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 classification schemes of mental disorders. [Menninger
00800	et al.] Historians do  not  seem  curious  about  what  persons  with
00900	persecutory delusions were called all that time. (It is doubtful that
01000	there weren't any.) In the 18th century the term reappears in  German
01100	classifications  to  refer to delusional states which were considered
01200	disorders of intellect rather than emotion. [Lewis ].
01300		Little agreement about the term's usuage  was  reached  until
01400	the  present  time  when  it  has  achieved  adjectival  status as in
01500	"paranoid personality" and "paranoid state". Currently  the  term  is
01600	used  to  refer  to  the  presence of delusions (false beliefs). Some
01700	users refer to any sort of delusion as indicative of paranoia but the
01800	primary  usage  restricts the term to persecutory delusions. Somatic,
01900	erotic, grandeur and jealousy delusions are often  simply  identified
02000	as such without calling them paranoid.
02100	
02200	.SS Characteristics of Clinical Paranoias
02300		In dividing the world of experience into conceptual classes ,
02400	we also sort and group  objects  and  events  together  according  to
02500	properties  they  have in common. The members of a class resemble one
02600	another in sharing  certain  properties.    The  resemblance  between
02700	members  of  a  class is not exact or total.  Members of a conceptual
02800	class are considered more or less alike and there  exist  degrees  of
02900	resemblance.  Humans  are  neither subjective nor objective, they are
03000	projective.   In forming classifications we project our interests and
03100	intentions  onto  the world. Thus the world of experience consists of
03200	relations, not of objects isolated from human intentions.
03300		Observations and classifications made by clinicians regarding
03400	paranoia  have  been  thoroughly   described   in   the   psychiatric
03500	literature.  Extensive  accounts can be found in Swanson, Bohnert and
03600	Smith (1970) and in Cameron (1967).    I  shall  attempt  to  give  a
03700	condensed description of paranoid phenomena as they appear in, or are
03800	described by, patients in a psychiatric interview.
03900	
04000		The phenomena the model attempts to explain can be  described
04100	under  concepts  of suspiciousness, self-reference, hypersensitivity,
04200	fearfulness , hostility and rigidity - these properties  representing
04300	empirical indicators of paranoia.                   
04400	
04500	.F Suspiciousness
04600		The  main  characteristic  of  the  clinical  paranoid   mode
04700	consists of suspiciousness of others which derives from the patient's
04800	malevolence beliefs.      The  patient  believes  others,  known  and
04900	unknown,  have  evil intentions towards him. He is continously on the
05000	look-out for signs of malevolence which he often reads from  his  own
05100	probings.  He is hypervigilant; people must be watched, their schemes
05200	unmasked and foiled.  He is  convinced  others  try  to  bring  about
05300	undesirable  states  in  himself  such  as  humiliation,  harassment,
05400	subjugation, injury and even death.  In an interview  he  may  report
05500	such beliefs directly or ,if he is guarded , they will only be hinted
05600	at.  He does not confide easily. Disclosure may depend upon  how  the
05700	interviewer  responds  in  the  dialogue  to  reports  of fluctuating
05800	suspicions or of absolute convictions of malevolence.
05900		He  is  greatly concerned with "evidence". No room is allowed
06000	for mistakes, ambiguities or chance  happenings.  "Paranoids  have  a
06100	greater  passion  for  the  truth  than  other  madmen  " -(Bellow in
06200	Sammler's Planet).  Using trivial evidential details, he  leaps  from
06300	the undeniable to the unbelievable.
06400		The patient may vary in his own estimate of the  strength  of
06500	his  malevolence  beliefs. If they consist of weakly-held suspicions,
06600	he may have moments of reasoning with himself in which  he  tries  to
06700	reject  them as ill-founded.  But when the beliefs represent absolute
06800	convictions, he does not  struggle  to  dismiss  them.   They  become
06900	pre-conditions for countering actions against tormentors who wish and
07000	try to do him evil.  He seeks affirmation of his beliefs, sympathy  ,
07100	and  allies  in  positions of power such as clinicians or lawyers who
07200	can help him take action. "It is certain that my conviction increases
07300	the moment another soul will believe in it." -(Conrad in Lord Jim).
