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00100 THE PARANOID MODE
00200 The Concept of Paranoia
00300 Like ourselves, the ancient Greeks called one another
00400 paranoid. The term `paranoia' (Gr.: para=beside; nous = mind)
00500 referred to states of craziness and mental deterioration. For roughly
00600 the next two thousand years the term disappeared from classifications
00700 of mental disorders. Historians have not seemed curious about what
00800 persons with persecutory delusions were called all that time. (It is
00900 doubtful that there weren't any.) In the 18th century the term
01000 reappears in German classifications to refer to delusional states
01100 categorized as disorders of intellect rather than emotion. (Lewis,
01200 1970 ).
01300 Little agreement about the term's usuage was reached until
01400 this half of the present century when it achieved a solid adjectival
01500 status, as in "paranoid personality" and "paranoid state". At
01600 present the category `paranoid' has high reliability (85-95%
01700 interjudge agreement). The term is generally used to refer to the
01800 presence of persecutory delusions. Somatic, erotic, grandeur and
01900 jealousy delusions are simply identified as such without
02000 characterizing them as paranoid.
02100 To introduce what being paranoid is like, let us first
02200 consider two sorts of human activity, one termed "ordinary" and the
02300 other termed "paranoid".
02400 In the ordinary mode of human action a person goes about his
02500 business of everyday living in a matter-of-fact way. He deals with
02600 recurrent and routine situations in his environment as they arise,
02700 taking things at their face value. Events proceed in accordance with
02800 his beliefs and expectations and thus can be managed routinely. Only
02900 a small amount of attention need be devoted to monitoring the
03000 environment , simply checking that everthing is as expected. This
03100 placid ongoing flow of events can be interrupted by the the detection
03200 of signs of alarm or opportunity at any time. But the predominant
03300 condition is one of a steady progression of events so ordinary as to
03400 be uneventful.
03500 In contrast to this routine ordinariness are arousal states
03600 of emergency . The particular aroused emergency to be considered
03700 herein considering is termed the "paranoid mode" characterized by a
03800 continous wary suspiciousness. To appreciate the nature and problems
03900 of this state, imagine the situation of a spy in a hostile country.
04000 To him, everyone he meets is a potential enemy, a threat to existence
04100 who must be evaluated for malevolence. To survive he must be
04200 hypervigilant and fully mobilized to attack, to flee, to stalk. In
04300 this situation appearances are not to be taken at face value as
04400 ordinary events or routine background but each must be attended to
04500 and interpreted in order to detect malevolence. Events in the
04600 environment, which in the ordinary mode would not be connected to the
04700 self, become referred to the self as potentially menacing. The
04800 unintended effects of others may be misinterpreted as intended and
04900 the undesigned tends to become confused with the designed. Nothing
05000 can be allowed to be unattendible. The dominant intention of the
05100 agent is to detect malevolence from others.
05200 (INCLUDE SOME DESCRIPTIONS OF NATURAL PARANOIA BY BIOGRAPHERS
05300 HISTORIANS, POLITICAL SCIENTISTS, NOVELISTS ?)
05400
05500 Characteristics of Clinical Paranoias
05600 When dividing the world of experience into conceptual classes
05700 , we sort and group together objects and events according to
05800 properties they have in common. The members of a class resemble one
05900 another in sharing certain properties. The resemblance between
06000 members of a class is neither exact nor total. Members of a
06100 conceptual class are considered more or less alike and there exist
06200 degrees of resemblance. Humans are neither subjective nor objective;
06300 they are projective. In forming classifications, we project our
06400 intentions onto the world. Thus the world of experience consists of
06500 our interactive relations, not simply of objects isolated from human
06600 interests.
06700 Observations and classifications made by clinicians regarding
06800 naturally-occurring paranoid disorders have been thoroughly described
06900 in the psychiatric literature. Extensive accounts can be found in
07000 Swanson, Bohnert and Smith (1970) and in Cameron (1967). I shall
07100 attempt to give a condensed description of paranoid phenomena as they
07200 appear in, or are described by, patients in a psychiatric interview.
07300 It is many of these phenomena which the proposed simulation model
07400 attempts to explain.
07500
07600 The main phenomena of paranoid disorders can be summarized
07700 under concepts of suspiciousness, self-reference, hypersensitivity,
07800 fearfulness , hostility and rigidity. These class-concepts represent
07900 common empirical indicators of the paranoid mode.
