Psychotherapy and the Paranoid Process is a comprehensive study of the paranoid process and its treatment through psychotherapy. Initially, Meissner provides a conceptual framework for the paranoid process in the evolving context of psychoanalytic clinical thinking. He traces theories of the paranoid process from Freud's theoretical constructs through ego psychology, object relations, self psychology and developmental theory.

The paranoid process as defined by Meissner is an extension of the theories of internalization, particularly concerning itself with those forms of internalization that have pathogenic potential. According to Meissner, these core internalizations serve as the basis for the organization of the individual's inner psychic world as well as the source of externalizations that influence the nature of the individual's object world. The core mechanisms of