What’s Paranoia and Why Is it Harmful?

July 12, 2019
Paranoia is a complex mental and emotional. The field of psychiatry considers it a smaller part of larger disorders, whereas psychoanalysis considers it a condition in and of itself.

What’s paranoia exactly? Before we answer that, it’s worth mentioning that psychoanalysts and psychiatrists have slightly different responses. The concept first started in psychiatry and people first believed it was just a form of insanity.

As time went on, the field of psychiatry tossed it out as a different diagnosis. This was partly because experts started to see it as just a part of other mental illnesses such as schizophrenia. Thus, it was no longer its own condition and became more of a symptom of others. According to the DSM, the condition most similar to it is delusional disorder.

It’s a whole different story with psychoanalysis. Sigmund Freud considered it a form of neurosis that came from obsession. Later on, especially thanks to the Schreber case, he started to consider it as a form of psychosis. Then there was Lacan, who actually wrote his doctoral thesis based on the Aimée case: cured paranoia.

The paranoid is never entirely mistaken.”

-Sigmund Freud-

A Bit of History about Paranoia

A woman experiencing hallucinations where she feels like she's becoming detached from herself.

For a long time, people used the word paranoia as a synonym for madness. The German Kahlbaum was the first person to refer to it as its own issue in 1863. Kraft-Ebing took that concept a bit further in 1879. He defined it as “mental alienation which affects primarily judgment and reasoning“.

Although there were other attempts to describe this mental issue, Kraepelin’s theory from 1889 stood out. From that moment on, people understood paranoia as a kind of disorder where you have delirious ideas, without any other meaningful symptoms.

It was in the DSM until 1987, when it was replaced by syndromes such as “delusional disorder” and “paranoid personality disorder”.

Paranoia in Psychoanalysis

Sigmund Freud started talking about paranoia, without fully conceptualizing it, in his book The Neuro-Psychoses of Defence (1894). Freudian psychoanalysis focused mainly on neurosis. At first, Freud associated paranoia with projection, but he ended up making no further conclusions about it. 

Neisser came to shape the fundamental way that psychoanalysis looks at paranoia as a mental condition. He said that it was essentially “a unique way of interpreting”. A paranoid person feels like everything they see and hear is about them in some way or another.

Jacques Lacan took this concept much farther. In a text from 1958, where he talks about Freud’s Schreber case, he defines paranoia as “the identification of enjoyment in another person’s place“.

Lacan was a cryptic writer and isn’t easy to understand. In simpler terms, his statement is like the motto for paranoia: “the Other is enjoying me“.

A woman sitting in a dark room with her hands on her head.

Clarifying the Concept of Paranoia

In psychoanalysis, a paranoiac isn’t just a mistrustful person, as we tend to think. Someone with this condition works off of two assumptions. The first is that some kind of “evil” or “bad” thing has been let loose and that they’ll be its victim. The second is that what’s going on in the world is related to them.

The paranoid person interprets the world through those two lenses, based on their delusion. A delusion is basically a nonsensical story. When it comes to paranoia, that story is about some form of evil that’s preying on the person. “Evil spirits are taking over my mind,” for example.

In this state, they interpret all the things they see through the lens of the story their mind has brought to life. Thus, something as simple as losing a possession could be proof that those spirits, aliens, demons, or whatever else, are playing with and tormenting them. 

It’s the motto that Lacan pointed out: “the Other is enjoying me.” Faced with that, they feel “passivized”. They shift everything that happens to them onto that Other: “It wasn’t me, it was them“. That belief and that delusion can lead to simple things, such as jealousy, or to more serious issues, such as the Aimée case.

  • Freud, S. (1911). Puntualizaciones psicoanalíticas sobre un caso de paranoia (Dementia paranoides) descrito autobiográficamente. Obras completas, 12, 1-73.