07400		The conceptual content of the malevolence beliefs may involve
07500	a  specific other person or a conspiracy of others such as the Mafia,
07600	the FBI, Communists, Hell's Angels.  The patient sees  himself  as  a
07700	victim  ,one  who  suffers  at  the hands of others rather than as an
07800	agent who brings the suffering on himself.  Other agents subject  him
07900	to and make him the object of their evil intentions. He dwells on and
08000	rehearses in his mind these outrages. He schemes to defeat or  escape
08100	his  adversaries.   The misdeeds of others are denounced, desparaged,
08200	condemned and belittled. He feels interfered with  and  discriminated
08300	against.   At  times  the  conceptual  content of the beliefs are not
08400	directly  expressed  in  an  interview.    The  patient  may  be   so
08500	mistrustful of how their disclosure might be used against him that he
08600	cautiously feels his way through an  interview  offering  only  hints
08700	which the clinician then uses to infer the presence of delusions.
08800	
08900		A  clinician  faces  the  task  of distinguishing whether the
09000	malevolence beliefs are true, false or  pretense.   Some  malevolence
09100	beliefs  may  turn  out to be true.  Others are true but have derived
09200	from the paranoid's tendency to accuse  and  provoke  others  to  the
09300	point where they in fact display hostility towards him.
09400	
09500	
09600	.F Self-Reference and Hypersensitivity
09700	
09800	
09900		The patient believes many more events in the world pertain to
10000	himself in a negative way than seems justified  to  other  observers.
10100	For  example,  he  is convinced that newspaper headlines are directed
10200	personally at him or that the statements of radio announcers  contain
10300	special  messages  for him. In his hypervigilance he hypersensitively
10400	reads himself into situations which  are  not  actually  intended  to
10500	pertain  to  him  and his particular concerns.      The references to
10600	the self are usually interpreted as malevolent conceptually.  He  may
10700	believe  he  is  being observed and mysteriously influenced by others
10800	with evil intentions. He is excessively concerned about  eyes  (which
10900	can  both  watch  and punish), cameras, telescopes ,etc. which may be
11000	directed his way.
11100	
11200		References to the self are misconstrued as slurs, slights  or
11300	unfair  judgements.    He may feel he is being watched, stared at and
11400	even mysteriously influenced. He is hypersensitive to criticism.   In
11500	crowds  he  believes he is intentionally bumped and on the highway he
11600	feels repeatedly tail-gaited. Badgered and bombarded  without  relief
11700	by  this  stream of wrongs , he becomes hyperirritable, querulous and
11800	guarrelsome.
11900		He is touchy about certain topics, flaring up when linguistic
12000	representations  of  particular  conceptual  domains  appear  in  the
12100	conversation.    For example, any remarks about his age, religion, or
12200	family, or sexlife may set him off.   Even  when  these  domains  are
12300	touched  upon  without reference to him, e.g. religion in general, he
12400	takes it  personally.      When  a  delusional  complex  is  present,
12500	linguistic  terms  far  removed but still connectable to the complex,
12600	stir him up.  Thus for a man holding beliefs that the Mafia intend to
12700	harm  him,  a  remark  about  Italy  might  cause  him  to react in a
12800	suspicious or fearful manner.
12900	
13000	.F Affect-States   
13100	
13200		The major affects expressed, both verbally  and  nonverbally,
13300	are  those of fear and anger.  The patient may be fearful of physical
13400	attack and injury even to the point of death.  He fears  others  wish
13500	to  subjugate  and control him.  His fear is justified in his mind by
13600	the many physical threats he detects in the conduct of others towards
13700	him.  He  is  hostile  to  what  are  interpreted  as insinuations or
13800	demeaning allusions. His chronic irritability becomes punctuated with
13900	outbursts of raging tirades and diatribes.  When he feels he is being
14000	overwhelmed he may erupt and in desperation physically attack others.
14100		The experienced and expressed affects of fear and anger blend
14200	with one another  in  varying  proportions  to  yield  an  unpleasant
14300	negative  affect  state  made  continuous by fantasied rehearsals and
14400	retellings of past  wrongs.    Depending  on  his  interpretation  of
14500	malevolent  input,  the  patient  may  move away from others in being
14600	guarded, secretive and evasive and then may suddenly jump  at  others
14700	with  sarcastic  accusations  and  arguments.       His affect-states
14800	become chained into loops with those others in  his  life  space  who
14900	take  censoring action towards him because of his uncommunicativeness
15000	or outbursts.
