Где вы, доктор Бехтерев?
А параноики рисуют нолики.
Обьяснить характер нынешнего президента просто манией, как я процитировал в посте " Трамп это диагноз", невозможно.
В DSM-5 в группе Personality clusters имеется Cluster A (odd or eccentric disorders) к которому относится Paranoid personality disorder, описывающий президента и некоторых "выдающихся" авторов ЖЖ - резонёра, арбата, джорджа, хахама, шкробиуса (читая его посты в ветке Таинственное исчезновение. 3 "ставишь галочки" на 6 из семи характеристик Paranoid personality disorder, а по поводу седьмого: "recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner" - просто нет информации), поэтому повторяющиеся вопросы якова к этим деятелям: "где ваша совесть" - мягко говоря, неадекватны..
Инетереснее другое - трдиционное психоналитическое обьяснение источника параноидальной личности "is in the early childhood" - "Vulnerability to paranoia begins in the earliest months of the child's relationship to the mother."
На столе у меня лежит том The Harvard Guide to modern psychiatry. Fifth Printing 1980 приведу ряд цитат из соответствующей главы: Chapter 12 Paranoia and Paranoid States:
Classification and Symptoms
Paranoia and paranoid states are a group of psychoses characterized by delusions of influence, reference, grandiosity, jealousy, or persecution that occur without hallucinations. The delusions are logically organized and systematized in paranoia and less logical in paranoid states. Pure paranoia is rarely diagnosed in modern times because it is so narrowly defined. Many more marginal cases occur than were originally conceived, and most recover, or don't recover, without contact with a psychiatrist.
Paranoia
In pure paranoia, a chronic delusional state, logical and well systematized, develops gradually. Hallucinations are rare and exacerbations and remissions occur, but the personality remains essentially intact and can function well in relation to the environment. The delusions may become increasingly complex as more energy and logic are applied to their elaboration.
Diagnosis
The essential diagnostic feature of paranoid reactions is a marked delusional system. Lack of trust is evident, rooted in an absence of trust in the parent-child relationship. The patient also manifests defensiveness and suspiciousness during examination. Suspiciousness may actually coexist with naivete-a lack of normal guardedness-with regard to the actions and expectations of others (Grunebaum and Perlman, 1973). The patient suffering from this form of social skills deficit thus often feels he is being taken advantage of, a situation that may heighten the inflexibility of his demands, his tendency to rationalize and blame, and his feeling of general inadequacy, particularly sexual inadequacy.
Intelligence tests may or may not be helpful in the diagnosis of the paranoiac. Paranoid patients cooperate with testing and perform well verbally, but discrepancies appear in subtests. As the tests grow more difficult, the patient becomes more tense and suspicious. The Rorschach test may reveal very little if the paranoia is mild or has abated; it may demonstrate a great deal with a frankly paranoid patient.
The total impression from the Rorschach of a paranoid patient communicates external threat, a need for selfprotection, and problems of impulse control. The Thematic Apperception Test (TAT) reveals doubts concerning people's motives, confusion of sexuality, manipulation of the main figure by others, and a tendency to moralize.
The nature of the delusions differentiates the specific paranoid syndromes. As described earlier, the delusional system in paranoia is well systematized and logical; it is less well systematized in paranoid states and is frankly bizarre in paranoid schizophrenia.
Epidemiology
The statistics for paranoid illnesses are obscure for three general reasons: because of the suspicious nature of the patient population (which keeps its secrets to itself); because of a tendency to view many of these people as merely cranks; and because paranoid people do not come to official attention, especially in nonurban communities. Although Kraepelin found that paranoia was more common in men, certain forms, like erotomania, are more common in women. A recent study of only fifty-two patients (Johanson, 1964) revealed equal male and female distribution.
Some relationship has been noted between paranoid reactions and immigrant or migrant status; individuals moving to a foreign country may experience a paranoid or schizophrenic reaction, which may abate when they return home (Johanson, 1964); these responses may be primitive reactions to loss. On the other hand, while paranoid schizophrenia is the most common form of schizophrenia among nativeborn Americans, as a group they are less susceptible to paranoid states than immigrants; the meaning of this difference is not clear (Polatin, 1975).
Pathogenesis
These psychiatric illnesses appear to have no genetic or neuropathological etiology; psychological mechanisms play the major role. We will discuss these mechanisms as currently understood within a psychoanalytic framework.
Vulnerability to paranoia begins in the earliest months of the child's relationship to the mother. Many factors in different combinations play important roles, including coldness and strife between the parents; the pain of frustrated instinctual needs; subsequent intrapsychic maneuvers of the child to deal with the aggression mobilized by this frustration; and insufficient or excessive perceptual stimulation, which may occur at any point in the child's early development. Later on in childhood, the defensive sexual sequelae to these early infantile factors result in feelings of danger to one's stability and self-defeat.
A background of fear, bitterness, frustration, callousness, and occasional open warfare exists in many families of paranoids, resulting in frustration of the child's instinctual needs and an attitude of basic mistrust. A pervasive yearning for the mother in a special close way leads to an abnormally intense primitive identification with her. This identification is heightened when minimal gratification is denied. The child then has to defend himself against both the need for gratification and the fear of its frustration.
If perceptual deprivation (by inadequate parental contact) or overload (by family strife) is maintained for a sufficient length of time with sufficient severity, it can provide a climate for a paranoid reaction (Sarvis, 1962). Susceptibility to a paranoid reaction varies with the availability of defenses and escape mechanisms, such as sleep, unconscious fantasy, and identification with the aggressor.
For a child to thrive and grow normally, he must obtain a basic minimum of satisfaction for his needs. In addition, he must experience an external reality in which his parents live their lives in a reasonable manner. Both of these factors are lacking in the paranoid-to-be. Since the child cannot change his environment, he changes himself (his ego) to console himself. He manufactures a "reality" that explains to him why he is immobilized and terrified in his surroundings and resorts to three chief mechanisms of defense-denial, distortion, and projection. Denial is used to nullify the effects of painful reality but, in fact, is an aversion to this painful reality, which is nonetheless always close to the surface of his awareness. Distortion occurs not only in the form of comforting daydreams and unconscious fantasies but also in the form of contradiction-a coherent, manufactured fabric to explain his misery. Projection in particular is used to deal with massive aggression for which there is no outlet. The child projects his aggression onto the parent because the hatred is too painful to bear and identifies with the image of that hateful parent-mechanisms referred to as "projective identification" by Melanie Klein (1932) and "identification with the aggressor" by Anna Freud (1936). The child attempts to resolve this painful situation by a process of repression that leads to the formation of a hostile, demanding set of values (primitive superego).
In summary, the disparate symptomatology apparent in male and female paranoids can be explained by the nature of their premature leap into the oedipal situation. Precocity in this developmental sphere enables the child to escape the accumulated frustrations of the early motherchild relationship. For the male, this escape carries the threat of homosexuality; for the female, the threat of incest.