00100	.SEC THE PARANOID MODE
00200	.SS The Concept of Paranoia
00300		Like  ourselves,  the  ancient  Greeks  called  one   another
00400	paranoid.  The  term `paranoia' (Gr.: para=beside; nous = mind) was a
00500	lay rather than a medical term which referred to states of  craziness
00600	and  mental  deterioration.  For  two thousand years the term did not
00700	appear in the classifications of mental disorders.  Historians do not
00800	seem  curious  about  what  persons  with  persecutory delusions were
00900	called all that time. (It is doubtful that there weren't any.) In the
01000	18th century the term reappears in German classifications to refer to
01100	delusional states categorized as disorders of intellect  rather  than
01200	emotion. (Lewis, 1970 ).
01300		Little agreement about the term's usuage  was  reached  until
01400	this  half of the present century when it achieved adjectival status,
01500	as in "paranoid personality" and "paranoid  state".  At  present  the
01600	term  is  generally  used  to  refer  to  the presence of persecutory
01700	delusions. Somatic erotic, grandeur and jealousy delusions are simply
01800	identified as such without characterizing them as paranoid.
01900		To introduce the paranoid mode, I shall contrast two modes of
02000	human activity, one termed "ordinary" and one termed "paranoid".
02100		In the ordinary mode a person  goes  about  his  business  of
02200	everyday  living  in  a  matter-of-fact  way.  He  deals with routine
02300	situations in his environment as  they  arise,  in  the  main  taking
02400	things  at  their  face value.  Events proceed in accordance with his
02500	beliefs and expectations and thus can be managed  routinely.  Only  a
02600	small   amount  of  attention  need  be  devoted  to  monitoring  the
02700	environment , simply checking that everthing is as expected.     This
02800	placid  ongoing  sequence  can be interrupted by the the detection of
02900	signs of alarm  or  opportunity  at  any  time  but  the  predominant
03000	condition  is one of a steady progression of events so ordinary as to
03100	be uneventful.
03200		In  contrast to this routine ordinariness is an arousal state
03300	of emergency  .     The  particular  aroused  emergency  I  shall  be
03400	considering  is  the  paranoid mode characterized by a continous wary
03500	suspiciousness. To get  some  feeling  for  this  mode,  imagine  the
03600	situation  of a spy in a hostile country.   To him, everyone he meets
03700	is a potential enemy, a threat to his existence who must be evaluated
03800	for  malevolence.   A  secret  agent  must be hypervigilant and fully
03900	mobilized  to  attack,  to  flee,  to  stalk.   In   this   situation
04000	appearances  are  not to be taken at face value as ordinary events or
04100	routine background but each is attended to and interpreted to  detect
04200	malevolence.  Events  in  the environment, which in the ordinary mode
04300	would not be connected to the self, become referred to  the  self  as
04400	potentially  menacing.   The  unintended  may  be  misinterpreted  as
04500	intended and  the  undesigned  tends  to  become  confused  with  the
04600	designed.   Nothing is unattendible. The predominant intention of the
04700	agent is to detect malevolence from others.  In paranoid patients the
04800	over-riding belief in, and expectation of, malevolence on the part of
04900	others keeps them in an aroused alarm state , a  state  which  occurs
05000	only  occasionally  in  the  ordinary  mode.   (MORE  HERE ON EVERDAY
05100	PARANOIA ?? (ACCOUNTS OF  PARANOID  MODE  IN  LITERARY  STYLE--CORVO,
05200	HEMINGWAY,HOFSTADER,FOWLES, JOE LOUIS STORY??)
05300	
05400	.SS Characteristics of Clinical Paranoias
05500		When dividing the world of experience into conceptual classes
05600	, we as well sort and group together, objects and events according to
05700	properties they have in common. The members of a class  resemble  one
05800	another  in  sharing  certain  properties.    The resemblance between
05900	members of a class is not exact or total.  Members  of  a  conceptual
06000	class  are  considered  more or less alike and there exist degrees of
06100	resemblance.  Humans are neither subjective nor objective;  they  are
06200	projective.   In  forming  classifications, we project our intentions
06300	onto the world. Thus the world of experience consists of  interactive
06400	relations, not simply of objects isolated from human interests.
