Dali said that The Great Paranoiac had been conceived after a discussion with Josep María Sert about Arcimboldo, and that the protagonist's face is fashioned on 'Empordà countryfolk, the greatest paranoiacs of all'. The remarkable work suggests strongly that Dali was now convinced that the intense feelings of shame which had always troubled him were paranoid in character. The leitmotif of the person hiding his head in shame had first appeared in Dali's work in 1929, and between then and 1936 had recurred in more than thirty paintings and drawings. In The Great Paranoiac it attains its most eloquent expression. Almost all the characters in the picture are burying their heads in their hands or refusing to look, particularly the seated female whose buttocks form the nose of the protagonist. Brushing against this buttocks-nose is the shapely bottom of Gala: presumably Dali is hinting once again that his shame-imbued erotic fantasies are centered on this part of the body. The double figuration employed in the delineation of the head of the Great Paranoiac is as successful as any achieved by the painter, and is perhaps even more striking in the repetition of the motif in the left background, where the back of the head merges into an anguished group of people all hiding their faces or running away. […] As the eye scans the details of the painting, one is struck by the male couple among the rocks just behind the Great Paranoiac's head, one of whom has an unexpected red blob on his head, as if Dali wanted us to look closely. This figure, who is ordering an ashamed male to leave (like God expelling Adam from the Garden of Eden), has the indubitable look of Dali's father. Clearly he continued to be a major problem