08000
08100 Suspiciousness
08200 The chief characteristic of clinical paranoid disorders
08300 consists of suspiciousness, a mistrust of others based on the
08400 patient's malevolence beliefs. The patient believes others,
08500 known and unknown, have evil intentions towards him. In his relations
08600 with others he is continously on the look-out for signs of
08700 malevolence which he often reads from the results of his own
08800 probings. He is hypervigilant; people must be watched, their schemes
08900 unmasked and foiled. He is convinced others try to bring about
09000 undesirable states in himself such as humiliation, harassment, mental
09100 subjugation, physical injury and even death. In an interview he
09200 may report such beliefs directly or ,if he is well-guarded, he offers
09300 only hints. He does not confide easily. Disclosure may depend upon
09400 how the interviewer responds in the dialogue to the patient's reports
09500 of fluctuating suspicions and/or absolute convictions.
09600 He is greatly concerned with "evidence". No room is allowed
09700 for mistakes, ambiguities or chance happenings. "Paranoids have a
09800 greater passion for the truth than other madmen." -(Saul Bellow in
09900 Sammler's Planet). Using trivial evidential details, his inferences
10000 leap from the undeniable to the unbelievable.
10100 The patient may vary in his own estimate of the strength of
10200 his malevolence beliefs. If they consist of weakly-held suspicions,
10300 he may have moments of reasoning with himself in which he tries to
10400 reject them as ill-founded. But when the beliefs represent absolute
10500 convictions, he does not struggle to dismiss them. They become
10600 pre-conditions for countering actions against tormentors who wish and
10700 try to do him evil. He seeks affirmation of his beliefs. ("It is
10800 certain that my conviction increases the moment another soul will
10900 believe in it." Joseph Conrad in Lord Jim.). He wants sympathy and
11000 allies in positions of power such as clinicians or lawyers who can
11100 help him take action against his oppressors.
11200 The malevolence beliefs may involve a specific other person
11300 or a conspiracy of others such as the Mafia, the FBI, Communists,
11400 Hell's Angels. The patient sees himself as a victim ,one who suffers
11500 at the hands of others rather than as an agent who brings the
11600 suffering on himself. Other agents subject him to, and make him the
11700 object of, their evil intentions. He dwells on and rehearses these
11800 outrages in his imagination. He schemes to defeat or escape his
11900 adversaries.
12000 The misdeeds of others are denounced, disparaged, condemned
12100 and belittled. He feels interfered with and discriminated against.
12200 The specific content of the beliefs may not be directly expressed in
12300 a first interview. The patient may be so mistrustful of how their
12400 disclosure might be used against him that he cautiously feels his way
12500 through an interview offering only hints which an interviewer can use
12600 to infer the presence of persecutory delusions.
12700
12800 Using his own credibility judgements, the interviewer
12900 attempts to determine whether the patient's malevolence beliefs are
13000 delusions (false beliefs) or not. Experienced clinicians realize that
13100 some malevolence beliefs can turn out to be true. Others may
13200 represent correct estimations on the part of the patient who,
13300 however, fails to see that the malevolence of others is a secondary
13400 consequence of his tendency to accuse and provoke others to the point
13500 where they in fact become hostile towards him.
13600
13700
13800 Self-Reference and Hypersensitivity
13900
14000
14100 The patient may believe many events in the world pertain
14200 directly to himself. Other observers of his situation find his
14300 conviction hard to accept. For example, he may be convinced that
14400 newspaper headlines refer to him personally or that the statements of
14500 radio announcers contain special messages for him. Hypervigilant, he
14600 hypersensitively reads himself into situations which are not actually
14700 intended to pertain to him and his particular concerns.
14800
14900 References to the self are misconstrued as slurs, snubs,
15000 slights or unfair judgements. He may feel he is being watched and
15100 stared at. He is excessively concerned about eyes (which can both
15200 watch and punish). Cameras, telescopes ,etc. which may be directed
15300 his way unnerve him. He may feel mysteriously influenced through
15400 electricity, radio waves, or (more contemporaneously) by emanations
15500 from computers. He is hypersensitive to criticism. In crowds he
15600 believes he is intentionally bumped. Driving on the highway he feels
15700 repeatedly followed too-closely by the car behind. Badgered and
15800 bombarded without relief by this stream of wrongs , he becomes
15900 hyper-irritable, querulous and quarrelsome.