06500		Observations and classifications made by clinicians regarding
06600	paranoias   have   been   thoroughly  described  in  the  psychiatric
06700	literature.  Extensive accounts can be found in Swanson, Bohnert  and
06800	Smith  (1970)  and  in  Cameron  (1967).    I shall attempt to give a
06900	condensed description of paranoid phenomena as they appear in, or are
07000	described  by,  patients  in  a  psychiatric interview. It is many of
07100	these phenomena the model to be proposed attempts to explain.
07200	
07300		These  phenomena  can  be  summarized   under   concepts   of
07400	suspiciousness,   self-reference,   hypersensitivity,  fearfulness  ,
07500	hostility and rigidity. In turn, these class-concepts  are  taken  to
07600	represent the empirical indicators of the paranoid mode.
07700	
07800	.F Suspiciousness
07900		The main characteristic of clinical paranoid  modes  consists
08000	of  suspiciousness,  a  mistrust  of  others  based  on the patient's
08100	malevolence beliefs.      The  patient  believes  others,  known  and
08200	unknown,  have  evil intentions towards him. He is continously on the
08300	look-out for signs of malevolence  which  he  often  reads  from  the
08400	results  of  his  own  probings.  He is hypervigilant; people must be
08500	watched, their schemes unmasked and foiled.  He is  convinced  others
08600	try to bring about undesirable states in himself such as humiliation,
08700	harassment, mental subjugation, physical injury and even  death.   In
08800	an interview he may report such beliefs directly or ,if he is guarded
08900	, they  will  only  be  hinted  at.   He  does  not  confide  easily.
09000	Disclosure  may  depend  upon  how  the  interviewer  responds in the
09100	dialogue  to  reports  of  fluctuating  suspicions  or  of   absolute
09200	convictions of malevolence.
09300		He is greatly concerned with "evidence". No room  is  allowed
09400	for  mistakes,  ambiguities  or chance happenings.  "Paranoids have a
09500	greater passion for the truth than other madmen "  -(Saul  Bellow  in
09600	Sammler's  Planet).   Using trivial evidential details, he leaps from
09700	the undeniable to the unbelievable.
09800		The  patient  may vary in his own estimate of the strength of
09900	his malevolence beliefs. If they consist of  weakly-held  suspicions,
10000	he  may  have  moments of reasoning with himself in which he tries to
10100	reject them as ill-founded.  But when the beliefs represent  absolute
10200	convictions,  he  does  not  struggle  to dismiss them.   They become
10300	pre-conditions for countering actions against tormentors who wish and
10400	try  to do him evil.  He seeks affirmation of his beliefs, sympathy ,
10500	and allies in positions of power such as clinicians  or  lawyers  who
10600	can help him take action. "It is certain that my conviction increases
10700	the moment another soul will believe in it." -(Joseph Conrad in  Lord
10800	Jim).
10900		The malevolence beliefs may involve a specific  other  person
11000	or  a  conspiracy  of  others such as the Mafia, the FBI, Communists,
11100	Hell's Angels.  The patient sees himself as a victim ,one who suffers
11200	at  the  hands  of  others  rather  than  as  an agent who brings the
11300	suffering on himself.  Other agents subject him to, and make him  the
11400	object  of,  their evil intentions. He dwells on and rehearses in his
11500	mind these outrages. He schemes to defeat or escape his  adversaries.
11600	The  misdeeds  of  others  are  denounced,  desparaged, condemned and
11700	belittled. He feels interfered with and discriminated  against.   The
11800	specific content of the beliefs may not directly expressed in a first
11900	interview.     The  patient  may  be  so  mistrustful  of  how  their
12000	disclosure might be used against him that he cautiously feels his way
12100	through an  interview  offering  only  hints  which  the  experienced
12200	clinician then uses to infer the presence of persecutory delusions.
