A Case of Oral Delusions of Persecution

Now that we are able to turn the searchlight of psycho-analytical knowledge on to the wide field of schizophrenia, we are constantly realizing how invaluable is this psychosis in supplying us with facts, fresh discoveries and connecting-links. Both the structure of the ego and the most primitive positions of the libido can be seen and studied in this disease with a clarity nowhere else obtainable. In particular we see that the mechanisms at work in the formation of the typical psychotic pictures, for example, that of paranoid ideas, take on a special imprint from the component instincts which are variously stressed in every case.

Nevertheless, it is not common for a single component instinct to appear, as it were, isolated out in a patient and to dominate the whole picture. So it may, perhaps, be of interest if I give a detailed account of the following case in which the 'persecution' took on an exclusively oral character.1 We shall see what complicated mechanisms may come into play on the oral level, and that one may actually speak not merely of oral identification, but of oral projection. After discussing the particular case, I shall have something to say about the significance, in other cases, of these oral mechanisms which are embedded in the structure of many neuroses.

The patient, a working man, thirty-five years old, complained of nothing but the manifold persecutions to which he said he was exposed on all sides. At bottom, all these persecutions bore a close resemblance to one another. Let me try to marshal his complaints in some sort of order.

They were as follows: Passers-by 'squeezed' his head together and sucked it till it was drained dry and festered like a wound. The reason why people attacked his head in this way was that they were hungry. When anyone was 'squeezing up' the patient's head like this, he had a peculiar feeling in his mouth. (Here he made the motion of sucking.) Similarly his hands would be made feeble and dry: people made the