Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.

Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA
BY ROBERT C. BAK, M.D. (NEW YORK)

Until the works of Ferenczi (I) and Freud gave us essential

insight into paranoia, Kraepelin's point of view dominated.
Kraepelin gave the classic description, delineating the symptom
complex, and the bulk of the ensuing research attempted to
isolate paranoia as a disease entity. With the separation of
the paraphrenias from dementia pr<ecox, the sole two remaining
clinical forms of sensitive paranoia were the paranoia of jeal-
ousy and litigious paranoia. Most investigators held that the
psychosis was characterogenic, originating in a specific paranoid
constitution, which manifested itself in certain personality
traits. The psychosis was supposed to develop under the influ-
ence of certain experiences as an exaggeration of the underlying
constitution. Among the precipitating experiences were par-
ticularly emphasized injuries to the ego, such as slights, frus-
trated ambitions, injustices.
Freud (2) emerged with his brilliant genetic theory of para-
noia, demonstrated by means of Schreber's autobiography.
Essentially this theory states that in paranoia the ego sets up
defenses against homosexuality, from which there results a
regression from sublimated homosexuality to narcissism. The
libido is withdrawn from the loved person, the homosexual
trend ('I love him') is denied and turned into its opposite ('I
hate him'), and the hatred is then projected ('because he per-
secutes me'). Projection undoes the withdrawal. The subse-
quent formation of delusions is a work of reconstruction, which
carries the libido back to the object, but with a negative prefix.
This ingenious theory seemed applicable to the various clinical
forms of paranoia.
Clinical psychiatry took over elements of Freud's theory but
in an attenuated form. Schulte (3) developed the 'we' theory
of paranoia, translating the idea of reconstruction into Gestalt

Read before the New York Psychoanalytic Society on June 19, 1945.
285
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

286 ROBERT C. BAK

terminology. He stated that the paranoiac regains contact with

the group in his delusional relations, thus 'closing the wound'
of isolation. Cameron (4) recently, and similarly, attributed
paranoid delusions to a defective development of role-taking
and a relative inadequacy in social perspectives. In place of
projection and reconstruction he introduced the concept of
'pseudo-community', organized by the paranoiac's reaction to
his own preoccupations out of fragments of the social behavior
of others. Mayer-Gross (5), paraphrasing the idea of libido
withdrawal, derived persecutory delusions from the 'cooling
of sympathetic emotions', which are then projected on the out-
side world. Kretschmer (6) in his study of the 'sensitive
Beziehungswahn' stressed the sexual ethical conflict as the main
factor, and derived the paranoid reaction from the interplay
of character and environment: a weak sexual endowment is
manifested in an 'uncertainty of instinctual drives', while
psychical trauma and exhaustion serve as precipitating factors.
In psychoanalytic circles at the time of Freud's paper on
Schreber, interest was mainly focused on libidinal trends and
the defense against them; hence, the discovery of the role of
homosexuality was of enormous significance for an under-
standing of paranoia. To this emphasis, perhaps, may be due
the inadequate answer to the main and specific question,
namely, why the beloved person should be transformed into
a persecutor.
Starcke (7) and van Ophuijsen (8) attempted to explain this
particular vicissitude of the homosexual trend. In their valu-
able contributions, still dominated by the reigning interest in
phases of libido development, they upheld the view that the
original persecutor is the scybalum, and that the delusions
of persecution are derived mainly by elaboration and symboli-
zations of anal sensations. But this addition to the homosexual
aspect did not provide sufficient clarification.
Another factor had to be considered. The enormous role
played by aggression in paranoia could not elude Freud very
long (9). In the Ego and the Id, discussing the duality of
instincts, he stated that the paranoiac does not directly trans-
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA

form the personal relationship from love into hate. From the
start there is present an ambivalence; the transformation takes
place by a reactive shifting of cathexis. The quantity of energy
withdrawn from erotic trends is added to the hostile impulses.
This new important point clarified the second defensive step
of the ego in paranoia. The first step is the withdrawal of love
as a defense against the sexual wish. Reenforcement of hostility
by the liberated energy constitutes the second step, and this
second step accounts for the hatred felt for the previously loved
person. The way in which this hatred is rationalized and
nourished by interpretations of other persons' unconscious
wishes was illuminated earlier by Freud in the article, Certain
Neurotic Mechanisms in Jealousy, Paranoia and Homo-
sexuality (IO). But hatred and hostility are not by any means
paranoia. Therefore it seemed that somewhere in the third
step of Freud's scheme, that of the projection of the aggression,
lay the secret of persecutory delusional formation.
Klein (II), who refers also to Roheirri's (I2) findings, believes
that the fixation point of paranoia lies in the period of maximal
sadism, during which the mother's body is attacked by means
of dangerous and poisonous excreta. The delusions of per-
secution are supposed to arise from the anxiety attached to
these attacks.
Nunberg j r j ] in his much quoted paper, Homosexuality,
Magic and Aggression, gives us a profound hint in a somewhat
different direction. He describes a particular type of homo-
sexual, in whom the sexual act satisfies simultaneously both
aggressive and libidinal impulses. In this type the ego ideal
is projected onto the love object, which then receives sadistic
treatment in the sexual act. In paranoia the sadism is turned
largely into its opposite, into masochism. This paper, follow-
ing a somewhat similar line of thought, will corroborate
Nunberg's view.
The patient, a man of thirty-seven, began his analysis after
an acute anxiety state with depression, for which he had spent
four weeks in a hospital. He improved considerably but felt
the need of further help to get at the cause of his acute break-
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

288 ROBERT C. BAK

down. A few weeks prior to his hospitalization, he had become

apprehensive about his relations with his fiancee. As the wed-
ding day approached, although he was intensely desirous of
being married, his anxiety mounted. He started to examine
his penis and to worry about his ordinarily well-functioning
potency. With increasing panic he observed a slackening of
his mental faculties. He felt as if a catastrophe impended, as
if he were sitting on a volcano whose eruption would sweep
him away. At this point he asked for psychiatric help and was
hospitalized.
In the hospital he was preoccupied mainly with three topics.
In the first place he thought that he had lost his mind, which
seemed proved to him by his own difficulty in thinking and by
his suicidal impulses. Second, he thought he was incapable of
getting married; this it was which made him think of suicide
as the only way of avoiding the prospect of remaining a bachelor
and leading 'a lonely, horrid, hideous existence'. Third, he
feared his nervous breakdown would be interpreted by people
to be the result of some sexual aberration, and that they might
spread gossip about him in this connection. This was his first
definitely paranoid idea, which later turned out to be related
to childhood experiences of 'being buggered' (anal intercourse).
Early in his treatment it became evident that the patient's
main difficulty lay in his relation to men. Among women he
was successful, especially in sexual relations, yet he had not
developed any emotional tie up to the time of his engagement.
His life was void of male friendships. His contacts were mainly
restricted to the professional field, but even these relations
proved to be very fragile. Previous to and during treatment,
he got into states of anxiety which ran according to a more
or less similar pattern. In most instances, he felt slighted by
either of his older superiors, or by one of his rivals with
whom he had had pleasant relations prior to the conflict; or
he felt as though some injustice was inflicted upon him. A
variation of these feelings occurred when he tried to get out of
a situation in which he felt some obligation. The feeling that
something was expected of him was experienced as something
 Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA 289

forced upon him. He was afraid he might be taken advantage

of, 'used' and 'reduced to a mere tool'.
During a short absence from treatment he went through a
typical episode which he communicated to me in a letter that
gives insight into the structure and course of such a conflict.
'I am writing you regarding the recurrence of my troubles.
Their cause is concerned with some of my personal relation-
ships which are in reality getting out of hand. 1 realize that
1 am abnormally conscious of and concerned with these mat-
ters. But, this consciousness and concern is part of the cycle
of wanting good personal relations, of being conscious of their
status, of anxiety about them and of deterioration in them,
partly because of the concern.
'A month ago, 1 moved to another building. The people
were unfriendly and made no welcome and while 1 made some
efforts to cultivate several members, I was not very successful.
As a result of a strained feeling I refused to attend two of
their private parties and that seems to have facilitated their
resentment (which I feel, whether it exists or not). And during
the course of a drinking bout indulged in by one of them,
some quite serious indignities were inflicted on all members
including me.
'The indignities as such are a minor problem. However,
other reactions are much more disturbing and are making
me seriously consider drastic measures. The main reactions
are: sleeplessness, marked tension and much the same feeling
of "sitting on a volcano" which I have described to you. In
addition, I feel ill at ease with people, noncommunicative,
and the anxiety, which is apparently detectable, spoils rela-
tionships with people with whom I had previously made a
considerable favorable contact.
'The fear that I feel has been tremendous too, and is
probably greater than I've experienced for eighteen months.
As far as I can analyze it, the fear comes from the idea that
I'll eventually have to batter and beat one or more people-
or be battered and beatenJ Some of it is from the feeling
that I'll get into a physical combat and will be disgraced and
"talked about" by other members of the community-dis-
1 Italics mine.
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