16000 He is touchy about certain topics, flaring up when references
16100 to particular conceptual domains appear in the conversation. For
16200 example, any remarks about his age, religion, family, or sexlife may
16300 set him off. Even when these domains are touched upon without
16400 reference to him, e.g. religion in general, he may take it
16500 personally. When a delusional complex is present, linguistic terms
16600 far removed from, but still conceptually connectable to, the complex
16700 stir him up. Thus, to a man holding beliefs that the Mafia intend to
16800 harm him, any remark about Italy might lead him to react in a
16900 suspicious or fearful manner.
17000
17100 Affect-States
17200
17300 The major affects expressed, both verbally and nonverbally,
17400 are those of fear, anger and mistrust. The patient fears that others
17500 wish to subjugate and control him. He may be fearful of physical
17600 attack and injury even to the point of death. His fear is justified
17700 in his mind by the many threats he detects in the conduct of others
17800 towards him. He is hostile to what are interpreted as insinuations
17900 or demeaning allusions. His chronic irritability becomes punctuated
18000 with outbursts of raging tirades and diatribes. When he feels he is
18100 being overwhelmed, he may erupt and in desperation physically attack
18200 others.
18300 The affects of fear, anger and mistrust he experiences blend
18400 with one another in varying proportions to yield an unpleasant
18500 negative affect state made continuous by fantasied rehearsals and
18600 retellings of past wrongs. Depending on his interpretation of
18700 input from other people, the patient may move away from others and
18800 become guarded, secretive and evasive. Or he may suddenly jump at
18900 others with sarcastic accusations and arguments. His negative
19000 affect-states become locked into self-perpetuating cycles with other
19100 people in his life space who may take censoring action towards him
19200 because of his uncommunicativeness or outbursts.
19300
19400
19500 Rigidity
19600
19700 Another salient characteristic of the paranoid mode is
19800 excessive rigidity. The patient's beliefs in his sensitive areas
19900 remain fixed, difficult to influence by evidence or persuasion.
20000 The patient himself makes few verification attempts which might
20100 falsify his convictions. To change a belief is to admit being
20200 wrong. To forgive others also opens a crack in the wall of
20300 righteousness. He does not apologize nor accept apology. He
20400 stubbornly follows rules to the letter and his literal
20500 interpretations of an organization's regulations can drive others
20600 wild. It is this insistent posture of rigidity and inflexibility
20700 which makes the treatment of paranoid processes by symbolic-semantic
20800 methods so difficult. The patient clings to his convictions in spite
20900 of all the "rational" counter-evidence offered.
21000
21100 Theories of Paranoia
21200
21300 Attempts to explain, to make intelligible, paranoid disorders
21400 have been offered since antiquity. None of these verbally-stated
21500 formulations has won the consensus which typifies scientific theories
21600 since they were neither systematic nor testable.
21700 Science represents a search for consensus knowledge,
21800 judgements about which agreement can be obtained. (See Ziman, 1968).
21900 For a theory to gain scientific consensus, it must meet requirements
22000 of systemicity and testability.
22100 For a theory to be systematic, its hypotheses must cohere and
22200 not be isolated. They must connect with one another and collaborate
22300 in a consistent way. Each hypothesis stands as an initial assumption
22400 or as a consequence of one or more initial assumptions. The
22500 consequence relation can be one of logical or empirical entailment
22600 but the system of hypotheses, to be consistent, should not contain
22700 contradictions.
22800 For a theory to be testable, it must be sensitive to
22900 empirical data which can strenghten or weaken its acceptability as
23000 true or authentic. Each hypothesis in the theory need not be directly
23100 or independently testable. But the theory as a conjunction of
23200 hypotheses must be brought into contact with data of observation, if
23300 not directly, then indirectly, through a translation process in which
23400 a consequence of the theory can be compared with observational
23500 evidence.
23600 Previous theories of paranoia can be criticized for not
23700 satisfying these requirements of systemicity and testability. The
23800 model to be presented fulfills these requirements. When theories are
23900 presented in literary form it is difficult to know what such
24000 formulations imply or whether the implications are consistent. Being
24100 vague, they do not tell us what we are supposed to do in order to
24200 believe the world behaves as their authors have conceived it. If a
24300 formulation is untestable, the issues it raises are undecidable and
24400 unsettleable; thus the necessary consensus cannot be reached.
