DELUSIONAL CONTAGION AND MELANCHOLIA IN PARANOIA
Ariane Bilheran Ph.D

Translation by TTB,  June 24, 2021
original text revised Sept 9,2020
written December 2019

The paranoiac delusion has the particularity of being contagious... In this context, the psychic mechanisms at work are notably the collusion between the melancholic core of the paranoiac person and the traces of unresolved pathological mourning in the " victim of the paranoiac individual (or group) , that we call “the paranoiaed" (the one who undergoes the paranoiac person delusion.)

One of the most essential mysteries to be solved in the field of human psyche lies in the delusional contagion of paranoia. In fact, the only delusion capable of operating by contagion is the paranoiac delusion. "This contagion calls out because it is capable of operating on a large scale, on individuals, groups or masses, who, in other circumstances, would not have deluded themselves in this way.

Rosalie's plan



Rosalie, a long-time chronic paranoiac patient, plans to commit suicide by euthanasia on her 73rd birthday. She is not ill, and even less physically suffering. She wants to die "cleanly» and justifies her action for a health reason: to leave with her body still preserved, to manage her entire inheritance, so that none of her heirs can contest anything. She takes care to put her son, the only one who would have been likely to resist her in her project, at a distance, and embarks all her other children, as well as a former boyfriend and her best friend. All of them let themselves be contaminated by the deadly objective, which lasts for nine months: registration on the waiting list in the clinic in Switzerland, request to the boyfriend of her youth to pay for the suicide (about 10,000 euros), because "it's his fault" that she ruined her life (he broke off the relationship when she was 20 years old), search for adhesion from her children in the name of her "free will", assiduous presence demanded from her best friend by her side during months to empty her apartment. Everyone, under psychic domination, consents to this act. She is persuaded that thus, by the euthanasia, she will escape the degradation of her own body, the dependence, but also the judgment on her own soul and "the end of the world". She is also convinced that in this way her death will not burden anyone. Only ashes should remain of her body, nothing of her personal belongings. During all the time preparing the suicide, Rosalie organizes a macabre staging which subtly designates all her entourage as her murderers, from the moment when she obtains, by dint of delusional conviction, their adhesion to her project (financial, material, logistical), without anyone being able to perceive the intense psychic suffering, nor the delusion of ruin at work in an underlying way, and even less the melancholic cruelty which presides over it.

When the delusion spreads...

Delusional contagion is a mechanism observed in regressed groups where there is at least one paranoiac profile exercising its power. It is distinguished from perverse control by the fact that it is the delusion itself that spreads in all its aspects (persecution, mythomania, megalomania, personality cult, ideological certainty...).

Lasègue and Falret (1877) indicate in particular that, for a delusion to be contagious, it is necessary for the person who is subjected to the contagion to participate. The delusional person is the active, intelligent element, who progressively imposes his delusion on the second, and who gradually becomes common to them. In the delusion of two, the "contagioned"(the one who is contaminated by the paranoiac) subject recognizes rather quickly the inanity of his conceptions, when he is distant from the delusional one, which demonstrates well the existence of a phenomenon of psychic engulfment.

  • The paradoxical injunction: mental confusion

Mental confusion is a necessary (but not sufficient) means to the propagation of the delusion. It operates from the paradoxical injunction, namely, to say everything and its opposite at the same time, giving the appearance of "logical reasoning". Let us take up the case of Rosalie again:

"It is because I do not suffer that I want to die properly. "The paradox lies in the fact that the psychic suffering at the origin of this desire of death is absolutely denied. Or "if you love me, you help me to die", which is another paradox, because of course, loving the person implies that we wish to see him/her live.

  • Repeated traumatic shocks: emotional confusion.


Emotional confusion is obtained by repeated traumatic shocks divulged by the paranoiac person, source of a stunning shock [SM1] that makes the psychic spaces between the paranoiac and paranoiac’s victim ("the paranoiaed") porous. In the example of Rosalie, the repeated abuses consist in taking time, energy, money, to obtain the adhesion to a project that everyone initially disapproves of. She forces her best friend to a daily routine where the latter is in charge of sorting objects before death, to give them to such and such a person. Rosalie obliges her childhood love to pay the cost of her euthanasia as well as the transportation costs, managing to make him assume the guilt of all the misfortunes she has gone through in her life. She exhibits her project in front of her daughter, whose father had tragically committed suicide two years earlier... The delusional contagion spreads very quickly and easily in a weakened group, in which the paternal figures of authority no longer function or are misused (the third party, the law, the educator, the manager). People experience themselves as terrorized children faced with an all-consuming power that nothing can stop. Rosalie sees no moral, spiritual or even emotional limit to her project: her family does not understand her because she has always been "the original", such is the discourse she holds, without any empathy for the suffering she causes in the staging of this suicide disguised as a murder, of which all are designated guilty (none is moreover "capable" of keeping her alive, not even her grandchildren, such is the message amply broadcast)