ROBERT C. BAK

graced because of "starting a fight" (if I win), or because of

getting a licking (if I lose). Some of these aspects have tor-
tured me day and night for a week and that means that it
has been more distressing than any situation since before I
stopped seeing you regularly. If one feature is most disturb-
ing, it is the fear which may be noticeable to others and thus
tends (because of that) to cause more panic.
'At times like last night, I become almost panic-stricken
when my mind "runs away" with all sorts of paranoid ideas.
It would not be possible to name all of these, but most of
them have to do with suspicion of conspiracies against me. I
am moderately sure (during saner moments) that there are
no conspiracies other than perhaps some small talk between
the two people whom I dislike and distrust the most. I seri-
ously suspect them of it, however, whether or not it is true.'
The scene of 'indignities' referred to in the letter were truly
remarkable. The patient remained seated, motionless while a
drunken, boisterous person spilled beer around the room, chal-
lenging him to fight, spilling beer on him, making him soaking
wet. He could neither protest nor leave. He sat there in
a kind of paralyzed fascination, waiting for the assault. Only
later was he overwhelmed by a desire to 'split that man's head,
and ruining the reputation of the whole place in case he was
not rehabilitated'.
The conflict with one individual tended to include the group
of which the individual was a member (Jews, Catholics, or
various nationalities). When precipitated by the transference,
as a 'transitive transference' reaction (I 4) only the conflict with
the group became conscious. Thus, at one time the patient
felt particularly slighted by taxi drivers. They were impolite,
they cut in front of him, bumped into his car, pushed him out
of their way; furthermore, sailors spat in front of him, salesmen
'threw the change' in his face. He was fairly convinced in
these phases that these were not chance happenings, but that
they were directed against him. The reaction to these experi-
ences was impulses of violence 'against the inferior mob or
race', anxiety about them, and the desire to flee. He was on
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA

the way to developing the paranoiac pattern of the 'haunted

man' whose fate is fleeing from one city to another.
Further clinical details which confirm the diagnosis of para-
noia are omitted: systematization, excessive vulnerability,
traces of megalomania, marked tendency to projection, ideas
of reference and persecution, and litigious fantasies.
There is in the patient's history an organic factor that shaped
his entire future. He was born with hypospadias. This seems
to have remained unnoticed until the age of five, when he
entered school. He became conspicuous through his urination:
'He can piss through a nut-hole', the boys teased him. His first
name was distorted into a nickname similar to one of the vulgar
expressions for the penis. They also changed his name into that
of a woman. The vague notion that something was wrong
became certainty when his mother said to him from an adjoin-
ing room, 'You are not quite like other boys', but avoided
further explanation. The fact that she did not tell him made
her appear guilty. At about the same age he agreed with his
younger brother to. mutual fellatio, which he performed.
When the brother's turn came, he refused. This, he reasoned,
occurred because his penis was unattractive. His enuresis was
ridiculed by his brother and his parents. The ardent desire
to be 'one of the boys', and his ostracism from the group became
early realities. His envy of other boys and his hostility against
them were vividly remembered. Later he heard that he was
taken by his mother to several doctors, and that they might
have operated on him.
He frequently examined his penis, found some scars on it,
and thought they might have been caused by circumcision or
by some other kind of operation. Up to an adult age, he could
not decide whether the missing part of his foreskin was con-
genital or surgical.
A remarkable fantasy at the age of nine relates to this prob-
lem. It is probably a retrograde projection. In the fantasy
he is not a child of his parents but the product of an experi-
ment, the result of some chemical concoction. He thought he
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).
ROBERT C. BAK

