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A Case of Paranoia Running Counter to the Psycho-Analytic

A Case of Paranoia Running Counter to the Psycho-Analytic

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Published by Michel Newman

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Published by: Michel Newman on Oct 09, 2011
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 By Sigmund Freud 
Some years ago a well-known lawyer consulted me about a case which had raised some doubtsin his mind. A young woman had asked him to protect her from the molestations of a man whohad drawn her into a love-affair. She declared that this man had abused her confidence by gettingunseen witnesses to photograph them while they were making love, and that by exhibiting thesepictures it was now in his power to bring disgrace on her and force her to resign the post sheoccupied. Her legal adviser was experienced enough to recognize the pathological stamp of thisaccusation; he remarked, however, that, as what appears to be incredible often actually happens,he would appreciate the opinion of a psychiatrist in the matter. He promised to call on me again,accompanied by the plaintiff.(Before I continue the account, I must confess that I have altered the
of the case in orderto preserve the incognito of the people concerned, but that I have altered nothing else. I considerit a wrong practice, however excellent the motive may be, to alter any detail in the presentationof a case. One can never tell what aspect of a case may be picked out by a reader of independent judgement, and one runs the risk of leading him astray.)Shortly afterwards I met the patient in person She was thirty years old, a most attractive andhandsome girl, who looked much younger than her age and was of a distinctly feminine type.She obviously resented the interference of a doctor and took no trouble to hide her distrust. Itwas clear that only the influence of her legal adviser, who was present, induced her to tell me thestory which follows and which set me a problem that will be mentioned later. Neither in hermanner nor by any kind of expression of emotion did she betray the slightest shame or shyness,such as one would have expected her to feel in the presence of a stranger. She was completelyunder the spell of the apprehension brought on by her experience.For many years she had been on the staff of a big business concern, in which she held aresponsible post. Her work had given her satisfaction and had been appreciated by her superiors.She had never sought any love-affairs with men, but had lived quietly with her old mother, of whom she was the sole support. She had no brothers or sisters; her father had died many yearsbefore. Recently an employee in her office, a highly cultivated and attractive man, had paid herattentions and she in turn had been drawn towards him. For external reasons, marriage was out of the question, but the man would not hear of giving up their relationship on that account. He hadpleaded that it was senseless to sacrifice to social convention all that they both longed for andhad an indisputable right to enjoy, something that could enrich their life as nothing else could. Ashe had promised not to expose her to any risk, she had at last consented to visit him in hisbachelor rooms in the daytime. There they kissed and embraced as they lay side by side, and hebegan to admire the charms which were now partly revealed. In the midst of this idyllic sceneshe was suddenly frightened by a noise, a kind of knock or click. It came from the direction of the writing-desk, which was standing across the window; the space between desk and windowwas partly taken up by a heavy curtain. She had at once asked her friend what this noise meant,
and was told, so she said, that it probably came from the small clock on the writing-desk. I shallventure, however, to make a comment presently on this part of her narrative.As she was leaving the house she had met two men on the staircase, who whispered something toeach other when they saw her. One of the strangers was carrying something which was wrappedup and looked like a small box. She was much exercised over this meeting, and on her way homeshe had already put together the following notions: the box might easily have been a camera, andthe man a photographer who had been hidden behind the curtain while she was in the room; theclick had been the noise of the shutter; the photograph had been taken as soon as he saw her in aparticularly compromising position which he wished to record. From that moment nothing couldabate her suspicion of her lover. She pursued him with reproaches and pestered him forexplanations and reassurances, not only when they met but also by letter. But it was in vain thathe tried to convince her that his feelings were sincere and that her suspicions were entirelywithout foundation. At last she called on the lawyer, told him of her experience and handed overthe letters which the suspect had written to her about the incident. Later I had an opportunity of seeing some of these letters. They made a very favourable impression on me, and consistedmainly in expressions of regret that such a beautiful and tender relationship should have been
destroyed by this ‘unfortunate morbid idea’.