A melancholic core in paranoia

  •   The melancholic core and its projection


According to Freud, "melancholia is characterized from the psychic point of view by a profoundly painful depression, a suspension of interest in the external world, the loss of the capacity to love, the inhibition of all activity, and the diminution of the feeling of self-esteem, which manifests itself in self-reproaches and self-injuries and goes as far as the delusional expectation of punishment" (Freud, 1915, p. 165-168). This melancholic core in paranoia seems to me to be fundamental for understanding the paranoiac's relationship to death and to any loss they are confronted with, their rejection of a guilt so unbearable that it leads to a decompensation orchestrated from the point of view of projection (the other is guilty, not them), their relationship to cruelty and hatred, which are typically melancholic in nature. To avoid self-accusation, the paranoiac person accuses the whole world. Thus, when she premeditates her act, Rosalie has not had any contact with her son Eugene for fourteen years. The latter has cut off contact with her son to protect himself from his mother's pathology. Rosalie has never wished him a birthday (her son has become "the bad object"), never contacts him, not a letter during all these years, except for a letter, seven years ago, containing a book and a small card. His mother wrote him these few words: "I went to see the exhibition on melancholy at the Grand Palais. I am sending you the guide to the exhibition, which you should like. "The book is entitled Melancholy. Genius and Madness in the West. Eugene is totally excluded from suicide; He will only inherit the legal minimum, Rosalie having specified in her will that he was not entitled to any photograph, any object that might have furnished her apartment (finally, not even those belonging to him), that he was not entitled to know the details of the suicide, nor the place or the day of the funeral, and finally that the notary was to transmit to him a black folder (incriminating his father, one of Rosalie's two ex-husbands) six months after the death.

In the paranoiac delusion, all is concentrated and folded up on oneself, in a diminution of the self. What holds Rosalie psychically is a delusional certainty of a "healthy" body, without the ravages of old age or disease. It is indeed the deep anguish of living diminished or sick, thus dependent on others or abandoned, which makes her conceive and carry out this project, to control to the last details her own death, made hard to understand by her relatives: her children and grandchildren are personae non grata (an unacceptable or unwelcome person) at the clinic in Switzerland, the cremated body will return to dust, no one will have been able to see her dying or dead face, except for her youthful boyfriend, whose duty will have been to take her hand at her last breath, which strongly resembles a cruel staging of the melancholic type ("look how you killed me", "it is with your money that I die"...).

The paranoiac people delude and feed themselves at the same time that their abuse and transgress. This is the reason why (...) their "targets" often become so at certain moments in their lives: loss of a loved one, of a job, divorce... ".

The melancholic core presiding over paranoia can be read in Lacan's "Aimée case" (1932) (1). Most of Aimée's hospitalizations for delusional episodes are due to a bereavement or a break-up, or to its commemoration. The pathological mourning of a first stillborn child leads to the search for external culprits, who represent her as well, in idealized doubles (erotomania), also illustrating the unbearable guilt linked to this mourning. From there, the delusion turns in a loop and fixes itself on the actress Mrs Z.


In the case of Rosalie, it would seem that the melancholic core has been amplified on the occasion of each of her two divorces. The file she leaves for Eugene in charge of her father shows once again her hatred against men, this guilt-tripping of the men in her life (her first love, then her two marriages) who have "betrayed" her by breaking off the relationship with her. The first has to pay for Rosalie's suicide and accompany her in her euthanasia project to hold her hand in her last breath, the second has committed suicide in a tragic way two years before, which also leads to a suicidal project by mimicry ("after what you will have made me undergo..."), the third is also made responsible for her sorrows, and treated with all the projective names that are : psychotic, paranoiac, manipulative... Eugene being her son, he is guilty by proxy, inheriting only the legal third that Rosalie was unable to conceal.


Nevertheless, we can see that the suicide project was probably set in motion as soon as the rupture with her son Eugène (who, in a certain way, embodied a form of "extension" of his father) became a reality. In the postcard, Rosalie mentioned the need to see him in order to "organize her inheritance". It is highly likely that her various break-ups in love worked as traumatic reminiscences of an original mourning that was never resolved and contributed to the increase of the paranoiac delusion.