12300	
12400		Using his own judgements, a clinician attempts  to  determine
12500	whether  the  malevolence  beliefs  expressed are true or false. This
12600	determination  is  usually  not  difficult  in   clinical   settings.
12700	Occasionally  malevolence beliefs turn out to be true.  Others can be
12800	judged as correct estimations on the part of the patient who does not
12900	see  that  historically  they  are the consequence of his tendency to
13000	accuse and provoke others to the point where  they  in  fact  display
13100	malevolence towards him.
13200	
13300	
13400	.F Self-Reference and Hypersensitivity
13500	
13600	
13700		The patient believes many events  in  the  world  pertain  to
13800	himself  in some negative way. Other observers find his position hard
13900	to accept. For example, he is convinced that newspaper headlines  are
14000	directed personally at him or that the statements of radio announcers
14100	contain special messages for him. Hypervigilant, he  hypersensitively
14200	reads  himself  into  situations  which  are not actually intended to
14300	pertain to him and his particular concerns.These  references  to  the
14400	self are interpreted as malevolent.
14500	
14600		References to the self are misconstrued as slurs, slights  or
14700	unfair judgements.  He may feel he is being watched and stared at. He
14800	is excessively  concerned  about  eyes  (which  can  both  watch  and
14900	punish), cameras, telescopes ,etc.  which may be directed his way. He
15000	may feel mysteriously influenced through electricity, radio waves, or
15100	(more   contempoaneously)   by   emanations  from  computers.  He  is
15200	hypersensitive  to  criticism.    In  crowds  he   believes   he   is
15300	intentionally  bumped  and driving on the highway he feels repeatedly
15400	tail-gaited. Badgered and bombarded without relief by this stream  of
15500	wrongs , he becomes hyperirritable, querulous and guarrelsome.
15600		He is touchy about certain topics, flaring up when references
15700	to  particular conceptual domains appear in the conversation.     For
15800	example, any remarks about his age, religion, or family,  or  sexlife
15900	may  set  him off.   Even when these domains are touched upon without
16000	reference to him, e.g. religion in general, he takes  it  personally.
16100	When  a  delusional  complex is present, linguistic terms far removed
16200	from, but still conceptually connectable to, the  complex,  stir  him
16300	up. Thus, to a man holding beliefs that the Mafia intend to harm him,
16400	any remark about Italy might lead him to react  in  a  suspicious  or
16500	fearful manner.
16600	
16700	.F Affect-States   
16800	
16900		The major affects expressed, both verbally  and  nonverbally,
17000	are those of fear, anger and mistrust.  The patient may be fearful of
17100	physical attack and injury even to the point of death.  He fears that
17200	others  wish  to subjugate and control him.  His fear is justified in
17300	his mind by the many threats he detects  in  the  conduct  of  others
17400	towards  him.   He is hostile to what are interpreted as insinuations
17500	or demeaning allusions. His chronic irritability  becomes  punctuated
17600	with  outbursts of raging tirades and diatribes.  When he feels he is
17700	being overwhelmed he may erupt and in desperation  physically  attack
17800	others.
17900		The experienced affects of fear,  anger  and  mistrust  blend
18000	with  one  another  in  varying  proportions  to  yield an unpleasant
18100	negative affect state made continuous  by  fantasied  rehearsals  and
18200	retellings  of  past  wrongs.     Depending  on his interpretation of
18300	malevolent input, the patient may move  away  from  others  in  being
18400	guarded,  secretive  and evasive. He then may suddenly jump at others
18500	with sarcastic accusations  and  arguments.        His  affect-states
18600	become locked into loops with other people in his life space who take
18700	censoring action towards him because of  his  uncommunicativeness  or
18800	outbursts.
18900	
19000	
19100	.F Rigidity
19200	
19300		Another empirical indicator of the paranoid mode is excessive
19400	rigidity.  The patient's beliefs in his sensitive areas remain fixed,
19500	difficult to influence  by  evidence  or  persuasion.    The  patient
19600	himself  makes  few  verification  attempts  which  might falsify his
19700	convictions.    To change a belief is  to  admit  being  wrong.    To
19800	forgive others also opens a crack in the wall of righteousness.    He
19900	does not apologize nor accept apology.  He stubbornly  follows  rules
20000	to  the  letter  and  his  literal interpretations of regulations can
20100	drive others wild.   It is this insistent  posture  of  rigidity  and
20200	inflexibility  which  makes  the  treatment  of paranoid processes by
20300	symbolic-semantic methods so difficult.
