The Analysis of a Paranoid Personality1

Recently, on rereading my paper on the "Function of Words in Psycho-Analytical Treatment', I noticed for the first time that almost all my clinical examples were taken from one patient, a woman whom I had in analysis from 1948 to 1952. In this present paper I shall give some account of this patient and describe certain aspects of her analysis.

There are, of course, certain disadvantages in reporting a case six years after the end of treatment, but these will, I hope, be compensated for by my having in the meantime acquired sufficient distance to be able to present both her and my contribution to the analytical relationship with reasonable detachment. As Miss Y was a person who tended to evoke very strong reactions in everyone who had dealings with her, the detachment given by the passage of time is perhaps of particular value in the present instance. I have, however, made no attempt to conceal my own emotional reactions, as I believe that by including them I shall give a truer account of the dynamics of the analytical process than I should were I to present myself as having been a detached observer throughout.

II

The story of Miss Y's analysis begins two years before she came to me for treatment. She was at that time in her mid-thirties, an unsuccessful actress living an insecure and Bohemian existence. Quite suddenly she became depressed and withdrew completely from her previously very sociable life. During her 'breakdown', as she called it, she experienced various peculiar changes in her moods and perception of reality. These she observed and recorded, using them as the material for a self-analysis which she conducted for the next year. As her only guides she relied on the only two books on psycho-analysis she had ever read, Theodore Reik's Ritual and Wilhelm Reich's Character Analysis. She also occasionally talked on the telephone with two doctors whom she had known when they were medical students and who both had shown a passing interest in psycho-analysi