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Psychoanalytic contributions to the theory of paranoia are reviewed. As a primary problem underlying paranoia, this paper emphasizes the importance of beating fantasy associated with a fragile personality structure rather than the theory of repressed homosexuality. Castration anxiety and homosexual conflict may precipitate paranoia, but all levels of psychosexual development and their corresponding danger situations contribute to the transformed fantasy of persecution and punishment; early infantile narcissism, aggression, and sadomasochism are especially important.
Severe preoedipal disturbance has contributed to deficient ego development and oedipal resolution. The failure to negotiate separation-individuation is associated with narcissistic arrest and impaired object relations and testing of reality. Ego integration, identity and sexual identity are unstable. Attempts at undoing, repair, or revenge of traumata and narcissistic injury and the maintenance of ego stability and (narcissistic) object relationship are more fundamental than homosexual object choice or the negative Oedipus complex in the understanding of paranoid psychopathology.