15100	
15200		As will be described, the affects of  shame  and  humiliation
15300	are  postulated  to  play  a  crucial  role  in the operations of the
15400	paranoid mode.     One  of  the  assumptions  of  the  theory  to  be
15500	presented  involves  a principle of escaping humiliation to prevent a
15600	further reduction in self-esteem through re-experienced humiliation.
15700	
15800	.F Rigidity
15900	
16000		Among the chief properties of  clinically  observed  paranoia
16100	are  those  phenomena  which  may  be  characterized as indicators of
16200	rigidity.  The patient's beliefs in his sensitive areas remain fixed,
16300	difficult  to  influence  by  evidence  or  persuasion.   The patient
16400	himself makes few verification attempts which  might  disconfirm  his
16500	convictions.    To  change  a  belief  is  to admit being wrong.   To
16600	forgive others also opens a crack in the wall of righteousness.    He
16700	does  not  apologize nor accept apology.  He stubbornly follows rules
16800	to the letter and his  literal  interpretations  of  regulations  can
16900	drive  others  wild.   It  is  this stance or posture of rigidity and
17000	inflexibility   which   makes   the   treatment   of   paranoia    by
17100	symbolic-semantic methods so difficult.
17200	
17300	.SS Theories of Paranoia
17400	
17500		While  paranoid  processes  represent  a  disorder  from  one
17600	standpoint, the observable regularities  of  the  disorder  imply  an
17700	underlying   nonrandom   "pathological"   order   at  another  level.
17800	Attempts to explain, to  make  intelligible,  the  order  behind  the
17900	disorder,   have  been  offered  since  antiquity.    None  of  these
18000	verbally-stated formulations have won the consensus characteristic of
18100	scientific  theories since they were neither systematic nor testable.
18300		Science   represents  a  search  for  consensible  knowledge,
18400	judgements about which  agreement  can  be  obtained.   Consensus  is
18500	reached  when  a  theory  fulfills  requirements  of  systemicity and
18600	testability.
18700		For a theory to be systematic, its  hypotheses  must  cohere,
18800	not  be  isolated,  connect  with  one  another  and collaborate in a
18900	consistent way. Each hypothesis stands as an initial assumption or as
19000	a  consequence  of  one or more initial assumptions.  The consequence
19100	relation can be one  of  logical  or  empirical  entailment  but  the
19200	system, to be consistent, cannot contain contradictions.
19300		For a theory to be testable, it must be sensitive to
19400	empirical data which can strenghten or weaken its acceptability. Each
19500	hypothesis  in  the  theory  need  not  be  directly or independently
19600	testable.   But the theory as a conjunction  of  hypotheses  must  be
19700	brought  into contact with data of observation, if not directly, then
19800	indirectly, through a translation  in  which  a  consequence  of  the
19900	theory can be compared with observational evidence.
20000		Previous theories of paranoia are to be  criticized  for  not
20100	satisfying  these  requirements  of systemicity and testability.  The
20200	model to be presented fulfills these requirements. When theories  are
20300	presented  in  literary  form  it  is  difficult  to  know  what such
20400	formulations imply or whether the implications are  consistent.  They
20500	do  not  tell us what we are supposed to do in order to replicate the
20600	experience of their authors.   If a formulation  is  untestable,  the
20700	issues  it  raises  are  undecidable  and  unsettleable and consensus
20800	cannot be reached.
20900	
21000		Theories stem from two sources, from hypotheses suggested  by
21100	new  descriptions  of the phenomena themselves and from modifications
21200	of a legacy of previous theories (bequeathed  myths  of  the  field).
21300	Each  generation develops new explanatory theories by discovering new
21400	phenomena or by modifying predecessor theories.  The old theories are
21500	unsatisfactory  or only partially satisfactory because they are found
21600	to  contain  anomalies  or  contradictions  which  must  be  removed.
