Paranoia
Introduction:
Paranoia is a mental disorder mainly characterized by persecutory
thoughts and many other symptoms. The causes of this disorder are many. In
addition, the description of paranoia and its symptoms passed through a long
time process. We will deal with the mentioned subjects in the following
paragraphs.
Origin of the word:
The origin of this word is Greek (paranoos= madness), and it consists of
two syllables, para that means beside, irregular, and noos that means mind. It
became paranoia with the modern Latin in the early 19th century, and means
distracted.1
Definition:
Paranoia is a thought process characterized by excessive fear or anxiety
to the extent of delusion2, and it includes persecutory beliefs of threats,
unwarranted jealousy, and/or exaggerated self-importance.3
History:
Paranoia has been deliberated through a long time4, started as madness
with the ancient Greeks, until present with DSM V, which only lists traits
describing paranoia: suspiciousness, intimacy avoidance, hostility and unusual
beliefs / experiences.
We will state the description (symptoms and thoughts) of paranoia
through historical periods and authors in the table below:
1
http://en.wikipedia.org/wiki/Paranoia
Same reference.
3
http://www.bing.com/search?q=definition+of+paranoia&form=PRAEEN&refig=38c98900bb244e8e82b5bf5d4
4896f68&pq=definition+of+paranoia&sc=8-14&sp=-1&qs=n&sk=
4
.http://en.wikipedia.org/wiki/Paranoia
2
Period/
Author
DSM
III/Magnan
Kraepelin
1905
Kraepelin
1921
Blueler
Kretschmer
Jaspers
Schnider
1950
Symptoms
Thoughts
Fragile personality,
hypochondria, undue
sensitivity, suspiciousness.
Pseudo-querulous
personality, vain, selfabsorbed, obstinate.Litigious,
distrustful.
Idiosyncratic and referential
thinking.
Grandiosity.
Contradiction between
feeling shy and the attitude
of entitlement.
Overcompensation.
Feelings of persecution.
Their failure is due to
machination. Feeling of
inadequacy.
Inner humiliation, selfdeprecation.
Vulnerable.
Two types: 1) combative,
actively quarrelsome,
eccentric, 2) passive and
secretive.
Leonhard and Overvaluing their abilities.
Shepherd,
Sixties
Polatin 1975 Rigid, watchful, selfish,
emotionally
undemonstrative. Explode if
confronted with different
opinion.
Millon,
Vigilance, abrasive irritability
Eighties
and counterattack. Social
isolation, hostile distancing of
oneself from others.
DSM IV
Unforgiving of insults,
perceives attacks and reacts
angrily, suspicious.
Feeling subjected to hostility
and oppression.
Failure due to ill will of others.
Inwardly hypersensitive.
Thoughts of mistrust.
Denial of personal insecurities.
Thoughts of being deceived,
doubts about loyalty, reads
hidden thoughts of others.
Causes of Paranoia:
Causes of paranoia are classified into two main categories:
Physical / Mental causes:
Chemical changes in the brain and physical causes of paranoia are not
fully understood, but symptoms of paranoia occurs in many mental
disorders,certain physical (neurological) diseases and as a side effect of the use
of certain drugs and chemicals.
Individuals suffering fromphysical / neurological diseases such as
strokes, brain injuries, various types of dementia (including Alzheimer disease),
Huntington andParkinson’sdiseases, and multiple sclerosis, manifest paranoia
as a symptom of the mentioned diseases5. The common factor among these
diseases is the damage of some brain cells.
Some medications and drugs can also cause paranoia,depending on the
dosage and time course. The table below shows some of these drugs and their
side effects:
Drug name
Corticosteroids
H-2 blockers
Amantadine
Amphetamines
Anti-HIV medications
Cocaine and other
addictive drugs
5
Reason
Decrease central nervous system serotonin levels.6
Affect histamine and interfere with the absorption of
vitamin B-12. Both are important to the brain
function.7
Works on dopaminergic and adrenergic activities.8
Increase the hormones’ amount, which causes the
symptoms when they reach the brain.9
Create a high level of Efavirenz, which belongsto a
class of drugs known as non-nucleoside reverse
transcriptase inhibitors (NNRTIs).10
Cause high blood pressure that may lead to strokes,
seizures, brain cells and blood vessels damage.11
http://en.wikipedia.org/wiki/Paranoia
http://www.drrichardhall.com/steroid.htm
7
http://www.webmd.com/alzheimers/news/20070803/acid-blockers-linked-to-mental-decline?page=2
8
http://en.wikipedia.org/wiki/Amantadine
9
http://amphetamines.com/effects/psychological-effects-of-amphetamines/
10
http://www.aidsmap.com/HIV-treatment-side-effects-and-mental-health/page/1439569/
11
http://www.drugfreeworld.org/drugfacts/cocaine/effects-of-cocaine.html
6
The common factor among the affected hormones is their role as
neurotransmitters, which help neurons in the brain to perform the synapse. A
synapse is the transition of electric signals from one neuron to
another.Paranoia could happen due to ill synapse.
