The case of Daniel Paul Schreber and the numerous subsequent interpretations of his Memoirs comprise this chapter. By re-analyzing Freud’s and Lacan’s engagement with Schreber, the chapter identifies points of contention with contemporary Mad Studies research. I ask what of the charge that psychoanalysis acts as a colonizing discourse? Can Schreber ever be disentangled from these analyses? And lastly, does psychoanalysis have anything left to say about any of this? We will find both Freud and Lacan lacking at points, but I shall also draw attention to the way in which, already from the time of Freud, an interesting diversion from psychiatric ontology takes place allowing madness to align itself with non-pathological forms of knowledge creation and subject formation. In a sense, despite the elitist interpretations provided by Freud/Lacan, I present the idea that paranoia, within the psychoanalytic tradition, is not necessarily oppositional to reason or rational thought. This insight is extended further following engagements with several theorists who develop analyses of Schreber’s Memoirs that move away from strictly clinical concerns to ones we may frame as cultural-historical. The ‘paranoid modernism’ imbued within Schreber’s writing allows us to appreciate how one’s idiosyncratic account of delusional paranoia may also provide a valuable critique of contemporaneous social, political and technological trends. In effect, this meta-analysis of Schreber brings us back to the central concept; paranoid knowledge.