Oral Erotism in Paraphrenia Facts and Theories

In 1919 Stärcke and von Ophuijsen published their well-known theory on the subject of paranoid delusions. It was based on clinical observations and was as follows: that in many cases the patient's sensation of being persecuted represents a working-over of sensations produced in the rectum by the contents of the bowel. A number of other writers confirmed these observations, but unfortunately very few cases have been published in sufficient detail. We have, however, had many reports of remarks made by such patients, which had to be taken as indications of this mechanism. Before regarding its existence as fully proved we must be able to demonstrate the following points1: (1) engrams dating from the period of the child's training in cleanliness which betray the influence of a marked degree of anal erotism; (2) the identification of the subject's own body with excrement; (3) the identification of the person who looked after him (or of the persecutors) with excrement; (4) the identification of his own body with that of the person who looked after him or with the substitutes for such a person (the persecutors). I myself was able to publish a detailed account of a case of senile paranoia in which all these conditions were fulfilled2 and to demonstrate the presence of the majority of them in the case of a second patient, who suffered from dementia paranoides. Unless we have evidence of all these characteristic points, the mechanism in question must be regarded as merely a probability. As I said, only a very few cases have been published in which its existence was completely proved, but there are on record a very much larger number of cases containing various indications of it. In reading through the psycho-analytical literature on the subject, I found such indications in 33 cases of paraphrenia.3 (Of course, the criteria enumerated are not all of equal cogency as evidence of its existence.)