 I need hardly justify my agreement with this judgement. But the case had a special interest forme other than a merely diagnostic one. The view had already been put forward in psycho-analytic literature that patients suffering from paranoia are struggling against an intensification of their homosexual trends - a fact pointing back to a narcissistic object-choice. And a furtherinterpretation had been made: that the persecutor is at bottom someone whom the patient loves orhas loved in the past. A synthesis of the two propositions would lead us to the necessaryconclusion that the persecutor must be of the same sex as the person persecuted. We did notmaintain, it is true, as universally and without exception valid the thesis that paranoia isdetermined by homosexuality; but this was only because our observations were not sufficientlynumerous; the thesis was one of those which in view of certain considerations become importantonly when universal application can be claimed for them. In psychiatric literature there iscertainly no lack of cases in which the patient imagines himself persecuted by a person of theopposite sex. It is one thing, however, to read of such cases, and quite a different thing to comeinto personal contact with one of them. My own observations and analyses and those of myfriends had so far confirmed the relation between paranoia and homosexuality without anydifficulty. But the present case emphatically contradicted it. The girl seemed to be defendingherself against love for a man by directly transforming the lover into a persecutor: there was nosign of the influence of a woman, no trace of a struggle against a homosexual attachment.In these circumstances the simplest thing would have been to abandon the theory that thedelusion of persecution invariably depends on homosexuality, and at the same time to abandoneverything that followed from that theory. Either the theory must be given up or else, in view of this departure from our expectations, we must side with the lawyer and assume that this was noparanoic combination but an actual experience which had been correctly interpreted. But I sawanother way out, by which a final verdict could for the moment be postponed. I recollected howoften wrong views have been taken about people who are ill psychically, simply because thephysician has not studied them thoroughly enough and has thus not learnt enough about them. Itherefore said that I could not form an immediate opinion, and asked the patient to call on me asecond time, when she could relate her story again at greater length and add any subsidiary
details that might have been omitted. Thanks to the lawyer’s influence I secured this promise
from the reluctant patient; and he helped me in another way by saying that at our second meetinghis presence would be unnecessary.The story told me by the patient on this second occasion did not conflict with the previous one,but the additional details she supplied resolved all doubts and difficulties. To begin with, she hadvisited the young man in his rooms not once but twice. It was on the second occasion that the hadbeen disturbed by the suspicious noise: in her original story she had suppressed, or omitted tomention, the first visit because it had no longer seemed of importance to her. Nothingnoteworthy had happened during this first visit, but something did happen on the day after it. Herdepartment in the business was under the direction of an elderly lady whom she described as
follows: ‘She has white hair like my mother.’ This elderly superior had a great liki
ng for her andtreated her with affection, though some times she teased her; the girl regarded herself as her
 particular favourite. On the day after her first visit to the young man’s rooms he appeared in the
office to discuss some business matter with this elderly lady. While they were talking in lowvoices the patient suddenly felt convinced that he was telling her about their adventure of theprevious day - indeed, that the two of them had for some time been having a love-affair, whichshe had hitherto overlooked. The white-haired motherly old lady now knew everything, and her
speech and conduct in the course of the day confirmed the patient’s suspicion. At the first
opportunity she took her lover to task about his betrayal. He naturally protested vigorouslyagainst what he called a senseless accusation. For the time being, in fact, he succeeded in freeingher from her delusion, and she regained enough confidence to repeat her visit to his rooms ashort time - I believe it was a few weeks - afterwards. The rest we know already from her firstnarrative.In the first place, this new information removes any doubts as to the pathological nature of hersuspicion. It is easy to see that the white-haired elderly superior was a substitute for her mother,that in spite of his youth her lover had been put in the place of her father, and that it was thestrength of her mother-complex which had driven the patient to suspect a love-relationshipbetween these ill-matched partners, however unlikely such a relation might be. Moreover, thisdisposes of the apparent contradiction to the expectation, based on psycho-analytic theory, thatthe development of a delusion of persecution will turn out to be determined by an over-powerfulhomosexual attachment. The
persecutor - the agency whose influence the patient wishesto escape -
is here again not a man but a woman. The superior knew about the girl’s love affairs,disapproved of them, and showed her disapproval by mysterious hints. The patient’s attachment
to her own sex opposed her attempts to adopt a person of the other sex as a love-object. Her lovefor her mother had become the spokesman of all those tendencies which, playing the part of a
‘conscience’, seek to arrest a girl’s first step along the new road to normal se
xual satisfaction - inmany respects a dangerous one; and indeed it succeeded in disturbing her relation with men.
When a mother hinders or arrests a daughter’s sexual activity, she is fulfilling a normal function
whose lines are laid down by events in childhood, which has powerful, unconscious motives, and
has received the sanction of society. It is the daughter’s business to emancipate herself from this
influence and to decide for herself on broad and rational grounds what her share of enjoyment ordenial of sexual pleasure shall be. If in the attempt to emancipate herself she falls a victim to aneurosis it implies the presence of a mother-complex which is as a rule over-powerful, and iscertainly unmastered. The conflict between this complex and the new direction taken by the
libido is dealt with in the form of one neurosis or another, according to the subject’s disposition.

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