24500
24600 Theories stem from two sources: (1) from hypotheses suggested
24700 by new descriptions or revisualizations of the phenomena themselves
24800 and (2) from modifications of a legacy of previous theories serving
24900 as the bequeathed myths of the field. Each generation attempts to
25000 formulate new explanatory theories by discovering new phenomena or by
25100 modifying predecessor theories. The old theories are unsatisfactory
25200 or only partially satisfactory because they are found to contain
25300 anomalies or contradictions which must be removed. Sometimes previous
25400 theories are viewed as lacking evidential support by current
25500 standards. Theories are mainly superseded rather than disproved. The
25600 new versions try to remove the contradictions and increase
25700 comprehensiveness by explaining more phenomena.
25800 Theories have many functions. They can be summarized as
25900 follows ( Bunge, 1967):
26000 (1)To systematize knowledge.
26100 (2)To explain facts by showing how they are the entailed
26200 consequences of the systematizing hypotheses.
26300 (3)To increase knowledge by deriving new facts.
26400 (4)To enhance the testability of hypotheses by connecting
26500 them to observations.
26600 (5)To guide research by:
26700 (a) posing fruitful problems
26800 (b) suggesting new data to gather
26900 (c) opening new lines of investigation.
27000 (6)To map a portion of reality.
27100 It would be excessive to demand that a single theory fulfill
27200 all these functions. In the pre-consensus states of undeveloped
27300 fields we should be happy in achieving even one of them. Models, as
27400 well as theories, can be assigned these functions when they are
27500 theoretical in type. Our model was constructed primarily to serve
27600 functions (2) and (4), offering a testable explanation.
27700 Again, theories offered as scientific explanations should be
27800 (a) systematic (i.e. coherent and consistent) and (b)
27900 empirically testable. Prior formulations about the paranoid mode
28000 have not met these criteria and thus are deservedly bygone notions.
28100 For example, to account for paranoid processes by hypothesizing an
28200 imbalance of intellect and affect is so vague and global a
28300 formulation as not to merit explanatory status. For an explanation to
28400 achieve consensus, it must be of the right type, syatematic and
28500 testable. To meet these criteria, I shall propose a postulated
28600 structure of symbol-manipulating processes, strategies, functions or
28700 procedures which is capable of producing the observable regularities
28800 of the paranoid mode.
28900 In psychiatry it is still useful to view some things which
29000 happen to a man in causal mechanical terms. But a man is not only a
29100 passive recipient, subject to Newtons's laws. He is also an active
29200 agent, a language user who thereby can monitor himself, control
29300 himself, direct himself, and emancipate himself while commenting upon
29400 and criticizing these performances. Modern psychiatric theory based
29500 on information-processing principles, views man as an agent as well
29600 as recipient. It must also come to grips with those enigmatic cases
29700 in which what causally happens to a man can be a consequence of his
29800 unrecognized reasons.
29900 Let us consider some explanations for the paranoid mode
30000 beginning with Freud in the late 19th century. (Historians can
30100 certainly find concepts of intentions, affects and beliefs as far
30200 back as Aristotle, who seldom quoted his sources. "It's all been said
30300 before but you have to say it again because nobody listens"- Gide).
30400 To explain persecutory paranoia, Freud postulated defense mechanisms
30500 of repression and projection (Freud, 1896). He assumed the patient's
30600 believed persecution by others represented intolerable ( and hence
30700 repressed and projected) self-reproaches for childhood sexual
30800 experiences. Today hardly anyone finds this explanation acceptable.
30900 Although the formulation has withered , the concepts of defense and
31000 projection have weathered.
31100 Sometime during Freud's friendship with Fliess (1897-1902),
31200 the latter proposed to Freud that paranoia arose from unconscious
31300 homosexual conflict (Jones,1955). For years Freud was silent about
31400 this notion in his discussions of paranoia. Then in 1911, in his
31500 notes on the Schreber case, he developed the Fliess formulation in
31600 terms of transformations being applied to the basic proposition `I (a
31700 man) love him.' He postulated this proposition to be so intolerable
31800 as not to be admitted to consciousness and therefore subjected to
31900 unconscious transformations, first into `I do not love him, I hate
32000 him' which in turn was transformed into the conscious belief `He
32100 hates me' with the accompanying conclusion `Therefore I am justified
32200 in hating him'.(Freud,1911).