would have to go through further experiments and ordeals and

probably come to a terrible end.
During puberty he became concerned with the relative
enlargement of the glans penis and thought this might cause
difficulty in withdrawing his penis from the vagina. From his
first sexual intercourse with a prostitute he contracted gonor-
rhcea requiring long and painful treatments. The idea of
injury done by women to the penis was thus confirmed. The
evil role of women was represented in the dream:
'I was incarcerated in a sort of prison. A great many
people were making efforts to get me out. I finally got out.
You were standing in the background.'
Before the dream he had been pondering whether he should
give up his affair with his current girl, a divorcee. The asso-
ciations led through the links carnis, flesh, vulva to a memory
which he was hesitant about confiding. 'It's too base and cruel',
he said. As a boy of four or five he was playing with another
child when they saw two dogs stuck together in coitus. They
did not know quite what it was, and they chased the dogs with
sticks toward a barbed-wire fence. The dogs became entangled
in the barbed wire and hung suspended on the fence, their
skins torn by the wire. He then got the vague idea that the
dog's penis was cut off and that the bitch ran away with the
male's penis inside of her.
Why he should discontinue his friendship with the divorcee
became clear only later. Separation in time from her husband
was not sufficient. He could not escape the feeling that the
penis of the former husband was left in the wife's vagina. He
had been told by his mother as a youngster that only a first
marriage counts in heaven. He then visualized the second
husband, roaming alone, lonely, having no place anywhere.
The notion persisted in the unconscious that woman inflicts
injury on the man's penis, can tear it off and harbor it in the
vagina. In the act of marriage not only his name but the man's
penis is bestowed. The mother possesses the father's penis, and
has power to destroy it.
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA 293

The mother's treatment of the boy was total rejection. He

felt he had been reared without any love at all. He could not
recall any token of affection from his mother, no memory of
caressing or tenderness. By contrast, the remembrance of a
maid clasping him to her bosom, and the attendant feeling of
her softness and warmth stood out in relief in his memory.
The mother was no protection for him from his father; they
presented a common front and participated in punishing the
child. 'Wait until father comes home' was her repetitive
admonition. Being the eldest, he saw the arrival of six chil-
dren, one every second year.
Whatever the 'constitutional predisposition', the hypospadias
more than paved the way to a preponderantly negative cedipus.
The feminine component of his bisexuality was supplemented
by his mother's harsh treatment, and by his fantasy of her
threatening image. The convergence of these factors resulted
in an identification with the castrating parent, the aggressive.
phallic mother.
He turned to his father to be loved and appreciated by him.
The father was a withdrawn, cold, strict, hard-working farmer.
It was impossible to get in his good graces. The patient remem-
bered often, with tears, how unappreciative his father was of
him. As a child of six. he was helping his father gather hay.
He worked diligently the whole day, and driving home from
the fields he asked his father if his work that day was worth
fifty cents, and if so whether he could have it. The father
ignored him completely. He pleaded, and finally in despera-
tion asked if his work was worth at least a nickel. His father
brushed him off as before. The emotional cathexis of these
memories was tremendous. Not being loved, and particularly
not having had any physical contact as a token of love, caused
him a great deal of suffering. He felt very much moved when
a neighbor's son put his arms around him. He felt a strong
desire to go hand in hand with his father and for many years
resented that the father did not play with him and did not
teach him to fight. 'Together with father' he would have been
strong, powerful, and a member of the male group. But
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