Paranoia in psychoanalytical approach:
Paranoia is related to the anal stage in the early childhood period
(Bergeret)12, and it consists of the trio of homosexuality, fixation, and
projection.
Castration complex, attachment to the mother, narcissism, and fear of
castration, are the factors of homosexuality, adding to them the premature
fixation of the libido. In early childhood, jealousy arises against rivals (older
brothers or sisters); these feelings are aggressive and may contain death
wishes. Thus, they are repressed (due to training) and transformed so that the
rivals of the earlier period become the first homosexual love objects. (Freud)13
The fusion relationship with the mother leads the child to identify
himself with her, and to search for love objects where he can rediscover
himself. Due to this attachment and fixation on the mother (his first love
object), it becomes hard to pass on to another woman.In addition to this, a
high value is set on his male organ accompanied by the fear of losing it in the
love object of the other sex. This happens when the child discovers that a
woman does not have a penis.Thus, paranoia is a defense against
homosexuality.
On the other hand, the father turns into the persecutor, due to the
primal scene; he took the mother, humiliated the child, and was unfaithful. The
father is denied as the law imposer and security provider, and this is related
first, to the fusion relationship between the child and his mother, who did not
let the child see or determine the father as another (law imposer). That
happens during the mirror stage (LACAN)14. The father, in such situations,
could be of no mentioned importance (not strong enough to impose the law).
12
http://www.ovni.ch/~farfadet/bergeret,html
Freud, Sigmund. Certain neurotic mechanism in jealousy, paranoia and homosexuality. International journal
of psychoanalysis.
14
Mills, Jon. Lacan on Paranoiac knowledge.
13
Delusional jealousy in paranoiacs, originates from the repressed
impulses towards unfaithfulness of the object(Freud), which is of the same sex
of the subject, so that it contains an acidulated homosexuality. The feelings of
unfaithfulness are projected on the love object (partner). In this case, the
reality is denied, the imaginary is delusional, and the symbolic is illogical. The
desire of not to know becomes the master of the situation. (LACAN)
Based of the early childhood experience, a paranoid individual uses
cleavage, splitting, denial of reality, projective identification and projection as
defense mechanisms. He has an unintegrated ego, a fragmented self-image, as
well as a lost identity and object. (Melanie Klein)15
Treatment:
The efficiency of paranoia treatment depends on the cause and if it is
determined accurately. As we mentioned above, paranoia can occur due to
several diseases and drugs. In these two cases, the symptoms of paranoia may
vanish or decrease when the disease is treated in the first case, and if the
medication that causes the symptoms is stopped or is taken in corrected
dosage…
Paranoia as a mental disease should be treated under the care of
psychiatric physician with typical antipsychotic medications such as
Chlorpromazine or Haloperidol, or with atypical antipsychotic medications such
as Clozapine, Olanzapine, or Risperdone.16
Some paranoid individuals can improve with the help of support groups,
especially when family members and friends of the patient attend such groups
and learn how to deal with the concerned individual. Gestalt school
recommends support groups.
In psychoanalytic approach, paranoid patients do not seek help due to
suspicious attitude, so they do not coordinate with the psychotherapist. Those
individuals do not admit their illness, and they fail to reach transference with
the therapist. (Freud)17
15
http://www.melanie-klein-trust.org.uk/paranoid-schizoid-position
http://en.wikipedia.org/wiki/Paranoia
16
17
A. Fried, Joseph Agassi, Paranoia: A study in Diagnosis.
https://books.google.com.lb/books?id=N_nOBgAAQBAJ&pg=PT138&lpg=PT138&dq=of+Sydenham%27s,+and+in+the
+following+way.+Jackson%27s+principles+claim+that+the&source=bl&ots=K4KQZxEkd8&sig=Md6Kax0hveNhdJl6CK
Contagious Paranoia:
We can apply the definition of paranoia to large groups of people, who
are characterized with fearfulness, hypersensitivity, suspiciousness, hostility
and other paranoid properties. It is contagious and untreatable. Paul Balles
gives examples of national paranoia18, the Cold War between the US and
Russia, and the security measures in the USA after 9/11…
QJkO4sHEg&hl=en&sa=X&ei=K1_zVJTFB873ao_WgLAO&ved=0CBwQ6AEwAA#v=onepage&q=of%20Sydenham's%
2C%20and%20in%20the%20following%20way.%20Jackson's%20principles%20claim%20that%20the&f=false
18
Balles, Paul. Contagious Paranoia, http://www.veteranstoday.com/2012/09/09/contagious-paranoia/