  • Ruin

The idea of ruin, a melancholic characteristic, can be found in paranoia: the person thinks that he/ she is deprived of his/her possessions and blames himself or herself (guilt).

This theme of disappearance can sometimes go as far as a nihilistic idea, concerning a part of oneself, one's body, others, or the world: we then speak of delusions of negation, which join the melancholic core. This delusional state can be similar to Cotard's syndrome, whose hypochondriac theme is associated with ideas of immortality, damnation, negation of organs (organs experienced as rotten, turned into stone...), negation of the body. With the idea of ruin, paranoiac can delude themselves about the imminent end of the world, to the point of stripping them of everything, living in a house where the roof leaks, where there is no more maintenance... The paranoiac who deludes themselves on the mode of ruin can create what they fear: to put themselves in condition to be banned from banking, to no longer be able to pay their rent, to have to sleep outside without a roof, or to sleep in a disused house... Each time, the delusion is orchestrated in such a way that the designated persecutor or the murderer is the other, and systematically in a suggestive mode.

·     Denial of loss and melancholia

As we have seen, what makes the bed of delusional contagion is the mental confusion engendered by the paradoxical injunction, as well as the emotional confusion engendered by the reiterated traumatic shocks. Nevertheless, what creates the possible graft effect is the contagion from melancholia and its sadistic side introjected by the paranoiac’s victim ("the paranoiaed").

- Firstly, the melancholic core of the paranoiac is projected onto others, and thus comes to collide with the traces of pathological mourning that are not conscious in the life of the paranoiac victim ("the paranoiaed"). One could even say that the latter introjects what the paranoiac expels, namely this unsymbolized melancholic core, which even makes the psychic presence of the paranoiac indispensable to them () (which can explain certain fanatical clings of sect victims to their guru). The paranoiac indeed offers the reassurance of a total and global world in which everything is explained, in which doubt is no longer allowed, where there is no longer any separating space. This has the effect of a "magic band-aid" in the face of the loss not supported by the psyche.

The paranoiac designates others as their executioner while operating traumatic shocks.

- Secondly, the collage also operates through the introjection of melancholic sadism. The paranoiac designates others as their executioner while at the same time operating traumatic shocks. This paradox is the very origin of the paranoiac victim's (“the paranoiaed”) belief that they are guilty of their fate, that they deserve the treatment they receive from the paranoiac person.

- Thirdly, the bonding operates by the elaboration of powerful defense mechanisms in the victim of the paranoiac (“the paranoiaed”), which lead them into delusional certainty.


- Original and pathological mourning


"Nothing can be understood at the borders of depressions, psychoses and perversions without the notion of the "original mourning ", said Racamier (1992). We recall that, according to Caillot, "the normal paradoxical narcissistic position is characterized by the success of the original conflict and mourning" (Caillot, 2015).

This original  mourning is "the fundamental psychological process by which the self, from the first childhood, even before its emergence and until its death, renounces the total possession of the object, makes its mourning of an absolute narcissistic unison and an indefinite constancy of being, and by this very mourning, which founds its own origins, operates the discovery of the object as of oneself, and the invention of the interiority" (Racamier, 1992, p. 29). The structuring dialectic of the psyche is the following one: "the self is found in what it loses itself" (Racamier, 1992, p. 30). It concerns the loss of a state of "narcissistic unison", of "narcissistic closure". From the acceptance of the loss is born the discovery of oneself.

With regard to psychosis, Racamier (2001) speaks well of "reciprocal encompassments" and it is also what occurs at the time of the delusional contagion: each psyche finds itself encompassed in the paranoiac delusion. It is now impossible to utter a false note, a criticism of the dogma, an opinion, or an emotion. Just as the paranoiac temporality is cyclic, without filiation, without future, without origin, without debt, without loss nor passage nor mourning, the relation requires this globalizing aspect of symbiotic fusion in the same psyche, without asperities nor holes. The paranoiac delusion guarantees plenitude, even if paradoxically this state of plenitude annihilates the existence of the subject. There are no more "prohibitions” because there are no longer "inter" spaces, anymore between the psyches, henceforth stuck. The passages to the act (incest, murder...) are henceforth allowed. To exist supposes the tearing off of oneself from others, the renunciation of the total possession of the object, and thus the mourning of the absolute, perfect, symbiotic relation with the other. "The self thus establishes its origins by recognizing that it is not the absolute master of its origins. It discovers itself by losing itself; such is the identity paradox", says Racamier (ibid), and let us remember well that what founds the paranoiac psychosis in particular is well and truly: the denial of the origins.