20400	
20500	.SS Theories of Paranoia
20600	
20700		While  paranoid  processes  represent  a  disorder  from  one
20800	standpoint, the observable regularities  of  the  disorder  imply  an
20900	underlying   nonrandom   "pathological"   order   at  another  level.
21000	Attempts to explain, to  make  intelligible,  the  order  behind  the
21100	disorder,   have  been  offered  since  antiquity.    None  of  these
21200	verbally-stated formulations have won the consensus characteristic of
21300	scientific  theories since they were neither systematic nor testable.
21400		Science   represents  a  search  for  consensible  knowledge,
21500	judgements about which agreement can  be  obtained  under  particular
21600	requirements.(Ziman,  1968).   The major requirements for a theory to
21700	reach consensus involve systemicity and testability.
21800		For a theory to be systematic, its  hypotheses  must  cohere,
21900	not  be  isolated,  connect  with  one  another  and collaborate in a
22000	consistent way. Each hypothesis stands as an initial assumption or as
22100	a  consequence  of  one or more initial assumptions.  The consequence
22200	relation can be one  of  logical  or  empirical  entailment  but  the
22300	system, to be consistent, should not contain contradictions.
22400		For  a  theory  to  be  testable,  it  must  be  sensitive to
22500	empirical data which can strenghten or weaken its acceptability. Each
22600	hypothesis  in  the  theory  need  not  be  directly or independently
22700	testable.   But the theory as a conjunction  of  hypotheses  must  be
22800	brought  into contact with data of observation, if not directly, then
22900	indirectly, through a translation process in which a  consequence  of
23000	the theory can be compared with observational evidence.
23100		Previous theories of  paranoia  can  be  criticized  for  not
23200	satisfying  these  requirements  of systemicity and testability.  The
23300	model to be presented fulfills these requirements. When theories  are
23400	presented  in  literary  form  it  is  difficult  to  know  what such
23500	formulations imply or whether the implications are consistent. If  we
23600	seek  validation,  they  do not tell us what we are supposed to do in
23700	order  to  replicate  the  experience  of  their  authors.     If   a
23800	formulation  is  untestable,  the  issues  it raises are undecidable,
23900	unsettleable and consensus cannot be reached.
24000	
24100		Theories stem from two sources, (1) from hypotheses suggested
24200	by new descriptions (revisualizations) of  the  phenomena  themselves
24300	and  (2)  from modifications of a legacy of previous theories serving
24400	as the bequeathed myths of the field.  Each  generation  attempts  to
24500	formulate new explanatory theories by discovering new phenomena or by
24600	modifying predecessor theories.  The old theories are  unsatisfactory
24700	or  only  partially  satisfactory  because  they are found to contain
24800	anomalies or contradictions which must be removed. Sometimes previous
24900	theories   are  viewed  as  lacking  evidential  support  by  current
25000	standards. Theories are  mainly  superseded  rather  than  disproved.
25100	The  new  versions  try  to  remove  the  contradictions and increase
25200	comprehensiveness by explaining more phenomena.
25300		Theories  have  many  functions.   They  can be summarized as
25400	follows ( Bunge, 1967) .V
25500		(1)To systematize knowledge.
25600		(2)To explain facts by showing how they are the entailed
25700			consequences of the systematizing hypotheses.
25800		(3)To increase knowledge by deriving new facts.
25900		(4)To enhance the testability of hypotheses by connecting
26000			them to observations.
26100		(5)To guide research by:
26200			(a) posing fruitful problems
26300			(b) suggesting new data to gather
26400			(c) opening new lines of investigation
26500		(6)To map a portion of reality. .END
26600		It is excessive to demand that a single theory to fulfill all
26700	these functions.  In undeveloped fields in  pre-consensus  states  we
26800	should  be happy in achieving even one of them.    Models, as well as
26900	theories, can be assigned these functions when they  are  theoretical
27000	in  type.  Our model was constructed primarily to serve functions (2)
27100	and (4), testable explanation.
