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As a young student analyst, I felt some trepidation to learn that one of my referrals at a clinic, in December 1971, was to be a man diagnosed as a paranoid schizophrenic. This feeling was not allayed during the initial interview when I was confronted with a bizarre looking young adult male, 18 years of age. He said that he had been recently released from a local hospital where he received a series of electric shock treatments. This was the second hospitalization for this man.
During the initial interview, he complained of three things:
Delusions: He felt that he was the reincarnation of Hitler and/or he was the Devil (narcissistic defense—evil).
Psychic Powers: He felt that he could predict the future, perform mystical acts, and will things to happen (omnipotence).
Somatic Complaints: He complained of hemorrhoids (anal) and various other physical difficulties, such as the feeling that he was “rotting away” (narcissistic defense). The patient's three presenting complaints presented a clinical picture of his narcissism.
The patient seemed unaware of my presence as he presented his complaints. At moments he was clear and lucid, at other moments he was delusional—the lamps in the office were disguised people, the door knob a breast, a figurine was a penis. The patient's first