The introjection of melancholic sadism

The interweaving of the psyches operates through the introjection of melancholic sadism (2), a manifestation in the paranoiac of the denied melancholic cruelty: the other is guilty, and for that must pay.

From then on, transgression is constitutive of addiction: the victims of the paranoiac demand punishment (their own or that of others) because they believe themselves, they are guilty (they introjects the paranoiac accusation), in this sense, punishment come to relieve the conscience and lead to addiction to the delusional contagion, a demand for punishment to which the paranoiac individual responds. The victims of paranoiac (the paranoied) pay: thus, in the sects, they gives their money, their time, even to the point of endangering themselves and their family.

These sadistic projections are expressed in the persecution of the group's scapegoat, and can, at any moment, turn into masochistic and murderous impulses, as with the suicides and mass murders in sectarian processes. The delusion creates the same motive, the same false reasoning, the same premeditation. It is not a question of identification but of collage: a psychic graft sealed on a "pact of denial in front of the melancholy". The passion of the paranoiac delusion replaces the melancholic emptiness, the blunting of the affects, the abyss of doubts. The collective under delusional contagion meets maniac episodes and a hypnotic illusion of absolute reassurance, notably in the cult of the personality of the paranoiac leader.

Through their delusion, paranoiac persons eliminate the nuances, the asperities, and even the ambivalence proper to many situations. The individual becomes a pawn in a global and totalizing thought, and their psyche regresses to the state of that of an infant taken entirely in charge in all aspects of life. Thus, functions besides the totalitarian power of the paranoia. The sacrifices and passages to the act also exist to reformulate together in the psychosis the vows of bonding.


In the case of Rosalie, the people surrounding her end up introjecting the sadism and being swallowed up in the melancholic devouring. She occupies all the psychic space of her close relations, calls them every day to expose her project and its modalities, practicing a brainwashing during months until the fateful date. No one is able to set a limit or to hear the anguish and psychic suffering at work. No detail is forgotten in this deadly premeditation, everything is planned.

First of all, and as a corollary of the introjection of sadistic impulses ("if he mistreats me, it's because I deserve it"), the victim of paranoia ("the paranoiaed”) creates a mechanism of idealization, which is often recognized in sectarian phenomena. In the case of Rosalie, her ex-boyfriend comes to idealize this woman who, against all odds, is finally "the only one who really loved him", to the point of wishing "to die with him".

Moreover, cleavage is the defense mechanism generated by pathological mourning, according to Freud's studies on melancholy (1915), and then those of Abraham and Torok (1978). Pathological mourning implies an impossible symbolization of the loss and leads to a nostalgic experience, at the origin of the cleavage. Moreover, this pathological mourning leads to hatred and sadism against oneself and others (projection).

From then on, the delusional contagion operates on the basis of the defense mechanisms (idealization, cleavage, projection) that everyone is forced to use, in order to try to survive the paranoiac delusion that is spreading (whether in the family, in the company, or in an entire society).

Once the collage has taken place, the victims of paranoiac ("the paranoiaed"), having idealized their persecutor, having deployed the cleavage and the projection, are definitively ready to graft themselves to the delusion: reason gets carried away, becomes everything and its opposite; it is impossible to sort out the logical and the illogical, the true and the false, the good and the evil, it is the paradoxical bric-a-brac. The essential of the paranoiac delusion does not consist in sorting or in making logic prevail, but in "everything being there", even if the opposites coexist. It is this "everything" that is abusive in paranoia.

Conclusion

Not to think anymore, not to feel anymore, to melt in the paranoiac delusion like the baby in the belly of its mother, with a feeling of absolute and omnipotence, here is what paranoia requires. That this mother is bad, destructive, and violent does not matter anymore at this stage, only the bonding avoiding at all costs the confrontation with the mourning and the melancholy takes precedence and this, whatever the price to be paid in terms of violent passages to the act. The paranoiac people delude and feed at the same time that they abuse and transgress. This is the reason why, if we observe well, their "targets" often become so at certain moments in their lives: loss of a loved one, loss of a job, divorce... Because it is indeed on the denial of the loss that the paranoiac delusion is grafted. "Living together kills us, separating is deadly", reminds Caillot (2015) as a principal adage of the unresolved original mourning, leading to the confusion of the dead and the living, as well as that of generations, but also family ghosts, children of replacement, depression, suicide...