294 ROBERT C. BAX.

instead of the close relationship and gentle physical contact

he was beaten by the father for the slightest mischief. If
he got into a fight with his brothers, which they started, he
was nevertheless beaten by his father, being told he was older
and should know better. Sometimes he waited for hours in
a cold sweat for the threatened beating. The beatings, with
a stick, were ruthlessly sadistic. He was always found to be
in the wrong and was never exonerated. He fantasied though,
with great clarity, picking up a shovel, or getting hold of the
stick and attacking his father. After one beating he vowed that
when he grew up he would beat up his father.
Such powerful aggression in this helpless boy, who craved
for love and physical affection, intensified his ambivalence.
One part of the aggression remained in fantasy, and developed
into manifold sadistic reveries. He daydreamed, for instance,
that women were stationed in stalls like racing horses. Every
woman was set and alert, bent forward on her toes in the stall.
The patient, the boss, was beating them using his penis as
a rod. He remembered a beating in the fields, his father start-
ing back for the house, his being left behind overwhelmed
by rage and sorrow, the idea flashing through his mind, 'Now
he is going back to the house to screw mother'. The patient
advanced the theory that his father 'was taking something out
on him' at that time. There must have been a 'lack of sexual
synchronization between my parents'. He recalled vaguely that
his father had some sort of 'nervous breakdown' about that
time. We have noted that 'nervous breakdown' was linked
in the patient's mind to sexual (anal) aberration. It becomes
obvious that in the unconscious the experience of being beaten
by the father became libidinized into being sexually abused
by him. The yearning for affection was regressively debased
into masochistic degradation. In the masochistic act, part of
the sadism took a circuitous path to gratification. During
prostatic treatment the patient dreamed:
'I am going to the doctor for treatment. He looks like
a debonair Frenchman, with a goatee. He could be a psychia-
trist. The doctor starts to finger my anus, then it seems to
 Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA 295

change to intercourse. Finally I find myself dancing around

in the room like a witch with a broomstick in my arse.'
To get hold of the father's stick, to castrate him, is achieved
when anally he incorporates the father's penis, playing the part
of the castrating woman, ultimately the role of the phallic
• mother. The patient's pugnacity and his lifelong preoccupa-
tion with preparing himself for physical fights by 'jiu-jitsu'
lessons and 'commando training' also become understandable.
The constellation in which the paranoid reaction originates,
as we know from Freud, is homosexuality. One of the promi-
nent strivings in our patient had been the ambition to be recog-
nized, appreciated and loved by important, outstanding men.
The infantile desire to gain the father's recognition was never
abandoned. Before the acute phase of his illness he dreamed
that he went home, resolved the differences with his father,
and at the final reconciliation they both wept. In his day-
dreams he became the favorite son as a reward for his successes
and achievements. Fulfilment of the ego ideal, and being loved
according to this ideal, is a sublimation which binds large
quantities of homosexual and narcissistic libido. We know,
however, that relationships on this basis prove to be very fragile,
undermined as they are by strong ambivalence.
In such an unstable psychological structure economic changes
in the ego or in the id result in a threat to the ego, and put
the ego's defenses in action. An increase in homosexual libido
may be due to biological or to situational factors (seduction,
frustration); however, a greater role seems to be played in the
further development by injuries inflicted directly upon the
ego. Slights, frustrations, and disappointments reverse subli-
mations and liberate homosexual libido (I5): 'You are not a
man. You should be treated as a woman.' The failure of
sublimation and the direct threat of castration lead to a retreat
from phallic activity and induce a masochistic regression
(homosexuality) where, according to the phallic and anal-
sadistic organization, the desires to be castrated, beaten, and
anally abused are reactivated.
A dream illustrates this point:
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

296 ROBERT C. BAK

'Hitler, Mussolini, and Hirohito are about to be executed,

but Hirohito cannot be found. I offer to replace him. The
execution looks like a decapitation. I put my head on the
scaffold; they separate the scalp from my skull, and push a
knife into the back of my head.'
Through masochistic identification he could become the father,
the powerful and loved enemy. The price he had to pay was
castration (circumcision and anal intercourse).
This regression from sublimated homosexuality to masochism
is an essential feature of the paranoid reaction, and constitutes
the first defensive action of the ego. The withdrawal of love
that follows is the second step in the defense through which
the ego protects itself from the masochistic threat coming from
the id, Alienation, feelings of estrangement, detachment from
the previously beloved person, and free floating anxiety are the
clinical corollaries of this stage. The third step is an increase
of hostility, hatred of the love object, and the appearance of
sadistic fantasies. In making the transition from love to hate
the ego makes use of the displaceable energies contained in
the originally ambivalent attitude. Sadism then fulfils several
functions: the ego succeeds in turning passivity into activity
and exploiting it as a countercathexis against masochism; fur-
thermore, it reenforces the ego feelings (male attitude), and
represents a recathexis of phallic activity. At this point
mastery of the increased sadism is the primary task of the
ego. That it fails is due to the interplay of several factors:
weakness of the ego, masochistic fixation, and castration
anxiety. The ego has to get rid of the increased tension and
of the feelings of isolation, and this it manages by project-
ing a part of the sadism. The projection of sadism then would
be the fourth step of defense. It is 'the paranoid mechanism
proper', and it is a restitution. Projection is possible partly
through the unconscious hostility of the actual and past partici-
pants and runs according to this preordained path. In the
projection of the sadism the masochism is bound to return.
The patient's preoccupation with precipitating a 'physical show-
down' (being assaulted) and its ramified delusional e1abora-
 Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).
MASOCHISM IN PARANOIA 297

