PERSONALITY DISORDERS
Is Paranoia a personality issue?
As any good lawyer will tell you - that depends (and that’ll be $5,000 thanks).
What we call paranoia, shorthand for suspicion and mistrust, is a huge part of the disorder. But for it to be a clinically recognised disorder, the focus is whether your paranoia is irrational or excessive (unless you are the President of the United States, then it is of course Fake News).
How Paranoid must I be to have Paranoid PD?
It is normal (and human) to have had moments where we were more cautious or mistrustful; after all, we are constantly learning from experience.
But these moments of paranoia may suggest the presence of a disorder if the mistrust persists and turns into something uglier like believing others have bad motives and doubting their intentions “for no reason”.
Before a diagnosis may be made, Clinical Psychologists will look out for these symptoms:
Ψ Suspecting that others are manipulating, harming or deceiving him/her without sufficient basis
Ψ Preoccupied with unjustified doubts about loyalty or trustworthiness of your peers
Ψ Unwilling to confide in others because of unwarranted fear that information will be used maliciously
Ψ Finds hidden demeaning threats or meanings in benign or neutral remarks
Ψ Persistently bears grudges and unforgiving of others
Ψ Perceives attacks on his/her character or reputation
Ψ Recurrent suspicions, without justification, regarding fidelity of spouse/sexual partner
(you can see the trend now, can’t you)
You may have noticed by now that the underlying issue in Paranoid Personality Disorder is the lack of justification for paranoia.
Justification, in and of itself, is also highly subjective. This is because individuals with paranoia frequently disregard concrete evidence that contradict their beliefs and views. Some might even go to the lengths of alleging the presence of trickery or arguing that the evidence itself is untrustworthy or doctored (Fake News again anyone?).
As a result, a major consequence of Paranoid Personality Disorder (Paranoid PD) is the toll it takes on interpersonal relationships, due to the sufferer’s inability to look pass omnipresent doubt. Sufferers rarely confide in or fully “open up” to others, even to close friends and family.
Schizophrenia vs Paranoid Personality Disorder
People often associate Paranoid PD with Schizophrenia because persons suffering from either disorder seemingly exhibit similar psychotic symptoms (e.g. loss of contact with reality, delusions, hallucinations).
One difference is that often, individuals with Paranoid PD are in contact with reality, except that the symptoms usually manifest when the individual is under high levels of stress, and such episodes typically last only from a few minutes to a few hours. By contrast, persons suffering from schizophrenia experience a persistent and much deeper disconnect from reality lasting for significantly longer periods of time.
Therapy
People with Paranoid PD rarely seek psychological help due to the high levels of mistrust with those who do not agree with them (the list is usually long). Those who seek therapy often discontinue after initial consultations.
However, anecdotal evidence suggests that persons suffering from Paranoid PD are likely to consult a psychologist from time to time. This is a good starting point, even if therapy is irregular. The focus of these infrequent consultations will centre on first equipping them with skills to cope and function in their daily lives. These concerns usually revolve around challenges in interpersonal relationships. Your clinical psychologist will use these sessions to build trust and rapport (remember the Therapeutic Alliance with your psychologist?) to allow you to eventually address and work through the Paranoid PD.