32300 Great difficulty has been encountered in testing the
32400 formulation since there is no agreed-upon method for detecting the
32500 presence of unconscious homosexual conflict. The explanation is
32600 also inconsistent with another psychoanalytic tenet that everyone
32700 harbors unconscious homosexual conflicts. But not everyone becomes
32800 paranoid. To reconcile the inconsistency one would have to postulate
32900 some additional, possibly quantitative factors, to explain the
33000 intensity and extent of the paranoid mode in certain people. A
33100 further difficulty with the formulation has been the fact that
33200 overtly homosexual people can be paranoid, requiring in such cases a
33300 postulate of some other type of underlying conflict.
33400 Because of inconsistencies and difficulty in testing, the
33500 homosexual-conflict explanation has not achieved consensus. But as
33600 will be discussed, it may represent a special case in a more general
33700 theory which postulates self-censuring and humiliation to have
33800 central functions in the paranoid mode. Freud's later attempts at the
33900 explanation of paranoia assumed simply that love was transformed into
34000 hate (Freud,1923). This notion is too incomplete and unspecific a
34100 formulation to qualify as an acceptable scientific explanation.
34200 Contemporary requirements demand a more complex and precisely defined
34300 organization of functions to account for such a transformation.
34400 Likewise Cameron's explanation of paranoia as representing
34500 "projected hostilty" (Cameron,1967) represents a single, isolated
34600 hypothesis. An isolated tendency statement says little. What is
34700 needed is a system of tendency statements sufficiently complex to
34800 account for a variety of paranoid phenomena.
34900 Tomkins (Tomkins,1963) offered an arresting
35000 information-processing theory of the paranoid posture.It was
35100 articulated in terms of defensive strategies, transformations ,and
35200 maximizing-minimizing principles. He viewed the paranoid `posture' or
35300 mode as an attempt to cope with humiliation. He proposed that a
35400 person whose information processing is monopolized by the paranoid
35500 mode is in a permanent state of vigilance, in order to maximize the
35600 detection of insult and to minimize humiliation. To quote Tomkins:
35800 "The major source of distortion in his interpretation is
35900 in his insistence on processing all information as though
36000 it were relevant only to the possibility of humiliation."
36200 Swanson, Bohnert and Smith (1970), in their monograph on
36300 paranoia, proposed how a "homeostatic" individual might attempt to
36400 deal with "bewildering perceptions". They postulated that a
36500 person in homeostatic equilibrium perceives a pronounced inner or
36600 outer change which is inexplicable or unacceptable. The resultant
36700 disequilibrium is so bewildering that in order to restore
36800 equilibrium, the person constructs a paranoid explanation which
36900 attributes the cause of the change, not to an internal, but to an
37000 external source. With the cause of the change identified ,
37100 bewilderment is abolished and uncertainty reduced.
37200 Aspects of this formulation suggest symbol-processing
37300 strategies typical of cases of paranoid thinking associated with the
37400 experienced changes resulting from organic brain damage or
37500 amphetamine psychosis. These are conditions which mechanically happen
37600 to a man. In paranoid states, reactions or personalities where no
37700 pronounced physical change can be identified ,the formulation is
37800 insufficient and must be filled out with more complex and specific
37900 processes.
38000 In sum, the formulations of paranoia reviewed have not gained
38100 widespread acceptance because of various weaknesses and limitations.
38200 Currently there exists no reigning theory of paranoia. In such a
38300 pre-consensus state, the field is open for contending theories.
38400 Previous theories have contributed useful hypotheses. I
38500 have incorporated some of them (e.g. Tomkin's hypothesis regarding
38600 humiliation) in an attempt to explain paranoid phenomena in a
38700 different way, using an interactive simulation model. I shall
38800 attempt to explain sequences of paranoid symbolic behavior
38900 (conversational interactions) by describing in some detail a
39000 simulation of paranoid interview behavior , having in mind an
39100 audience of clinicians, behavioral scientists and colleagues in
39200 fields of computer science, artificial intelligence, and philosophy.
39300 The simulation model proposed (first described in Colby, Weber and
39400 Hilf,1971) stands as a putative explanation having the merits of
39500 being more explicit, systematic, consistent and testable than the
39600 theories described above. The model combines hypotheses of
39700 previous formulations with additional hypotheses and assumptions , in
39800 an attempt to present a coherent, unified explanation.
39900 Before we embark on a description of the model, let us first
40000 consider what it means to offer an explanation.