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In this paper I wish to draw attention to a combination of defence mechanisms which I observed in the analyses of paranoid patients. I do not intend to present a comprehensive study of paranoid conditions, nor do I wish to deal with the important problem of distinguishing between paranoid states in neurotic and psychotic patients.
The analysis of paranoid patients has some characteristic features. The patient is preoccupied with experiences in which a certain person or persons have done and are doing harm to him (or her). He produces abundant material to prove that he is the victim of this person's hostility, and he describes in much detail his own state of suffering, pain, fear and mental incapacity. The person by whom the patient feels persecuted is one very near to him (wife or husband or child), and often enough the patient is quite certain that his contemporary enemy does exactly the same things to him as an important figure in his earlier life, usually one of his parents. He concludes that he is doomed to suffer in this way and he feels very bitter about it.
The analytic sessions are filled by the patient's reporting ever new incidents in which he has been humiliated, attacked and in one way or another made to suffer.
He describes intolerable states of panic and agony. He cannot find peace anywhere. Attempts at activity do not relieve his state of mind, but on the contrary infinitely add to his suffering, because he cannot accomplish what he has started; either his mind goes blank, or a turmoil of ideas overwhelms him. He cannot read or converse with people because he cannot follow a train of thought, and a new terror sweeps over him. People will pounce on him, he will be scorned and ridiculed. And so one pain follows another, one persecution and anticipation of persecution leads on to others. When his persecutory fears have become transferred to the analyst, the analytic sessions become devoted to the enumeration of the analyst's wrongdoings. At such