tions, as being mistreated, injured, and persecuted, gratify the

original masochistic desires of castration, beating, and abuse
by the father. The delusion is a return of the repressed, and
paranoia is delusional masochism.
The ego aligns itself on the side of sadism. Masochism (id)
serves to reestablish object cathexis and to hinder further 'defu-
sion'. The antagonistic hypercathexis of the two psychic
agencies is an attempt to achieve equilibrium. Depending on
economic factors, the outcome may be flight, murder, suicide,
or subsiding of the tension and cessation of the attack. Megalo-
mania seems to be a later development when quantities of
masochistic cathexis are further withdrawn.
Omitting the individual persecutory mechanism, let us
examine briefly another characteristic feature of paranoia, that
of an expanding, generalized persecution by a group. The
answer may be found in the family constellation, perhaps more
specifically in a vicissitude of sibling rivalry. The infantile
prototype of this cohesive, hostile group may be traced in the
fused image of the parents, their 'common front', representing
the image of the phallic mother. This concept is later widened
and includes the group of siblings. In the course of develop-
ment these concepts in the ego ideal are further extended but
seem to preserve their fused character and highly ambivalent
cathexis. By regression they undergo a masochistic transforma-
tion to which can be applied Freud's (I6) formulation in a
modified version: 'My father loves me, I am the favorite, and
he beats my brothers'. The libidinal and sadistic impulse after
having undergone masochistic transformation is: 'My father
beats me; I am hated; they all want to beat me', and this maso-
chistic turn seems to correspond to reality. The love object,
the father, was the original persecutor. The family was aligned
against the patient in a 'common front'. His schoolmates ridi-
culed him. He was not accepted in fraternities, and his reli-
gious group was looked down on. Here we meet some of the
real elements in delusion to which Freud referred in one of his
last papers, Constructions in Analysis. True, to a large extent,
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

ROBERT C. BAK

the patient brought it on himself; but the paranoiac is not infre-

quently a person who has been persecuted in his past.
The sociological significance of this type of personality is
well known. Our patient also turns violently against under-
privileged minority groups. But once, when he witnessed a
scene in which a fragile, small, 1ewish-looking man was threat-
ened with beating, he suddenly felt as if he himself were .J ewish.
He identifies himself with the persecuted minority on the basis
of his history and on the basis of his masochistic propensity.
In releasing his sadism against these groups, he not only defends
himself against his own masochism, but realizes the beating
fantasy through dramatization.
To what extent have these observations general validity in
relation to paranoia? This case history is selected from a vast
number of clinical experiences in the study of paranoid psy-
choses and from the analyses of paranoid personalities. 'We
are indebted for the subtle and thorough analysis of a case
of paranoia to Ruth Mack Brunswick (I7). In addition to this
we are in possession of the full infantile history of this patient
described in Freud's(I8) inimitable way in the 'Wolf-man',
in The History of an Infantile Neurosis, and this patient's later
paranoid condition, observed by Brunswick.
The paranoia that started about twelve years after the analy-
sis with Freud centered around a hypochondriac idea. The
patient felt that his nose was swollen and disfigured by a scar
due to operations that were performed on it by a dermatologist
(who was a substitute for Freud). He felt crippled, and ruined
for life, and claimed that 'he could not go on living that way',
thereby repeating his mother's words which were related to
her abdominal illness. The injury to the nose was originally
self-inflicted and only later treated by the dermatologist.
Brunswick stated:
'The patient's failure to be satisfied by his self-castration
reveals a motive beyond the usual masochistic one of guilt,
which, regardless of the perpetrator, would be satisfied by the
act itself. The further motive is, of course, the libidinal one,
the desire for castration at the hands of the father as an ex pres-
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA 299

