, as Shakespeare demonstrated, expresses a fundamental duplicity: tragedy is about broken promises, and comedy about ineffective disguise. At the core of drama as a medium Edgar places the contrast between character and role. The same might be said about the internal dramas of persons diagnosed as mental patients: once their ‘inner objects’ are projected on to an outside tableau, the characters and roles portrayed often take on a life of their own. Edgar demonstrates this development in his play about the ‘resurrection’ of the psychotic painter Mary Barnes, especially in the scene where she acts out the various parts of the Crucifixion while simultaneously painting it. In the dramatized escape story about the South African lawyer Albie Sachs, who was detained for six months without trial, Edgar depicts an instance of extreme persecution and privation. Here a circumstantial role has become more important than one's own character. Edgar uses this play to express his concerns about the tendency to see oppression as a psychological concept, as if it had no existence outside the mind of the person experiencing it. Metaphors, he concludes, have real meanings even if they should not be taken literally, and we must allow the presence of the visionary and the Utopian in our lives if we are to have any chance of reducing political paranoia and the real persecution from which it flows.

Chapter 1

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Being in a persecutory world

The construction of a world model and its distortions

Salomon Resnik

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In order to write meaningfully about paranoia, it is necessary to go back to the origins of the concept of projection. The first use Freud makes of the term ‘projection’ is in his 1905 paper ‘Analysis of a case of chronic Paranoia’ in which he describes the case of Frau P., a woman of thirty-two, married and with a child of two. In her middle twenties she became confused and depressed. A few months after the birth of her child, she showed the first signs of paranoia: she became uncommunicative and distrustful, showed aversion to her husband, brothers and sisters, and complained about her neighbours. According to her, the neighbours were beginning to be rude and inconsiderate towards her. She thought people had something against her, though she had no clear idea what. Then she added that people in general began to show no respect for her and to do things against her. She complained that she was being watched by people in the street, who were able read her thoughts and so knew everything about her. One evening she thought that she was being watched while undressing, thereby adding an erotic element to the picture of her unwilling exhibitionism. She was describing a transformation in her world, which from our point of view could be seen as a distortion of the world-picture.

In addition, she experienced strange symptoms in her body. One day, when she was alone with her housemaid, she had a sensation in her lower abdomen, and thought that the girl had at that moment an improper (i.e. sexual) idea. These erotic sensations increased, and she felt her genitals ‘as one feels a heavy hand’ (dixit Freud). Then she began to develop horrifying sexual hallucinations of naked women showing the lower part of the body—the pubic region, and pubic hair, sometimes with male genitals. All this delusional somatic distortion added to her distorted transformation of the world. Here we have through Freud's description an excellent picture of the beginning of a delusional universe.

She went to Freud for treatment in the winter of 1895. Freud notes that her intelligence was undiminished in spite of all her delusions and hallucinations. Influenced as he was at that time by Breuer's technique, Freud was aiming at removal of the hallucinations and treatment of her persecutory feelings in a case which he diagnosed as paranoia.

Freud was still placing his hand on his patients' foreheads (he was following the Mesmertradition of magnetism) in orderto help them to remember and to associate, and in this way make contact with their unconscious fantasies and fears. He suggests that some of Frau P.'s delusions and hallucinations were to some extent based on actual facts—for instance, the first hallucinated images of a woman's abdomen appeared in a hydropathic establishment, a few hours after she had in fact seen a number of naked women at the baths. Freud showed interest in her memories about the past; the patient responded by mentioning scenes from her adolescence, at age seventeen or eighteen, when she had felt ashamed of being naked in her bath in front of her mother, her sister and her doctor. Then she was able to associate her brother with a scene at the age of six, when she was undressing in the nursery before going to bed; in that situation she had felt no shame. Freud suggests that she had omitted to feel shame as a child, and therefore that she repressed her sexual play with her brother (voyeurist and exhibitionist experiences). The repressed feelings returned as shame in her delusional, hallucinated, erotic compulsion.

