The delusion he nurses usually takes the form of a persecution complex. The patient is convinced that others are out to hurt him or to interfere with his wife.
A woman may develop the delusion, for example, that others are trying to poison her or to control her thoughts by special waves from another world.
A man or a woman may see himself as a new religious savior and his viewpoint may color all his attitudes towards his associates.
Since the patient shows little additional mental deterioration he often develops clear and logical plans for warding off the persecutions or affronts of others.
Such a plan may even involve a decision to kill his “enemy” which indicates the danger of such delusions.
The patient suffers from physical symptoms that have no organic bases e.g. there can be anesthetic (loss of sensitivity) in some parts of the body with the patient being unable to feel pain or a sensation in that part. Hysterical blindness, deafness, convulsion, inability to talk, etc. are examples of conversion symptoms.
Phobia or Phobic Reactions
Phobias are unwarranted fear: a person with a phobia realizes his fear is groundless but is still unable to rid himself of it.
A girl, for example, who has a panic reaction when a feather comes out of a pillow, may recognize this as an irrational fear, that is, as a phobia, but still not be able to rid herself of the intense emotional reaction to feathers.
A person with a phobic disorder often feels that he is compelled to think or act in a certain manner “against his will”, as the layman might say.
All of us are familiar with the more common phobias – claustrophobia, the fear of confined spaces; agoraphobia, the fear of open spaces; mysophobia, the fear of contamination; acrophobia, the fear of high places, and so on.
A person may also develop phobias about blood, germs, animals, and an almost endless variety of other things.
In phobic reactions, the person has learned to use fear of specific objects or situations as a shield to prevent or avoid anxiety-producing situations.
The object that terrorizes the phobic may bear only a symbolic relationship to the object or situation that originally produced anxiety.
The adult who has a child who was attacked by a bulldog may now be terrorized by all kinds and sizes of dogs, cats, furry animals, and even birds and fur pieces.
Thunder attacks in an open field may produce agoraphobia. This shift of fear reaction from one stimulus object to another is one example of displacement. In this case, the displacement may be due to simple generalization or irradiation of the original fear-evoking stimulus.
What the person consciously fears depends on the form and direction of the displacement and these are determined by the person’s psychological needs.
The highly moral woman’s morbid fear of syphilis may serve to satisfy her need to avoid situations in which she might give vent to unacceptable impulses.
The foregoing example illustrates another common aspect of phobic reactions. The source of danger may be internal as well as external.
What is “dangerous” in a given situation may be the phobic own impulse or desire in response to a specific stimulus or its symbolic surrogate-an unconscious desire or impulse that he has repressed because it is unacceptable to him.
Thus a person’s abnormal fear of knives may represent a repressed urge to commit suicide.
Patients with obsessive-compulsive reactions seem to be forced against their wishes to think about something (obsession) or to engage in unwanted action (compulsion). They usually recognize the irrationality of their action but feel they cannot help themselves.
The central characteristic of obsessive-compulsive reaction is a persistent repetition of an unwanted and often symbolic thought or act. Obsessions are characterized, by the persistent recurrence of certain undesired and disquieting thoughts.
Constant worry about death or finances, for example, may become an obsession. When an obsession becomes strong that it begins to interfere with a person with a person’s work, study, or rest, then it is abnormal.
Neurotic depression reactions may range from mild to extremely severe. The latter is usually defined, as psychotic while the former is neurotic.
The symptom of both types includes dejection, sadness, discouragement, and feelings of worthlessness and guilt.
Personality disorders are characterized by a general failure to acquire effective habits of adjustment and adequate social relationships.
Instead of limiting suffering to internal struggles and conflicts, the individual seems to display in addition, a developmental ineffectiveness in dealing with the environment.
Such persons display a lifelong pattern of disturbed social behavior. There are varieties of personality disorders. They include the following:
A person with this personality characteristically behaves toward others with suspiciousness, envy, jealousy, and stubbornness.
This personality shows an extensive inability to deal with interpersonal relations and it is expressed in one of these three patterns:
This involves helplessness, indecisiveness, and the tendency to instantly manipulate relationships with others so that the person would take care of or give emotional support or direction.
This personality shows continuing hostility not so much in direct opposition but in passive indirect ways such as stubbornness, procrastination, and indirect distinctions.
The aggressive personality typically reacts to frustrating situations with irritability, temporary tantrums, and distinctive behavior.
Psychopaths or Sociopath Personality
Persons with antisocial patterns usually in continuous social and legal trouble are referred to as psychopaths or sociopaths.
They seem callous and concerned only with their immediate satisfaction. They are often said to be lacking in conscience. Always on the wrong side of the law: Eg the thugs and people with criminal intentions.
This is the state of being unable to free oneself from harmful habits, especially taking drugs or narcotics.
Addiction to drugs and alcohol is also classified psychiatrically under the general category of personality disorders, specifically within the group of sociopathic disturbance.
The various forms of hysterical reactions just described; like other neurotic behavior described earlier, represent attempts by the individual to handle his conflicts.
Why one person will handle his problem by developing amnesia, another fugue, and another dissociation, is difficult to answer specifically.
In general, one may say that the neurotic symptoms a person develops have been evolving along with his other characteristics throughout his entire life.