Persecutors in Paranoid Delusions in Psychosis

Persecutors are like the imaginary monsters in the play of ordinary children.

Posted Oct 12, 2019

Real life experiences of adversity such as physical and/or sexual abuse, neglect, bullying, and foster home placement are highly correlated with an increased risk of psychosis in adult life.  Although a real abuser may have contributed to the onset of the psychosis, psychotic persons often attribute their misfortune to a person or entity others regard as delusional.   For example, a 19 year-old man heard a voice that sounded like a computer simulation of a woman’s voice.   He named the voice “Computer Girl”.   He believed that “Computer Girl” could read his mind and repeat his thoughts verbatim.  He believed “Computer Girl” was spreading rumors about him at school, which caused other students to reject him.  His parent's divorce when he was 8 years-old was traumatic to him, but he did not identify other adverse events in his childhood, and he considered his mother a loving and attentive person.  Instead of believing that his interpersonal difficulties in school resulted from his life-long shyness and anxiety about people (an internal origin of suffering), he believed that his suffering was being actively orchestrated by a person outside the self.  Persons experiencing psychosis who have beliefs about delusional persecutors commonly believe that their suffering does not arise psychologically from within the self, as a legacy of real past abuse disguised in the persona of the delusional abuser, or from some other internal cause.  Rather they believe their suffering is imposed from outside the self by a persecutor, who others consider delusional (e.g.; “Computer Girl”) who plays an ongoing role in the person’s day-to-day life.  Psychological persecutors may take the form of real people, living or dead, imagined people, voices, spirit entities, organizations, and machines. 

Typical persecutors in the United States include the FBI, the CIA, vaguely-specified “government” groups, family members, relatives, neighbors, and voices who threaten the person. At a recent conference in Japan, I was told that persons in that country suffering from psychosis often name “foreigners” as persecutors.  

Melanie Klein was the first psychoanalyst to adopt the psychoanalytic technique to work with children. Her experience with children provided background for a psychological understanding of persecutory delusions in adults. She was a contemporary of Sigmund Freud and extended his psychoanalytic ideas and techniques to a very early period of psychological development. 

Instead of asking patients to lie down on a couch, as was the practice with adult analysands, Klein invented play therapy better suited to young children. She invited children brought to her for consultation to play with the toys she kept in her office. The stories and themes that emerged in play reflected the unconscious fantasies of her child patients. 

As anyone who has spent time with young children knows, the narratives that emerge in their play are often dramatic, even violent at times. In a typical scene in play, a child might invite an adult to assume the role of a “monster” or “bad guy” over whom the child reigns victorious as the story unfolds. At times, a child may commandeer the role of the “monster” and enjoy terrorizing the adult. As the psychologist Piaget once observed, play is the child’s work—children use play to work through their fears by casting their anxieties in the form of stories that express and help to regulate their mental lives. 

As adults adept at such play know, skill is required to deliver a performance optimally satisfying to the child. If the adult plays a monster vanquished by the child, the monster must be scary enough for the child to celebrate a significant victory, but not so scary as to really frighten the child. If the child plays the monster, the adult who plays the victim must not surrender to the monster-child too quickly. The child playing the monster wants to be reassured of his or her magical powers by seeing the victim go down in flames, slowly enough to savor. 

To make the scene convincing and emotionally satisfying, the adult cast as the victim had best show signs of mock suffering at the hands of the monster-child, with moans of protest or pain, perhaps ending in a feigned collapse or pretend death to mark the child’s victory. In the play of ordinary children, the imagined monster is the developmental prototype for the persecutor that emerges later in life in psychosis. 

In some storylines, the child vanquishes the persecutor, which alleviates the child’s fears. In other storylines, the child identifies with the persecutor and becomes the fearsome monster, in which case someone else is the hapless victim of the persecutor rather than the child. Psychotic adults commonly get stuck in the role of the victim of the persecutor without any way to play out the persecution to a satisfactory end, as happens in childhood play. 

For example, I once worked with a man in psychotherapy who believed that everyone at his place of employment was in on a plot to one day have him arrested and imprisoned for what in truth was his failure to follow a trivial office guideline, a breach he committed at the behest of a supervisor. He believed his deviation from protocol to be a felony for which he would one day be incarcerated. In a psychotic version of child’s play meant to regulate anxiety, he had invited his workmates to play the role of persecutors in a drama that had no satisfactory end, because the misdemeanor he believed he had committed was a proxy for more serious crimes of thought and feeling for which he unconsciously felt guilty, crimes that deserved punishment

Or, the psychotic adult who has identified with the persecutor-monster may suffer delusional guilt, convinced that they have savaged the world in some monstrous rampage. For example, a psychotic man who believed he had omnipotent powers, as do children playing a glorified role, once told me of the guilt he felt for not preventing the deaths of innocent people.

In the case of ordinary children and delusions of persecution, the mind splits into paired mental representations of the victim and the persecutor. In my next blog, I will describe Klein’s account of the developmental origins of this splitting in Klein's concept of the paranoid-schizoid position.     

References

Klein, M. (1946). Notes on Some Schizoid Mechanisms. International Journal of Psychoanalysis, 27, 99-110.