Sexual Murder - Justicia Forense

effects of encephalitis and various infections on mental functioning, and heexplored the possible relationship of accidents and military service to thedevelopment of schizophrenia.Maier had a particular interest in substance abuse, and in 1926 wroteDer Kokainismus (Cocaine Addiction), which is considered a classic. In themid-1980s, there was an extensive cocaine epidemic in the U.S., and a greatdeal of research was begun on the evaluation and treatment of cocaine users.In 1987 Maier’s book was translated into English, as this text had alreadyexamined all the major areas of cocaine addiction some 60 years earlier. Areview of the topics covered in Cocaine Addiction reveals the depth of Maier’sunderstanding of the problem: physiological actions of cocaine; cocainerelatedillnesses; the effects of cocaine, including disturbances of perception,cognition, emotion, and motivation; and various symptom pictures incocaine intoxication, cocaine psychosis, and cocaine-related psychiatric problems.Maier also provided numerous clinical histories of cocaine addicts withadditional chapters on differential diagnosis, prognosis for acute intoxicationvs. the chronic abuser, anatomical alterations, and an outline for a programof treatment. The book ends with Maier’s view of the legal steps needed tocontrol cocaine addiction.But most relevant for the present book is Maier’s pioneering work onthe development of the content of delusions (for which he received a professorshipand ultimately was appointed chairman of the department of psychiatryat Zurich). In 1912, Maier published his dissertation research, “Onthe Subject of Catathymic Delusions and Paranoia.” A detailed look at Maier’spaper illuminates his use of the concept of catathymia to explain how underlying,emotionally laden conflicts can result in such a change in thinking thatdelusions develop.Maier begins his treatise by defining catathymia and attempting to showhow it relates to cases of (what we would call today) pure paranoia ordelusional disorder. In an effort to understand why individuals develop specificdelusional content in the way they do, he searched for unconsciousconnections that determine the makeup of psychotic ideas. The stream ofassociations, he believed, “can go in a wrong direction through the predominanceof a relatively strong affectivity” (p. 556). The delusional content istherefore greatly influenced by emotionally charged unconscious “complexes”such as a wish, a fear, or an ambivalent ambition. Delusions that grow outof these underlying conflicts are catathymic delusions, and are to be differentiatedfrom delusions that do not stem from complexes such as those withan organic base. But even in mental illnesses that are primarily organic inorigin such as manic–depressive psychosis, catathymic delusions can stilloccur secondarily, as long as the delusional ideas have a causal connectionto an underlying complex. In contrast, delusions that are not a result of