Later that evening, Dr. Kesselring said, “Some students came and offered him biscuits.”
The next day the previously healthy 70-year-old neurologist was dead.
“It was really unfortunate,” said Dr. Kesselring. Later analyses would back up Dr. Bekhterev’s assessment of Stalin — it seems that he was paranoid in the official, clinical sense. Still, Dr. Kesselring finds it perplexing that the Russian doctor would have thought it was appropriate or wise to throw around such a loaded word.
Dr. Kenneth S. Kendler, a psychiatrist who reviewed the latest research on paranoia for the Schizophrenia Bulletin last year, said that the word “paranoiac” hadn’t been used much in mental health literature since the 1930s.
He said that the word “paranoid” had, conversely, become so colloquial that people seem to have forgotten how serious it can be from a clinical standpoint.
“It’s a Greek term,” he said. “Para has the word parallel in it, so it really translates to being beside oneself.”
We’re all a little bit beside ourselves sometimes, but when you’re talking about real paranoia, it’s not about just a little bit, he said, it’s pervasive. Not everyone suffering from paranoia will end up with the same diagnosis: paranoid personality disorder and delusional disorder are two diagnoses, outlined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, where suspiciousness may play a role.
However it manifests, paranoia is debilitating. “It’s an insult to all the people who really suffer when you take the word out of context,” Dr. Kendler said.
How the old term paranoiac entered Mr. Scaramucci’s personal vocabulary is not clear. Despite his penchant for hyperbole, he has exhibited dueling impulses to consider the nuance of language in the past:
“I was scared. Actually, I was terrified. But I was not panicked,” Mr. Scaramucci wrote in his book “Hopping Over the Rabbit Hole.” “Panic is a different emotion. Panic implies that there is no rational thought taking place. That we are frozen and incapable of adjusting. Powerless to logic, and subject to seemingly unthinkable behavior.”