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Berkeley-Hill, O.A. (1922). A Case of Paranoid Dissociation. Psychoanal. Rev., 9(1):1-27.

(1922). Psychoanalytic Review, 9(1):1-27

A Case of Paranoid Dissociation

Owen A. R. Berkeley-Hill, M.A., M.D.

Case of A. B., European, male, aged 30. The patient was admitted on September II, 1920. From the first he showed marked symptoms of paranoid dissociation, and until May, 1921, the case ran a chronic pernicious course. During this period the patient strove desperately to understand himself, but it was not until he consented to undergo psychoanalytic treatment that any change for the better could be observed in the pernicious tendency of his malady. After one month's analysis he began to show that he had some insight into his mental condition, and that he was beginning to realize to how great extent the repression of homosexual, incestuous, and narcissistic cravings had been the etiological factor of his illness. Also he soon began to appreciate the fact that the physician in charge of his case was able and willing to make every effort to understand the nature of the struggle through which he had gone.

During the time he has been in the asylum the patient has written over thirty “letters” to the superintendent, some of them running to over forty pages of foolscap, and it is from these remarkable documents that a portion of the following notes are taken. The letters “L” and “X” will be considered first as they are, so to speak, biographies and deal with the patient's life up to the time when he came to the asylum.

The patient is the fourth child of English parents. He was born in N.

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