II. Observations on Paranoia and their Relationship to the Schreber Case1

This paper includes a brief review and evaluation of the major criticisms of the traditional theory of paranoia, followed by some general observations on paranoia regarding such issues as the role of hostility, the essential nature of a delusion, the megalomaniac aspects implicit in all delusions, and rationalization as a defence. An attempt will be made to relate these observations, where pertinent, to the Schreber psychopathology.

Although Freud's (1911) interpretation of the Schreber autobiography has frequently been subject to attack and criticism, a survey of the vast literature accumulated on the Schreber case can only impress one with the wisdom and insight revealed by Freud in his original formulation. No alternative explanation or theory of paranoia has been proposed which has merited comparable consideration, respect, and acceptance.

Major criticism of the traditional theory of paranoia elucidated by Freud has been centred around the invariability of the role of unconscious homosexuality in the dynamics of the disorder, in terms of varying ways by which the proposition 'I (a man) love him' presumably becomes transformed into a paranoid delusion. The striking contrast between Freud's formulation and the then current literature (e.g. Friedmann, 1908); Gerlich, 1908), however, would lead to the conclusion that Freud's primary contribution was perhaps not his elucidation of a relationship between homosexuality and paranoia, but rather was his demonstration of a way of thinking (the psychodynamic approach). Through application of the defence mechanism of projection, the psychopathology of paranoia was made meaningful in the context of motivational dynamics and understandable in the light of life's experience, in a way not previously accomplished.

The theory that paranoid delusions are always a defence against homosexuality has been challenged by evidence of two general types. First, many cas