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Bernstein, A. (1976). Problems in Treating Paranoia: A Case Illustration. Mod. Psychoanal., 1(2):191-200.

(1976). Modern Psychoanalysis, 1(2):191-200

Problems in Treating Paranoia: A Case Illustration

Arnold Bernstein

Reading the account of the treatment of a paranoid schizophrenic man reported by Lewis Ross, immediately brought to my mind a particularly difficult case I had treated a number of years ago. The parallels with respect to the history, psychodynamics and even the form in which their resistance were manifested in the treatment situation are too striking to be merely coincidental.

The analysand I treated was also a man of about thirty-five who manifested evidences of a narcissistic disorder complicated by the presence of paranoia and I am in the fortunate position, more than ten years later, to recover my experience with him, through the means of a tape recording, and to share them verbatim, for comparative and didactic purposes.

While Ross concentrated in his presentation upon the transference and resistance aspects of the analysand, I have shifted my attention to an examination of the countertransference and counterresistance problems faced by the analyst in his efforts to generate progress in the treatment.

It will become immediately apparent that the procedures I employed departed considerably from the paradigm of classical psychoanalysis. I felt obliged to try these, after many months of effort to implement the analysis through traditional means proved fruitless, and the client's paranoia took the form of a full blown delusional system with me as its central character.

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