Paranoid Personality Disorder


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The paranoid's world is hostile, arbitrary, malicious, and unpredictable. Consequently, he or she distrusts others and suspects them. No good deed goes unpunished. Every gesture of goodwill is surely fuelled by ulterior, self-interested and uncharitable motives. Paranoids are firmly convinced that people are out to exploit, harm, get, or deceive them, sometimes just for the fun of it. Evil needs no pretext or context, it is just out there without good or sufficient cause.

These nagging doubts about the loyalty or trustworthiness of others gnaw at the paranoid's mind ceaselessly. No one is spared his constant brooding. His hypervigilance extends to family members, friends, co-workers, and neighbors. Persecutory delusions are common: most paranoids believe that they are at the epicenter of conspiracies and collusions, big and small, quotidian and earth-shattering.

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The paranoid's conviction that he is the target of the unwelcome and frightful attentions of unnamed and occult structures and people serves well his grandiosity. Like narcissists, paranoids need to be at the center of attention. They must prove to themselves on an hourly basis that they are of sufficient importance and interest to warrant such persecution.

No wonder that patients with PPD (paranoid personality disorder) are typically socially isolated and considered eccentric.

I describe their existence thus in the Open Site Encyclopedia:

"They may cower at home, planning a defense against perceived attacks, yet may reject any attempts by others to communicate with them. They may become reclusive, maintaining suspicions that others may use information against them. From others, even the most benign gestures, comments, or events, assume threatening proportions, nefarious meanings or malicious intent. Even benign encounters may be misinterpreted as threats.

Paranoid persons may dwell on the trivial. They may be hypersensitive, bear grudges and be unforgiving. Remarks by others may be immediately interpreted as an insult, injury, attack, or slight directed at their personality or reputation, and may provoke aggressive responses. They may eventually be shunned because of their eccentric behavior; moreover, this may include close family members, as well as friends."

Read Notes from the therapy of a Paranoid Patient

Paranoid ideation is common among people with pronounced fantastic grandiosity which is a defense against a dysregulated (labile) sense of self-worth & a vanishingly low self-esteem. Yet, counterintuitively, such people are much more prone to reckless behaviors involving strangers in dangerous situations.

How can we reconcile this apparent conflict between psychodynamic (paranoia) and behavior (risk-seeking)? In such patients, paranoid ideation is provoked by socially stressful situations, emotional intimacy, self-imputed inferiority (challenge to grandiosity), & risk of loss (perceived disadvantage or weakness)

Paradoxically, therefore, such people would feel most threatened in the presence of their INTIMATE partners & nearest and dearest. But, they would trust total strangers as "safe" even in the most precarious, dangerous, & reckless situations (for example: when they are totally drunk or in a room together alone)

Their threat perception is not affected even when the stranger makes his nefarious intentions known - because there is no risk of intimacy or attachment involved. They are far more likely to end up having sex with a total unknown than with someone they love, for instance - & the sex would often be unprotected and in compromising circumstances

They are bound to shun & avoid all forms of intimacy with potential mates, including sex aversion, & compensate with instant faux "closeness" or "affection" & promiscuity with strangers.

Similarly, people with these psychological defenses would trust even known criminals, bums, or junkies over their friends & loved ones because they can feel equal or superior to these losers &, thus, their grandiosity is upheld & their self-esteem is restored.

People with paranoid ideation tend to suspect & fear anyone who has the perceived power to deny them something that they crave & depend on - or to take it away from them. Because they are focused on highly specific potential losses, they ignore the fact that strangers can sexually assault or even kill them. Such misjudgment and misperception of risk is enhanced by alcohol or drug abuse ("alcohol myopia").

Many additional Frequently Asked Questions (FAQs) about Personality Disorders - click HERE!

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