The patient spoke also about her depression, which she related to a quarrel between her husband and herbrother. She regretted that after the quarrel herbrother, of whom she was fond, would no longer come to their house, for she missed him very much. Frau P. thought at one point that her sister-in-law reproached her with managing things in such a way as to make it impossible for her brother to come back. However, the patient was later able to meet her brother again, but could not talk to him clearly, and she thought that he would understand her suffering since he knew the cause. My impression from Freud's account is that the patient was certain that there remained between her brother and herself some image related to their infantile sexuality which should be kept secret between them. Freud says that he was able after a time to help his patient talk about the various sexual scenes with her brother; these were related to the physical sensations in her abdomen. According to Freud, after this abreaction, the hallucinatory sensations and images disappeared; this enabled him to formulate the idea that the hallucinations were no more than parts of the content of repressed sexual experiences in childhood.

Frau P spoke constantly about her ‘inner’ voices and ‘inner’ hallucinations—one of them used to say ‘Here comes Frau P.’ At other moments the voices would repeat what she was reading in a book (this recalls Echo and Narcissus).

Freud thought that these voices had their origin in the repression of thoughts related to self-reproaches about her traumatic childhood sexual experiences: the voices were symptoms of the return of the repressed, and also a compromise between the resistance of the ego and the strength of the returning wishes. Freud writes at this point of ‘distortions’ following Frau P.'s experiences with her hallucinated voices—distortions of her feelings and perceptions.¹ The patient felt criticized by her inner hallucinated persecutory world. Her only relief lay in her mental space, once the inner persecutors moved from the internal to the external world. But then she felt that people ‘outside’ were making mocking and critical remarks about her: ‘There goes Frau P.’ was felt to mean that everybody in her environment was pointing at her in full knowledge of her infantile sexual fantasies and experiences. This atmosphere of criticism and mockery became unbearable, but it was the price she had to pay for her projections. It is in fact in this paper and thanks to this clinical case that Freud describes publicly for the first time the concept of ‘projection’, the birth of which I shall now go onto discuss.²

According to the Strachey translation, ‘in paranoia, the self-reproach is repressed in a manner which may be described as projection’. This ‘repression’ isaparticular one in that it consists of the erecting of a defensive symptom of distrust of other people. Freud uses the term projection as a pro-ject—a way of ejecting (Verwerfung³) the persecuting voices (the self-reproach) outside onto/into the world; the movement is much clearer in the original German text, where this kind of repression (Verdrängung) is a transfer from the inner to the outer world—Frau P. ‘s persecuting inner voices were repressed (verdrängt) into the Other, into persons in the outer world. It is clear to my mind that Freud's original formulation, whereby in paranoia projection takes place into other people, into objects is a precursor of Melanie Klein's notion of projective identification.

I must draw the reader's attention to the fact that in the German text of his paper, Freud uses the expression Wiederkehr des Verdrängten (Gesammelte Werke, 1, p. 401), translated as the ‘return of the repressed’. In the word Wiederkehr there is a play on wieder (again) and kehr (turn round); in terms of time, there is the idea of returning-and in terms of space, the space of the transference, it becomes akind of turning-round-again acrobatics of the mind, recalling the expression ‘athletics of the mind’ used by Bion. This latter expression comes in fact from the French surrealist poet, Antonin Artaud, in his Les Tarahumaras (1955). In my reading of Freud, I can imagine a playful and living metaphor through which by projection the Verdrängte appears reversed and turned into the animate creatures of the outer world. We cannot, however, go to the extent of postulating that the psychotic loses his entire self in this way and becomes a non-being. Indeed, the feeling that one is turning into a zombie, a mixture of life and death, implies that part of the self is always there to look at a shadowy world, like the giant overwhelming shadow of Nosferatus imposing itself on what remains of the living self.⁴

AN ECOLOGY OF DELUSION

I find it important in my clinical work to make use of the climate of the transference situation and the particular tonality of the atmosphere—whether it is monotonous or changing, for example. The German psychiatrists who follow the phenomenological approach use the concept of Stimmung, which in reference to some French a...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• List of contributors
• Foreword Vamik D. Volkan
• General introduction
• Part I Psychological
• Part II Social and institutional
• Part III Cultural and political
• Name index
• Subject index