The Black “Whole” of Paranoid Schizophrenia

It has been stated that paranoid schizophrenics are more cognitively able than those manifesting other forms of schizophrenia.  While this assertion may be somewhat dubious, there exists a reality that paranoid schizophrenics do think about their circumstances, instead of simply being overwhelmed and confused by their symptoms, albeit some delusional symptoms.  Given the basic delusional assumptions that paranoid schizophrenics may hold, paranoia is perhaps an understandable reaction to their symptoms.


The paranoia that certain schizophrenics display or perhaps conceal reflects a reaction to the attrbutions that form the premises of what paranoid schizophrenics believe.  It may or may not be obvious that paranoia exists as a result of a belief that something or someone perhaps incomprehensible holds power over one’s life, one’s self, one’s emotions and even one’s thoughts.  When the schizophrenic attributes intentionality to who or whatever is causing her symptoms, paranoia is an understandable reaction.


Thinking about one’s symptoms, (for example, one’s auditory hallucinations), is likely to lead to a compounding delusional system in the paranoid schizophrenic.  It is not a comforting situation to be alone with one’s non-normative experience, to hold ideas and beliefs that seemingly no one else supports, and to be afraid.  Schizophrenics feel compelled to make sense of themselves to nonpsychotic individuals.  They seek a reflection of their internal states, and, given that interpersonal behavior, implicating shared feeling, is comforting, it becomes evident that paranoid schizophrenics have little solace with regard to their existence.


This writer has asserted in the past that psychotic delusions can be combatted by the schizophrenic’s refusal to make a judgement about his hallucinations.  Consideration of the statement and postulation that “the whole if more than the sum of the parts”, reflects the reason behind a refusal to make a judgment:  a judgment about “the whole”, and it can be “a black hole”, allows for a refusal to enact gravitation toward the “reality” of what might become the paramount and constructed delusional system of the paranoid schizophrenic.  Note that, in many paranoid schizophrenics, this type of judgment about the whole may entail suicide.


I once read a quotation that essentially stated that “we are happy if, for everything inside us, there is an equal and opposite reflection of us in the outside world.”  This applies to one’s mental health, and it represents a basis for Humanistic theory and therapy.

Accurate reflection of the self is what is at the heart of the conundrum inherent in the delusional systems of schizophrenics.  If the schizophrenic makes a seemingly all-encompassing judgment about his condition of mental illness, his view of the self in the wake of such an affirmation of hallucinations and delusions may, again, form a basis for suicide.


Even relative comprehension of this article might provide some basis for psychotherapeutic reflection of the paranoid schizophrenic.  Nevertheless, this assertion would amount to contesting that psychoeducation is curative, and it is only marginally so. However, accurate reflection of schizophrenics’ internal state is what is lacking in psychotherapy with these individuals.


It should be noted that this article represents a kind of meta-theory, or theory about theory based essentially on the delusional theories of schizophrenics, paranoid or not so.  In terms of this, what is written here does not have the immediacy or the visceral quality of sensory experience or, for that matter, the pseudo-sensory experience of hallucinations.


Ultimately and as stated, accurate reflection of schizophrenics’ internal states is lacking in psychotherapy with these individuals.  It may be easier to empathize with these individuals—without validating their delusional systems-than is realized

Ann Reitan, PsyD

Ann Reitan, PsyD, is a clinical psychologist and well published essayist of fiction and creative nonfiction. She holds a Bachelor of Arts in Psychology from University of Washington, Master of Arts in Psychology from Pepperdine University, and Doctorate of Clinical Psychology from Alliant International University. Her post-doctoral research at Washington University in St. Louis, MO, involved personality theory, idiodynamics and creativity in literature. She recently published Illuminating Schizophrenia: Insights into the Uncommon Mind.
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