The starkness of the drawing gives the import of this card away. With the Ten of Swords, the querent has reached the lowest point of the cycle. Both within and without, the circumstances of the individual are such that things cannot possibly get worse. This card may indicate total despair, and in whichever areas of life it represents, the ultimate sense of betrayal. It is not for nothing that the figure in the illustration is shown to be stabbed in the back. The situation has gone beyond mere state of mind, which is shown by the preceding cards of this suit.
This is a bleak picture, yet it has to be remembered that if things are now at their worst, then things can only now get better. The Ten of Swords may indicate that state of total surrender or stripping away of illusions through which, for example, the alcoholic recognises a totally destructive illusion for what it is, and finally resolves never to drink again. Until this decisive point is reached, many individuals will remain attached to a relationship or a habit, etc, even where it causes a tremendous amount of pain.
Sometimes, this card indicates paranoia. Most often, however, it simply forces the querent to move onto greater things, ultimately.