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It is well known that in delusions of persecution the figure of the loved one reappears as the "persecutor". As a rule it is more or less disguised: for instance, instead of the beloved father there emerges the persecuting superior. Freud has called this phenomenon the return of the repressed libido, and more especially its return with a reversal of the sign; that is to say that what was repressed in the shape of love returns as hatred. This hatred is projected, and represents the content of the delusion.
The essential condition that must be fulfilled before such a reversal of sign can take place is naturally to be found in some attitude of ambivalency. But the question of its particular determinants remains to be discussed.
According to my observations, the content of the delusion is frequently anal persecution.2 Patients often complain of all sorts of other tortures, of radiations, etc., or simply of being teased or injured by some particular person. But even in these cases, if their confidence can be won, they may unexpectedly confess, with every sign of their surrendering some important secret, that, apart from all this, the essence of the matter consists in an inconceivable piece of villainy, which cannot even be spoken of, and can only be indicated by hints and gestures. Here are one or two instances:
An elderly female patient (a clinical mixed type, with features of manic-depressive insanity and hypochondriacal and nihilistic delusions of persecution) complained among other things that they had "turned her the wrong way round". On being asked the