21700	Sometimes  previous theories are viewed as lacking evidential support
21800	by current standards. Theories  are  mainly  superseded  rather  than
21900	disproved.   The new versions try to remove the contradictions and
22000	increase comprehensiveness by explaining more phenomena.
22100		Theories  have  many  functions.   They  can be summarized as
22200	follows [from Bunge?] .V
22300		(1)To systematize knowledge.
22400		(2)To explain facts by showing how they are the entailed
22500			consequences of the systematizing hypotheses.
22600		(3)To increase knowledge by deriving new facts.
22700		(4)To enhance the testability of hypotheses by connecting
22800			them to observations.
22900		(5)To guide research by:
23000			(a) posing fruitful problems
23100			(b) suggesting new data to gather
23200			(c) opening new lines of investigation
23300		(6)To map a portion of reality. .END
23400		It is a tall order for a  theory  to  fulfill  all  of  these
23500	functions.  In undeveloped fields we should be happy with even one of
23600	them.    Models  can  be  assigned  these  functions  when  they  are
23700	theoretical  in  type.    Our  model  was intended primarily to serve
23800	functions (2) and (4), testable explanation.
23900		Theories  offered  as  scientific  explanations should be (a)
24000	systematic	(i.e.  coherent and consistent) and  (b)  empirically
24100	testable. Prior psychological formulations about the paranoid mode do
24200	not meet these criteria and thus deserve to be bygone  notions.   For
24300	example,  to  account  for  paranoid  thought  process  by  citing an
24400	imbalance of intellect and affect or defective role-taking is  to  be
24500	so  global  and  untestable  as  to  not merit theory status. To gain
24600	consensus with an explanation of the right type we need  a  structure
24700	of symbol-manipulating processes, strategies, functions or procedures
24800	which is capable of producing  the  observable  regularities  of  the
24900	paranoid mode.
25000		In psychiatry it is still useful to view  some  things  which
25100	happen  to a man in mechanical terms. But a man is not only a passive
25200	recipient, subject to Newtons's laws, he is also an active  agent,  a
25300	language  user  who  thereby  can  monitor  himself, control himself,
25400	direct himself, comment on and criticize these performances.   Modern
25500	psychiatric  theory should try to offer an account of man as agent as
25600	well as recipient and come to grips with  those  enigmatic  cases  in
25700	which what happens to a man can be a consequence of what he has done.
25800		Let us  consider  some  psychological  explanations  for  the
25900	paranoid  mode  beginning  in the late 19th century.  (Historians can
26000	certainly find notions of intentions, affects and beliefs as far back
26100	as  Aristotle,  who  seldom  quoted his sources.   "Its all been said
26200	before but you have to say it again because  nobody  listens"(Gide)).
26300	In 1896 Freud [ ] proposed a formulation which postulated a defensive
26400	strategy or procedure to explain persecutory paranoia .   He  assumed
26500	the believed persecution of the self by others to represent projected
26600	self-reproaches for childhood masturbation.     Today  hardly  anyone
26700	finds  this  explanation  plausible.  While it has withered, however,
26800	the concepts of defense and projection have weathered the years.
26900		Around  the  turn of the century, Fliess (according to Jones[
27000	]) proposed in letters to Freud that paranoid thought stemmed from an
27100	unconscious   homosexual   conflict.      Freud  embraced  this  idea
27200	whole-heartedly  and  in  1910  [  ]  developed  it   in   terms   of
27300	transformations  being  applied  to  the basic proposition `I (a man)
27400	love him.' He postulated this proposition to be so intolerable as not
27500	to   be   admitted   to  consciousness  and  therefore  subjected  to
27600	unconscious transformations, first into `I do not love him, I hate
27700	him'  which  in  turn  was  transformed into the conscious belief `He
27800	hates me' with the accompanying conclusion `Therefore I am  justified
27900	in hating him'.  Great difficulty has been encountered in testing the
28000	theory since there is no agreed-on method for detecting the  presence
28100	of   unconscious   homosexual  conflict.   The  explanation  is  also
28200	inconsistent with another of  Freud's  ideas  that  everyone  harbors
28300	unconscious  homosexual conflicts. But not everyone becomes paranoid.
