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March 1963

Psychodynamics and Management of Paranoid States in Women

Arch Gen Psychiatry. 1963;8(3):263-268. doi:10.1001/archpsyc.1963.01720090051005

In the Schreber case, Freud described in detail the function of paranoid delusions as a defense against the emergence of latent homosexual wishes.1 He stated in a later brief paper that the same psychopathological formula applies to women patients.2 Several contributors to the literature of recent years have questioned the applicability of the Schreber formula to women Patients.3-5 This clinical presentation will question it further.

In addition, this paper discusses (1) some aspects of the psychodynamics of projectivedelusional-paranoid illness, (2) a method of therapeutic management for this illness, and (3) a particular research technique, elimination of variables.

Technique of Study  One step in rigorous research methodology is the relection or elimination of variables. Much clinical investigation is hampered by the difficulty, often even the impossibility, in achieving some measure of control over the infinite factors in the lives of patient subjects. The conscientious clinical

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