sion III anal-sadistic language of that father's love.' In dis-

cussing the patient's change of character, Brunswick relates
it to the 'irritable and aggressive' period of childhood. 'Behind
his tempers lay the masochistic desire for punishment at the
hands of the father; but the outward form of his character was
at that time sadistic. . . . In the present character change, the
same regression to the anal-sadistic or masochistic level was
present, but the role of the patient was passive. He was tor-
mented and abused, instead of being the tormentor.' About
the hypochondriac idea Brunswick wrote: 'The [childhood]
fantasy of being beaten on the penis was reflected in the delu-
sion of being injured on the nose by X [the dermatologist]'.
There are many more masochistic elements in the case history,
but still in the final analysis they are deprived of their due
Tole. Brunswick derives the loss of psychic equilibrium in the
patient from the flaring up of his love for the fatally ill Freud
(father). This love represents a danger of castration, the love
then is repressed and turned into hostility and has to be
projected. It is true that the sight of the fatally ill Freud stirred
up in the patient his old compassion for his father. In his child-
hood the sight of his sick father in a sanitarium became the pro-
totype for his compassion for cripples, beggars, poor, and con-
sumptive people, in whose presence he had to breathe noisily
so as not to become like them. It was one of his defenses
against identification with the castrated father.
We must add only some emphasis to Brunswick's analysis.
Love for the ill Freud (father), which had the unconscious
implication of the patient's being a 'woman', underwent regres-
sive change into being castrated and beaten. The homosexual
object choice regressed into masochistic identification. We
think that this form of regression constitutes the prerequisite
of a paranoid development, and the subsequent course in this
patient also supports this assumption. In his hypochondria
he consistently manceuvred to bring about his castration and
at the same time defended himself against it by aggressive and
litigious fantasies. This was the repetition of the sado-maso-
chistic phase of his childhood, to which he had been thrown
Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

30 0 ROBERT C. BAK

back partly because of a threat of castration. At that time he

had been a tormentor of animals and men, but, at the same
time, he indulged in fantasies of boys being beaten, and espe-
cially of being beaten on the penis. In a variation of these
fantasies, 'the Czarevitch . . . is shut up in a room (the ward-
robe) and beaten'. The Czarevitch was evidently himself. As
we know, in hypochondriac and persecutory delusions, these
fantasies find renewed expression.
A vast number of questions remains unanswered. The pri-
mary aim of this presentation has been to demonstrate the
crucial role that masochism plays in the paranoid mechanism.
In his paper, 'A Child Is Being Beaten', referring to the maso-
chistic beating fantasies, Freud wrote:
'People who harbor fantasies of this kind develop a special
sensitiveness and irritability towards anyone whom they can
put among the class of fathers. They allow themselves to be
easily offended by a person of this kind, and in that way (to
their own sorrow and cost) bring about the realization of the
imagined situation of being beaten by their father. I should
not be surprised if it were one day possible to prove that the
same fantasy is the basis of the delusional litigiousness of
paranoia.'
REFERENCES
1. FERENCZI, SANDOR: On the Part Played by Homosexuality in the Pathogenesis
of Paranoia. In Contributions to Psychoanalysis. Boston: Richard C.
Badger, 1916.
2. FREUD: Psychoanalytic Notes Upon an Autobiographical Account of a Case
of Paranoia (Dementia Paranoides), 1911. ColI. Papers, III.
3. SCHULTE, H.: Versuch einer Theorie der paranoischen Eigenbeziehung und
Wahnbildung. Psychologische Forschung, V, 1924, pp. 1-23.
4. CAMERON, N.: The Development of Paranoic Thinking. Psycho!. Rev., L,
1943, pp. 21g-233·
5. MAYER-GROSS, W.: Handbuch der Geisteshrankheiten. Spez. T. Bd. V,
pp. 303, If. Editor: Bumke. Berlin: Springer, 1932.
6. KRETSCHMER, E.: Die sensitive Beziehungsuiahn, Berlin: Springer, 1924.
7. STARCKE, A.: Die Rolle der analen und oralen Quantitiiten im Verjolgungs-
wahn und in analogen Systemgedanken. Int. Ztschr. f. Psa., XXI, 1935,
pp·5-2 2 •
8. VAN OPHUlJSEN, J. H. W.: On the Origin of the Feeling of Persecution. Int.
J. Psa., I, 1920, pp. 235- 239.
 Copyrighted Material. For use only by FieldingGraduateU. Reproduction prohibited.
Usage subject to PEP terms & conditions (see terms.pep-web.org).