28400	To reconcile the inconsistency  one  would  have  to  postulate  some
28500	additional,  possibly  quantitative factors, to explain the intensity
28600	and  extent  of  the  paranoid  mode  in  certain  people.    Another
28700	difficulty  is  the  fact  that  overtly  homosexual  people  can  be
28800	paranoid, requiring in such cases a postulate of some other  type  of
28900	underlying conflict.
29000		Because  of   its   inconsistency   and   untestability   the
29100	homosexual-conflict  explanation  has not achieved consensus.  But as
29200	will be discussed, it may contain a grain of truth as a limiting case
29300	for  a  more general hypotheses regarding humiliation in the paranoid
29400	mode. Freud's later attempts at the explanation of paranoia  (In  Ego
29500	and  Id)  assumed  simply that love was transformed into hate.   This
29600	notion is too vague and incomplete an articulation to qualify  for  a	
29700	contemporary  explanation  which  reqires  a  more  precisely defined
29800	organization of functions to account for such a transformation.
29900		Cameron's   explanation   [1967]   of   "projected  hostilty"
30000	represents a single, isolated hypothesis and thus does not qualify as
30100	an adequate explanation on grounds of systemicity.
30200		Tomkins    [    ]    in    196?     offered    an   arresting
30300	information-processing theory of the paranoid posture articulated  in
30400	terms     of     defensive     strategies,    transformations    ,and
30500	maximizing-minimizing principles. He viewed the paranoid mode  as  an
30600	attempt  to  cope  with  humiliation. He proposed that a person whose
30700	information processing is monopolized by the paranoid mode  is  in  a
30800	permanent  state  of  vigilance,  trying to maximize the detection of
30900	insult and to minimize humiliation.
31000	Regarding the paranoid, Tomkins stated:
31100	.V
31200		"The major source of distortion in his interpretation is
31300		 in his insistence on processing all information as though 
31400		 it were relevant only to the possibility of humiliation."
31500	.END
31600		In 1970 Swanson et al.[ ] in a book on paranoia portrayed how
31700	a  `homeostatic'  individual  attempts  to  deal  with   `bewildering
31800	perceptions'.     They   postulated  that  a  person  in  homeostatic
31900	equilibrium perceives a pronounced inner or  outer  change  which  is
32000	inexplicable  or  unacceptable.   The  resultant disequilibrium is so
32100	bewildering  that  in  order  to  restore  equilibrium,  the   person
32200	constructs  a  paranoid explanation which attributes the cause of the
32300	change, not to the self, but to an external source.  With  the  cause
32400	of  the change identified , bewilderment is abolished and uncertainty
32500	reduced.
32600		Elements  of  this  formulation  represent  symbol-processing
32700	strategies  particularly in cases of paranoid thinkng associated with
32800	the `pronounced changes'  of  organic  brain  damage  or  amphetamine
32900	psychosis.   These are conditions which happen to a man.  In paranoid
33000	states, reactions  or  personalities  where  no  pronounced  physical
33100	change  can  be identified ,the formulation is inadequate and must be
33200	filled out with more specific transformations.
33300		In sum, the rival theories of paranoia here reviewed have not
33400	gained  widespread  acceptance  because  of  various  weaknesses  and
33500	limitations. No reigning and unified theory  of  paranoia  is  widely
33600	accepted  today. In such a pre-consensus state the field is wide open
33700	for contenders. I shall approach this ancient problem of paranoia  in
33800	a different way, using the strategy of simulation. I shall attempt to
33900	to explain sequences of paranoid  symbolic  behavior  (conversational
34000	interactions)  by  describing in some detail a simulation of paranoid
34100	interview behavior , having in mind  an  audience  of  mental  health
34200	professionals  and  colleagues  in  fields of psychiatry, psychology,
34300	artificial intelligence, linguistics and philosophy.  The  simulation
34400	model  proposed stands as a candidate explanation intended to be more
34500	explicit, systematic,  consistent  and  testable  than  the  theories
34600	described   above.     The  model  combines  hypotheses  of  previous
34700	contributions (especially Tomkin's) with hypotheses  and  assumptions
34800	of  my  own  into  a coherent unified explanatory system. Let us next
34900	consider the nature of explanatory systems.