SE & OA Paranoia/ SA & OE Melancholia

In a previous post I noted the difference between narcissistic and echoistic (masochistic) paranoia. I wrote 

"Recently I noticed a difference in paranoia amongst some patients. The first group who act like masochists and are very concerned with love, kindness, and are very sensitive to the lack of love they receive have a narcissistic paranoia. It is narcissistic in that they have great intelligence or beauty and that other people either interfere with their power or implicitly because powerful people are interested in them then they must be powerful.

The other group behaves narcissistically in that they are aloof, think that they are very interesting to others, and interested in talking about important names. Their paranoia involves a sense of feeling deceived by others, feeling that some other person can really know about them and what they have done,and/or there is some lie in their family or perpetuated in their milieu and some mastermind behind it"

This finding still holds for me and I've encountered a few more OAs who have paranoid delusions along the lines of someone observing their emails, someone stealing their ideas from them, and other forms that have to deal with their personal lives being observed and their uniqueness being taken from them. This goes hand in hand with a mania that they will be famous, come into a lot of money, and do things to give back to the community. These forms of paranoia starkly contrast to the egoistic, power-based forms of paranoia.

In addition, a patient who has body dysmorphia has made me aware that melancholia will have the same dual form as paranoia. I've encountered the self-abasing, self-reviling melancholic who considers herself "stupid", "incapable" " a disappointment" etc. in the phallic stage form. I've also encountered the anal stage form where the person feels that she has cause to hated by 'all people'. It seems to me that just as this turns out to be an introjection from a denigrated father imago that body-dysmorphia too can't have any real perception behind it and must also be an introjection of a denigrated/monstrous imago. 

This establishes a firmer connection between the 4 libidinal types and the traditional account of the 4 humors.

At the anal stage both the SA and OE are dealing with 'being shit'. The SA doesn't have a problem sharing this with others or being submissive as a consequence of this while the OE has a pride that won't let her be as vocal or submissive and sees her externalize this on to others. Again, the SA is the phlegmatic and the OE is the melancholic.