Finally, in melancholic psychosis, the father figure is totally absent psychically, which suggests that melancholy would be a state prior to paranoia, from which the person suffering from paranoia would try to get rid of it by projecting the guilt outside of him, by looking for a form of father figure through the claim, the invocation of justice and of the Law. As this letter left before the "transit to Sirius" by the Order of the Solar Temple (3) testifies: "It was necessary that a group of men, women and children, having been previously prepared, had to go through the vicissitudes of these last years in the Law and in the Service so that the acquired experience could give fully its fruits to enrich the consciousness of the return to the Father. "

When the procedural side fails, the delusion of ruin and the staging of the loss are revealed, to which the paranoiac responds with delusional certainty and absolute control, as in the case of Rosalie. The paradise that the paranoiac promises you (and himself) is hell. The suicide lived as a liberation, or a means of taunting death is the consecration of this hell lived in its relation to the others.

Finally, with the weakening of the economy and social links, political violence as well as the communicative collage of modern media (immediacy) diffusing insane contents, the danger of propagation of delusional contagions (sects or more global totalitarian processes) is without precedent. The continuation of clinical investigations on delusional contagion and their disclosure are undoubtedly among the indispensable preventive acts.


Ariane BILHERAN, clinical psychologist, doctor in psychopathology and clinical psychology, master in moral and political philosophy, student of Ecole Normale (Paris).

Endnotes

1 - In this case, Lacan describes the treatment of a psychotic patient, hospitalized under constraint following an act. She stabbed an actress, whom she was watching as she left the theater after a performance. Lacan considers that she suffers from a "paranoia of self-punishment. "It should be noted that Aimée is herself a surrogate childbearing the name of an elder daughter who died before she came into the world.

2 - Let us understand here that sadism and masochism refer to a psychic posture of narcissistic type, and not libidinal (it is even less a question of sexuality in this case!). We could as well speak about the couple "tyrannizing-tyrannized". Racamier speaks about "omnipotent-inanity[SM1]  relation". For my part, I keep "sadism-masochism" from the point of view of affects, because it seems to me that it is one of the psychic responses brought to the emotional confusion, therefore in the register of affects, in reference notably to the cruelty of the melancholic type, which feeds on the suffering of others, or rather, revels in advance in the suffering it will cause (with melancholy, there is premeditation, as in the case of Rosalie). But this point can obviously be discussed.

3 - Created in 1984, the Order of the Solar Temple was an "esoteric neo-templar" group founded in Geneva by two "gurus", which was at the origin in 1994 and 1995 of three episodes of massacres of followers, orchestrated as "collective suicides", in Switzerland, France and Canada.


Bibliography »

– Aristote. L’Homme de génie et la mélancolie. Le Problème XXX, traduction, présentation et notes de J. Pigeaud, Paris, Payot & Rivages, 1988.

– Aulagnier, P. 1984. « L’apprenti-historien et le maître-sorcier », in Du discours identifiant au discours délirant, Paris, PUF, 2004.

– Bilheran, A. 2017. « Terrorisme, jeunesse, idéaux, paranoïa », in Soins, Elsevier.

– Binswanger, L. 1960. Mélancolie et manie, Paris, PUF, 1987, traduction de J. M. Azorin, Y. Tatoyan, A. Tatossian.

– Caillot, J.P. 2015. Le meurtriel, l’incestuel et le traumatique, Paris, Dunod.

– Freud, S. 1915. « Deuil et Mélancolie », in Métapsychologie, Paris, Gallimard, 1968, p. 165-168.

– Klein, M. 1929-1932, Essais de psychanalyse, Paris, Payot, 1968.

– Lacan, J. 1932. De la psychose paranoïaque dans ses rapports avec la personnalité, Paris, Seuil, 1975.

– Lasègue A., Falret J.P. (1877). « La folie à deux ou folie communiquée »,

Annales Médico- Psychologiques, Paris, 18 : 321-355.

– Racamier, P.C. 1992. Le génie des origines, Paris, Payot & Rivages.

– Racamier, P.C. 2001. Les schizophrènes, Paris, Payot.

– Tatossian, A. 1979. La phénoménologie des psychoses. Paris, Le Cercle Herméneutique, 2002.

– Verrecchia, B., Gohier, B., Goeb, J.-L., Rannou-Du- bas, K. Garre, J.-B. 2003. « Psychoses collectives, phénomènes de panique et suicides de masse. Rôle des médias », in Actualités Psychiatriques, Service de Psychiatrie et de psychologie médicale CHU d’Angers.


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