27200		I   have   stressed   that  theories  offered  as  scientific
27300	explanations should be (a) systematic	(i.e.       coherent      and
27400	consistent)   and   (b)  empirically  testable.  Prior  psychological
27500	formulations about the paranoid mode do not meet these  criteria  and
27600	thus  deserve  to  be  bygone  notions.   For example, to account for
27700	paranoid processes by hypothesizing imbalance of intellect and affect
27800	is  so  global  and  untestable  a formulation as not to merit theory
27900	status. To gain consensus, we need an explanation of the right  type,
28000	a  postulated structure of symbol-manipulating processes, strategies,
28100	functions or procedures which is capable of producing the  observable
28200	regularities of the paranoid mode.
28300		In psychiatry it is still useful to view  some  things  which
28400	happen  to  a man in causal mechanical terms. But a man is not only a
28500	passive recipient, subject to Newtons's laws, he is  also  an  active
28600	agent,  a  language  user  who  thereby  can monitor himself, control
28700	himself, direct himself, while commenting on  and  criticizing  these
28800	performances.    Modern  psychiatric  theory  should try to take into
28900	account that man is an agent as well as recipient and come  to  grips
29000	with  those  enigmatic  cases in which what causally happens to a man
29100	can be a consequence of his unrecognized reasons.
29200		Let us  consider  some  psychological  explanations  for  the
29300	paranoid  mode  beginning  in the late 19th century.  (Historians can
29400	certainly find concepts of intentions, affects  and  beliefs  as  far
29500	back  as  Aristotle,  who  seldom quoted his sources.   "Its all been
29600	said  before  but  you  have  to  say   it   again   because   nobody
29700	listens"(Gide)).  In  1896  Freud (Freud,1896) proposed a formulation
29800	which  postulated  a  defensive  strategy  or  procedure  to  explain
29900	persecutory  paranoia  .   He assumed the believed persecution of the
30000	self by others to represent projected self-reproaches  for  childhood
30100	masturbation.       Today   hardly   anyone  finds  this  explanation
30200	plausible.  While it has withered, however, the concepts  of  defense
30300	and projection have weathered.
30400		Sometime  during  their  relationship   (1897-1902),   Fliess
30500	asserted  to  Freud  that  paranoia  unconscious  homosexual conflict
30600	(Jones,1955).  For years Freud said nothingdea about this formulation
30700	until  1911  when  he  developed it in terms of transformations being
30800	applied to the basic proposition `I (a man) love him.' He  postulated
30900	this  proposition  to  be  so  intolerable  as  not to be admitted to
31000	consciousness and therefore subjected to unconscious transformations,
31100	first  into  `I  do  not  love  him,  I  hate  him' which in turn was
31200	transformed  into  the  conscious  belief  `He  hates  me'  with  the
31300	accompanying   conclusion   `Therefore   I  am  justified  in  hating
31400	him'.(Freud,1911).  Great difficulty has been encountered in  testing
31500	the  theory  since  there  is  no  agreed-on method for detecting the
31600	presence of unconscious homosexual  conflict.    The  explanation  is
31700	also  inconsistent  with  another  psychoanalytic tenet that everyone
31800	harbors unconscious homosexual conflicts. But  not  everyone  becomes
31900	paranoid.  To reconcile the inconsistency one would have to postulate
32000	some  additional,  possibly  quantitative  factors,  to  explain  the
32100	intensity  and  extent  of  the  paranoid  mode  in certain people. A
32200	further difficulty with  the  formulation  has  been  the  fact  that
32300	overtly  homosexual people can be paranoid, requiring in such cases a
32400	postulate of some other type of underlying conflict.
32500		Because  of  inconsistencies  and  difficulty in testing, the
32600	homosexual-conflict explanation has not achieved consensus.   But  as
32700	will  be discussed, it may represent a special case in a more general
32800	theory which assumes humiliation to play a role in the paranoid mode.
