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