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The concept that paranoid symptoms are due to unconscious homosexual conflict is widely accepted. Ferenczi (18) stated that latent homosexuality is “demonstrable in every case of paranoia and paraphrenia.” Brill (5) declared that “paranoia is nothing but distorted homerotism.” Shockley (91) stated that “this theory, that homosexuality is the determining factor in producing these conditions (paranoid) may in fact be regarded as proven.” Knight (55) wrote, “An intense homosexual conflict is never absent in the male paranoiac.” Fisher (19) writes, “Once a diagnosis of paranoiac reaction is fairly certain, a subconscious homosexual orientation should be taken for granted.” Grinker and Serota (43) write, “The psychosis represents a defense against unconscious homosexual wishes which have become too strong for the individual to handle by sublimation or repression.”
Freud's analysis of Dr. Schreber's autobiography (25) provided the basis for these conclusions. Knight adds, “Perhaps no psychoanalytic theory of a psychosis rests on firmer foundations or has been less frequently attacked by critics of Freud.” Klein and Horwitz (54) find that “Freud's concept… has become so incorporated in psychiatric thinking that the homosexual area is explored immediately or even assumed to exist as the core of any paranoid state.” Karl Menninger (66, p. 262) states that Freud's interpretation was profound in influencing the thinking of medical science and “has been accepted by psychiatrists pretty generally all over the world.”
Although Freud's ideas were formulated and set forth as a theory, it is apparent that they have been widely accorded a factual status. However, many investigators question such a general applicability. Muncie (74) acknowledges that homosexuality is to be found in many such cases but observes that paranoid reactions often appear as a twisting of facts concerning unsatisfied or frustrated ambitions. Cameron (9, 10) considers that the influence of non-sexual factors is i