MASOCHISM IN PARANOIA

9. FREUD: The Ego and the Id. London: Hogarth Press, 1927.
10. - - - : Certain Neurotic Mechanisms in Jealousy, Paranoia and Homo-
sexuality, 1922. ColI. Papers, II, pp. 232-243.
11. KLEIN, MELANIE: The Psychoanalysis of Children. London: Hogarth Press,

1937·
12. R6HEIM, GEzA: Nach dem Tode des Uroaters. Imago, IX, 1923, pp. 83-121.
13. NUNBERG, HERMANN: Homosexualitdt, Magie und Aggression. Int. Ztschr.
f. Psa., XXII, 1936, pp. 5-18.
14. HERMAN, IMRE: Die Psychoanalyse als Methode. Vienna: Int. Psa. Verlag,
1936.
15. FREUD: On Narcissism: an Introduction, 1914. Coli. Papers, IV, pp. 30-59·
16. - - - : 'A Child Is Being Beaten'. A Contribution to the Study of the
Origin of Sexual Perversions, 1919. ColI. Papers, II, pp. 172-201.
17. BRUNSWICK, RUTH MACK: A Supplement to Freud's 'History of an Infantile
Neurosis'. Int. J. Psa., IX, 1928, pp. 43g-47 6.
18. FREUD: From the History of an Infantile Neurosis (1918). ColI. Papers, III,
pp. 47 1-5 1 9.
PEP-Web Copyright

Copyright. The PEP-Web Archive is protected by United States copyright laws and international treaty provisions.
1. All copyright (electronic and other) of the text, images, and photographs of the publications appearing on PEP-Web is retained by
the original publishers of the Journals, Books, and Videos. Saving the exceptions noted below, no portion of any of the text, images,
photographs, or videos may be reproduced or stored in any form without prior permission of the Copyright owners.
2. Authorized Uses. Authorized Users may make all use of the Licensed Materials as is consistent with the Fair Use Provisions of
United States and international law. Nothing in this Agreement is intended to limit in any way whatsoever any Authorized User’s
rights under the Fair Use provisions of United States or international law to use the Licensed Materials.
3. During the term of any subscription the Licensed Materials may be used for purposes of research, education or other
non-commercial use as follows:
a. Digitally Copy. Authorized Users may download and digitally copy a reasonable portion of the Licensed Materials for their own use
only.
b. Print Copy. Authorized Users may print (one copy per user) reasonable potions of the Licensed Materials for their own use only.

Copyright Warranty. Licensor warrants that it has the right to license the rights granted under this Agreement to use Licensed
Materials, that it has obtained any and all necessary permissions from third parties to license the Licensed Materials, and that use of
the Licensed Materials by Authorized Users in accordance with the terms of this Agreement shall not infringe the copyright of any third
party. The Licensor shall indemnify and hold Licensee and Authorized Users harmless for any losses, claims, damages, awards,
penalties, or injuries incurred, including reasonable attorney's fees, which arise from any claim by any third party of an alleged
infringement of copyright or any other property right arising out of the use of the Licensed Materials by the Licensee or any Authorized
User in accordance with the terms of this Agreement. This indemnity shall survive the termination of this agreement. NO LIMITATION
OF LIABILITY SET FORTH ELSEWHERE IN THIS AGREEMENT IS APPLICABLE TO THIS INDEMNIFICATION.

Commercial reproduction. No purchaser or user shall use any portion of the contents of PEP-Web in any form of commercial
exploitation, including, but not limited to, commercial print or broadcast media, and no purchaser or user shall reproduce it as its own
any material contained herein.