Paranoid personality disorder: what it is and how to deal with it

Paranoid Personality Disorder is characterised by a persistent and unwarranted tendency to interpret the intentions and actions of others as evil (paranoia)

What is Paranoid Personality Disorder?

Distrust and suspiciousness in others develops an unjustified fear that others are plotting against them and can attack them at any time and for no reason.

Because of this attitude, paranoid personality disorder sufferers may act in a cautious and guarded manner and appear ‘cold’ and emotionless.

They constantly feel resentment, tend to overreact to even the slightest affront and are ready to strike back when they believe they are being mistreated.

Such a mode of interaction does not encourage others to be kind and generous but on the contrary produces distrust and hostility.

It thus happens that the aggressive and suspicious nature of a patient with paranoid personality disorder may provoke in others the kind of behaviour he or she anticipates and thus confirm his or her paranoid approach to life.

The reaction of someone with Paranoid Personality Disorder

Since the main threat is posed by others, the paranoid person is alert to any signs of danger or falsehood in the interaction by continually searching for the underlying meaning of individuals’ intentions.

Not being trusting of others results in an excessive need to be self-sufficient and a strong sense of autonomy.

Individuals with paranoid personality disorder may be pathologically jealous, often suspecting their spouse or sexual partner of being unfaithful without adequate justification.

They may gather trivial or circumstantial ‘evidence’ to support their jealous beliefs.

Therapy of paranoid personality disorder is very difficult, not least because the subjects’ distrust also extends to the therapists; they feel that the therapists may have manipulative intentions towards them or may be plotting with family members against them.

It is very difficult for them to agree to continue therapy, but if they do, they have a fair chance of improvement with a medium to long course of cognitive-behavioural psychotherapy (1 to 2 years).

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