Such cases are not favorable for analysis and rather hopeless. I am not
as lucky as _Bjerre_[19] to be able to report a complete cure of a case
of paranoia. Usually these patients abandon the psychoanalysis, finding
some pretext to turn from the consultant. It is useless to explain to
them the mechanism of transference. From the moment when they perceive a
leaning towards their consultant that sympathetic feeling is changed
into anxiety and distrust. They are unwilling to recognize their
homosexuality. Their psychic disturbance is too deep and a correction is
no longer possible. Often the subjects stay away after only a few
visits. This sudden abandonment stands in sharp contrast to their
initial enthusiasm for the new method of treatment. Others stay on with
the analysis for a few weeks but make little or no progress. So long as
their homosexual tendencies are not touched upon, it is possible to keep
up the psychoanalysis a little longer but the psychoanalysis is
superficial under the circumstances, as they cannot be induced to apply
candor, always keep secrets from the consultant, and cover under silence
whatever comes into their mind bearing on their attitude towards their
physician.
He carried his revolver whenever he called at my office, always ready to
shoot down the alleged enemy. I tried to make him understand that he was
tortured by his own homosexual and criminal thoughts. He listened
incredulously but was not so averse as I have seen most paranoiacs.
This patient also stayed away after three weeks of analysis because the
analysis produced in him a tremendous excitement. He thought I was in
league with his father[20] to part him from his girl. The real object of
his love was the father who seems to me to play an important rôle in the
psychogenesis of male paranoia.
I saw him two years later during the war. He had joined the army as
volunteer, had made an excellent record for himself and had been
slightly wounded. Since the war he felt better. He had given up the
engagement shortly after the treatment. His ideas of persecution had
subsided to a great extent, he claimed.
The next case shows us a paranoiac jealousy with insane notions based on
proofs ferreted out and scrutinized with remarkable ingenuity. Such
cases form the borderline towards the class of querrulants who clamor
always for their “rights,” precisely because an inner voice clamoring
for “injustice” must be drowned.
78. Mr. S. D. is referred to me by his family physician from a distance.
I am asked to determine whether his jealousy is justified or the result
of a morbid state of mind.
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