Reply to Dr. Meissner

THE PUBLICATION OF MEISSNER'S volume, The Paranoid Process(1978), was welcome and promised much by its title alone. The title emphasized the importance of process, implicit also in the term, "psychodynamics." Additionally welcome was the extensive clinical material—three hundred pages devoted to careful, intensive study of just ten cases; detailed clinical presentation in the best tradition of Freud's introduction of psychoanalytic concepts.

There is, therefore, a basis for some fundamental agreement in our dealing with the problems of paranoia. We stress in our presentations focusing on concrete individual cases, and we both emphasize process. Despite parallelism in some fundamental views, we also, almost paradoxically, differ: I speak as a culturalist, and Meissner accounts for identical individual behaviors quite otherwise, because his thinking is in terms of classical Freudian concepts. At the outset, he disqualifies psychodynamics from the purview of process. He considers my concepts as something that "hovers in the background of the reflection of paranoid psychodynamics, [remaining] … unfocused and nonspecific…" He says, "I will not pursue the dimension of process … since it would carry us too far afield…" But, to explain the clinical phenomena in my last and major case, he nevertheless invokes "the schema suggested by the paranoid process…" We obviously have different views of process and psychodynamics. For me, Meissner's concepts of paranoid process represent his particular analysis of paranoid psychodynamics. I have different concepts of the pathological process which I refer to directly as paranoid psychodynamics. Despite this semantic difference, we recognize certain important phenomena in essentially identical ways.

One of the most crucial points of agreement, for example, that we have in our observations is the fact that the paranoid frequently functions in such ways as to elicit from others the very behavior he experiences as hostile and pe