Thursday, November 10, 2011

psychoanalytic basics- paranoia and melancholia

At the phallic-oedipal phase of development I have been showing that what is created is a maternal phallus that opposes the father's phallus. The narcissist has a secret phallus by which he opposes the ego ideal of excellence or recognition and can deny his lack of success in the symbolic order. Paranoia shows that at some point if he tries to get rid of that ideal (attacks the internal father) that it returns in the form of the father trying to persecute him.

Analogously, with the ego ideal of devotion or gift-giving when the masochist attacks the inner father in disappointment in love she ends up having to turn accusations towards the father on to the self in melancholia.

In this way the paranoid pervert or psychotic will often function on the masochistic side and be concerned with love and devotion while the melancholic will function on the narcissistic side and in her self-reviling narcissistically put herself forward and bring attention to her worthlessness to everyone.

I will talk about the masochist's phallic-oedipal ego ideal soon in another post.

"In summing up the characteristics of paranoia, one should stress especially the fact that the delusion is concentrated around the ego. The patient tends to experience his delusion not autistically, but in contact with the outside world, during the course of which contact he frequently forms many ideas of reference. A large part of his personality remains intact, a state of mind from which one may assume also arises the tendency to furnish intellectual proofs for the correctness of his ideas. As a rule, the delusion has the same content as the already existing character anomaly, and thus it may appear to the observer as if the delusion develops as a mere intensification of such an anomaly. As a result of this relation, the course of the illness changes frequently and seems to oscillate between the extremes of the character anomaly, on the one hand, and the pronounced delusion, on the other."

I concluded that the ego strives insofar as possible to maintain its ties with reality in order not to be drawn further into the psychosis. It is true that the ego is powerless to prevent the development of a delusion, but at least in this way the ego succeeds in shaping the delusion according to the pattern of a defense mechanism. This last feature is probably responsible for the fact that paranoia seems to a certain degree receptive to psychotherapy, in which respect paranoia distinguishes itself favorably from schizophrenia. Katan, M. (1969). A Psychoanalytic Approach to the Diagnosis of Paranoia p.341-2

To avoid misunderstanding, I want to make a distinction between depression and melancholia. As long as reality thinking is maintained, I prefer to speak of the various depressive states as depressions. When delusions of self-guilt enter the picture, I speak of melancholia. In cases of melancholia, only a part of the personality is psychotic; all other possible phases of depression are simultaneously present.

Next, we may conclude that in melancholia, too, a total regression of a part of the personality takes place to the undifferentiated state. The ego wards off the aggression toward the object, whereupon the aggression appears in the tension between superego and ego. The aggression is aroused because the ego feels narcissistically wounded. I want to stress that in melancholia, on a higher level of development, the self-accusations are unable to cope with the conflict. As a result, deeper levels of development are affected. Furthermore, in the final stages of the regressive process, the ego is not successful in mastering the internalized conflict. This means that the ego is unable to prevent the hostility, which is turned inward, from finally leading to self-destruction. At this point, the ego can no longer prevent the regressive process from taking the final step toward the undifferentiated state. The conflict caused by the aggression is now decathected. The attempt at restitution recathects the conflict between superego and ego, with resulting delusional self-accusations. Thus, in my opinion, a strong similarity exists between the development of melancholia and that of jealousy paranoia. ibid. 339-40

For the ego, when it becomes fully identified with the object, does not abandon its early defence-mechanisms … [T]he annihilation and expulsion of the object … initiate the depressive position. If this be so it confirms my concept of the genetic connection between paranoia and melancholia. (Klein, a contribution to the psychogenesis of manic depressive states, p. 265).

I'll have to post more on Klein in the future. One can still agree with her judgment of form while disagreeing entirely with her assessment of development and lack of phenomenological differentiation.

No comments:

Post a Comment