Toward understanding paranoia: New theoretical formulations of the paranoid process

Neil Marinello (1989)

The problem addressed by this dissertation is that current psychological understanding of paranoia and its origins is inadequate for both clinical and research purposes. The clinical and research definitions of paranoia are shown to be inconsistent within themselves, an operational definition of paranoia (Haynes, 1986) is suggested, and a review of the etiological literature and research is conducted through an origin/state lens in four sections: psychoanalytic, cognitive/behavioral, neurobiologic, and developmental. Concluding that no theory has yet been proposed which adequately integrates and interconnects the factors operative in the paranoid process, the writer's own theoretical formulations are presented as a beginning effort to develop such a theory. It is proposed that there is no difference between the body's normal emergency state and a transient paranoid state. Both utilize the individual's personal reality construct, which consists of real and superstitious connections formed from infancy and modified continuously to incorporate present experiences with past constructs so as to make the future safer and more predictable. Pathological paranoia is the maintenance of the emergency state, an attempt to maximize assimilation and minimize accommodation (at the expense of reality) through the creation of self-reinforcing closed loops (delusions). Developmental phenomenology which increases the likelihood of pathological paranoia (remaining in the emergency state) is presented. The phenomenological paradigm for the premorbid paranoid dominated by feelings of powerlessness is the terrified child, whereas the paradigm for the premorbid paranoid dominated by feelings of powerfulness is the two-year-old king turned four-year-old spoiled brat. Therapeutic implications include the therapist's assuming the role of a powerful friend who can help, as well as the necessity of intervening with a show of force if the individual in a paranoid state is deemed potentially dangerous (i.e., comforting the child while restraining the brat). Research implications, including several empirically verifiable hypotheses derived from the theoretical formulation, are presented. Theoretical implications are discussed, emphasizing the changing nature of the theory, the areas requiring further development, and the possible applications of this theory's normalization of paranoia to other pathological conditions, creative and scientific endeavors, and international interconnectedness.