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This is the only psychoanalytic text about paranoid experience and mental organization. It is an extensive discussion by a prolific writer and teacher of metapsychology. Meissner reviews a heterogeneous literature, presents ten of his own cases, and outlines a theory with which he intends to integrate what we know abot paranoid disorders and ordinary mental life. Therefore, this book deserves a careful reading.
Meissner begins by sifting and sorting several hundred books and papers about paranoid syndromes. These range through neurologic and pharmacologic reports, descriptions of frightened and destructive families, sociocultural studies of authority and prejudice, and psychoanalytic formulations about various groups of patients—among many other matters.
Some of this may be essential to understanding and working with paranoid patients. For example, Meissner summarizes the rich and informative literature about Judge Schreber1 and his family. Later, he brings in Melanie Klein's descriptions of persecutory experience, infant-like envy and acquisitive aggression, as well as Guntrip's delineation of fear as pervasive human motive. He often returns to the clinical concurrence of paranoid symptoms with one or another kind of depression. By the end of this book, it is clear that much has been added to Freud's thinking about paranoid people.
Meissner tries to interweave these and other ideas in his discussions of his patients. These include two analytic cases and this section fills about half of the book. Meissner is instructive about the discomforts and difficulties incumbent on a paranoid patient's therapist. Often we are adrift, dragged by vague empathic tides, blustered by sudden squalls, struggling to re-suspend our attention or just to get some tolerable view of what is going on. Meissner knows a lot about trying to stay with a person who tends to experience every interaction from one end or the other of a vengeful and hateful relationship, a person whose only