What are today’s stressful events? Well—things like the budget deficit, terrorism, job loss and threat of losing one’s status. Don’t forget the paranoid response comes dramatically from the vulnerability and the projection becomes an attack in order to defend oneself. After all, the best defense is a good offense. The defense mechanism of projection is described as a defense mechanism of disavowal—of one’s uncomfortable and overwhelming internal feelings. What is especially notable is the intensity of the paranoid style response; its strength and vitriol and its ongoing continuous nature.
In an individual who becomes paranoid schizophrenic, the paranoid projection is completely out of control. Delusions and hallucinations distort reality and the anger and rage are murderous. The young Arizona man, Jared Loughner, who shot Representative Giffords and others was recently evaluated as incompetent to stand trial with the report indicating he suffers from delusional and hallucinatory symptoms. The result of these types of serious paranoid symptoms is the person who holes up from fear of everyone, or attacks someone first because they believe they will be attacked by them. Imagine the paranoid who hunkers down and then gets out the guns to defend against perceived attacks from others. SWAT teams know all about this. Imagine the person who climbs on the overpass to throw rocks at passing cars who are coming to attack him. Treatment issues are another matter, by the nature of paranoid symptoms and the avoidance and mistrust of others, they often discontinue medication and establishing a therapeutic relationship is not easy.