32900	Freud's  later attempts at the explanation of paranoia assumed simply
33000	that love was transformed into hate. (Freud,1923). This notion is too
33100	vague and incomplete an articulation to qualify as a	scientific
33200	explanation. Contemporary requirements  demand  a  more  complex  and
33300	precisely  defined  organization  of  functions to account for such a
33400	transformation.
33500		Likewise Cameron's explanation (1967) of "projected hostilty"
33600	represents  a single, isolated hypothesis which lacks systemicity and
33700	is  insufficiently  complex  to  match  the  complexity  of  paranoid
33800	phenomena.
33900		Tomkins     (Tomkins,1963)     offered      an      arresting
34000	information-processing  theory of the paranoid posture articulated in
34100	terms    of    defensive     strategies,     transformations     ,and
34200	maximizing-minimizing principles. He viewed the paranoid `posture' or
34300	mode as an attempt to cope  with  humiliation.  He  proposed  that  a
34400	person  whose  information  processing is monopolized by the paranoid
34500	mode is in a permanent state of vigilance, in order to  maximize  the
34600	detection of insult and to minimize humiliation.
34700		Regarding the paranoid, Tomkins stated:
34800	.V
34900		"The major source of distortion in his interpretation is
35000		 in his insistence on processing all information as though 
35100		 it were relevant only to the possibility of humiliation."
35200	.END
35300		Swanson, Bohnert and Smith (1970), in  a  book  on  paranoia,
35400	portrayed  how  a  `homeostatic'  individual  attempts  to  deal with
35500	`bewildering perceptions'.      They  postulated  that  a  person  in
35600	homeostatic  equilibrium perceives a pronounced inner or outer change
35700	which is inexplicable or unacceptable.   The resultant disequilibrium
35800	is  so  bewildering  that in order to restore equilibrium, the person
35900	constructs a paranoid explanation which attributes the cause  of  the
36000	change,  not  to the self, but to an external source.  With the cause
36100	of the change identified , bewilderment is abolished and  uncertainty
36200	reduced.
36300		Elements  of  this  formulation  represent  symbol-processing
36400	strategies  particularly in cases of paranoid thinkng associated with
36500	the experienced changes resulting from of  organic  brain  damage  or
36600	amphetamine psychosis. These are conditions which mechanically happen
36700	to a man.  In paranoid states, reactions or  personalities  where  no
36800	pronounced  physical  change  can  be  identified ,the formulation is
36900	insufficient and must be filled out with more  complex  and  specific
37000	processes.
37100		In sum, the rival theories of paranoia here reviewed have not
37200	gained  widespread  acceptance  because  of  various  weaknesses  and
37300	limitations. We have no reigning  theory  of  paranoia.   In  such  a
37400	pre-consensus  state,  the  field  is  open  for contending theories.
37500	Previous  theories  have  contributed  useful  hypotheses.   I   have
37600	incorporated   some  of  them  (e.g.  Tomkin's  hypothesis  regarding
37700	humiliation) in  an  attempt  to  explain  paranoid  phenomena  in  a
37800	different  way,  using  an  interactive  simulation  model.   I shall
37900	attempt  to  to  explain  sequences  of  paranoid  symbolic  behavior
38000	(conversational   interactions)   by  describing  in  some  detail  a
38100	simulation of  paranoid  interview  behavior  ,  having  in  mind  an
38200	audience  of  mental health professionals and colleagues in fields of
38300	psychiatry, psychology, artificial intelligence, and philosophy.  The
38400	simulation  model  proposed  (Colby, Weber and Hilf,1971) stands as a
38500	putative explanation  having  the  merits  of  being  more  explicit,
38600	systematic,  consistent  and  testable  than  the  theories described
38700	above.      The model combines hypotheses  of  previous  formulations
38800	with  additional  hypotheses and assumptions of my own, in an attempt
38900	to present a coherent, unified explanation.  Let  us  first  consider
39000	some aspects of the nature of explanation.