What is paranoia and why does it harm us?

Paranoia is a complex mental and emotional state, which has been talked about since the time of Hippocrates. Psychiatry turned this concept into a complement to other disorders, while psychoanalysis approaches it as an independent entity.

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

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

In psychoanalysis something very different happened. Initially, 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, for his part, wrote his doctoral thesis based on the Aimée case: a cured paranoia.

… “that which is abolished within returns from the outside”.

-Sigmund Freud-

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 by its etymology, paranoia is something like “having a thought parallel”. The first to talk about it was Hippocrates.

For a long time the word paranoia was used as a synonym for madness.. 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 defined it as a “mental alienation that concerns primarily judgment and reasoning”.

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There were other attempts to describe this problem, but finally Kraepelin’s concept prevailed in 1889.. From that moment on, it took on the meaning of a type of disorder in which there are delusional ideas, 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 about paranoia, without fully conceptualizing it, in his work Defense neuropsychoses (1894). Freudian psychoanalysis dealt mainly with neuroses. Freud associated paranoia with the projection mechanism initially; then she didn’t move forward conclusively on it.

Neisser defined a fundamental aspect of the way in which psychoanalysis approaches 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, delved 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 enjoyment in the place of the other”.

Lacan is cryptic and is not easily understood. Let us simply say that his statement is equivalent to the slogan of paranoia: “The Other enjoys me”. Jacques Lacan says it literally this way: “The same It is offered as support so that God or the Other can enjoy their passivized being.”.

Elucidating the concept of paranoia

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

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The paranoid interprets the world from those 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 turn the person into a victim. “Perverse spirits take over my mind,” for example. Either the Martians or the devil.

In that state, a person interprets the facts from the story to which his mind has given 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 “passivized.” He attributes what happens in his life to him: “It wasn’t me, it was the Other”. This belief and delusion range from relatively simple situations, such as jealousy, to states that lead to more serious consequences, as in the Aimée case.