Book Review

THE BOOK CLUB

of

THE BRITISH PSYCHO-ANALYTICAL SOCIETY

AUTUMN 1998 LIST

Joseph H Berke, Stella Pierides, Andrea Sabbadini & Stanley Schneider (EDs) EVEN PARANOIDS HAVE ENEMIES. NEW PERSPECTIVES ON PARANOIA AND PERSECUTION Routledge 1998 pp. 233

This interesting and illuminating book addresses the vital social and psychological issues of prejudice, persecution and paranoia as they exist in individuals, organisations and groups. The title of this book "Even Paranoids Have Enemies" is apparently the reply Golda Meir is said to have made to Henry Kissinger who, during the 1973 Sinai Talks, accused her of being paranoid for hesitating to grant further concessions to the Arabs. Meir's reply pointed to the fact that, even if she were paranoid, this would riot alter the real situation in which she found herself -namely, that she and her country had enemies. Paranoia is no protection from persecution, nor is persecution immunisation against paranoia. The title of this book highlights the complex and ambiguous relationship between the internal and external factors involved in paranoia and persecution.
The editors have expanded the application of the term paranoid from the confines of clinical practice into societal issues. The whole spectrum covered by the word paranoia is familiar. We are all aware of, and able to recognise, paranoid phenomena in ourselves, others, society, history kind culture and distinguish them from the extremes of unease with the world. What is not often clearly discernible is the extent to which paranoid ideas and behaviour are connected to, or are the result of external persecutory processes. The book discusses the issue of differentiating between a paranoia that is the result of ill conceived thinking and it paranoia which is the result or processes going on outside of one's mind and out of our control. Segal (1994) in "Paranoia: New Psychoanalytic Perspectives" states that a certain degree of paranoia is desirable as it is a basis for discrimination. when we let a new experience touch us we acknowledge that it tray be good or bad which enable us to anticipate danger. This issue of differentiating actual from imagined events his been crucial to psychoanalytical theory and practice from its inception with particular reference to the issue of physical abuse in childhood in the memory of patients. Such controversy, which may not find a comfortable resolution, is, of course. crucially related to the themes of paranoia and persecution under consideration.

The book is divided into three parts, the first part is further subdivided into five chapters which emphasise how persecutory phenomena develop and are experienced, how individuals face the pain of being threatened or attacked by internal objects and how they attempt to protect themselves from them. The first three chapters are by psychoanalysts; Saloman Resnik working in Paris provides a review of the history of the concept of paranoia and moves on to provide a lucid and detailed analytic account of his work with four of his severely paranoid schizophrenic patients.
Andrea Sabbadini movingly describes his work with refugees who have undergone severe persecution and torture in their countries of origin. He looks at these patients predicament from the perspective of their traumatic experiences of permanent loss, which he contrast to the fundamental impermanence of their condition as refugees and argues for the centrality of mourning as part of the therapeutic process.

Ilanny Kogan working in Israel provides an original account of the Nazi genocide by focusing on the effect of survivor offspring, thus introducing a multigenerational perspective to our understanding of the mechanisms of persecution and paranoia. She believes that the mechanism of identification with either perpetrator or victim is of crucial importance and is repeated in the transference situation with the analyst, creating a "psychic hole" in the reality of these children which then becomes the source of persecutory anxieties and fantasies, often revolving around themes of death and survival.
Part two consists of four chapters, two of which I will mention. written by psychoanalysts that relate to the social and institutional aspects of paranoia and persecution; Otto Kernberg analyses from a theoretical perspective tile psychoanalytical contribution to our understanding of' the paranoia-genesis in institutions. He describes how severe persecutory and paranoid behaviour develops in groups and organisations and how bureaucracies and ideologies are the breeding ground for aggression, which is the root cause for severe narcissism and paranoia.

Hinshelwood observes that it is only within social groups that paranoia and persecution can exist; in small groups the destructive forces tend to take place within the grouping itself, in large groups, however, destructiveness is directed outwards towards another grouping.

Part three, consisting of five chapters, of which I mention three, considers large-scale cultural and political forces, which may induce paranoia or directly embody danger. Calvin Heron, in a very humane account, traces the development of his fear of the white police from the point when he first became aware of their cruising his neighbourhood in Chattanooga, Tennessee, to his being set up to become a drug informer by the police. In his personal experience, the white police have existed and continue to exist to persecute people for being black. He cites the pervasive image of the crimino-genic black man as rapist, thief, drug dealer, murderer and muses that the police act to protect white civilisation from "spoiling" blacks.

Hisako Watinabe points out that the whole educational, vocational and military edifice in Japan has served to grind people down, in order to fit them as cogs into a well oiled super efficient engine. This is Japan Inc., a state that maintains a sophisticated tightly knit system of control over its citizens. Any deviation from the norm is punished by shaming and ostracism.