Paranoid Personality Disorder

PPD PERSONALITY PROFILE

The key word for Paranoid Personality Disorder (PPD) is "mistrust." It is conceivable that, under certain circumstances, wariness, looking for hidden motives, or not trusting others may be adaptive--even life-saving--but the paranoid personality adopts this stance in most or all situations, including the most benign.

VIEW OF SELF: The paranoid personalities see themselves as righteous and mistreated by others.

VIEW OF OTHERS: They see other people essentially as devious, deceptive, treacherous, and covertly manipulative. They believe that other people want to interfere with them, put them down, discriminate against them--but all in a hidden or secret way under the guise of innocence. Paranoids may think that others form secret coalitions against them.

BELIEFS: The core beliefs consist of notions such as "I am vulnerable to other people," "Other people cannot be trusted," "Their motives are suspect," "They are deceptive," "They're out to undermine me or depreciate me." The conditional beliefs are "If I am not careful, people will manipulate, abuse, or take advantage of me," "If people are friendly, they are trying to use me," "If people seem distant, it proves they are unfriendly." The instrumental (or self-instructional) beliefs are "Be on guard," "Don't trust anybody," "Look for hidden motives," "Don't get taken in."

THREATS: The main fears are concerned with being secretly manipulated, controlled, demeaned, or discriminated against.

STRATEGIES: With this notion that other people are against them, the paranoid personalities are driven to be hypervigilant and always on guard. They are wary, suspicious, and looking all the time for cues that may confront these "adversaries" with allegations about being wronged and consequently provoke the kind of hostility that they believed already existed.

AFFECTS: The main affect is anger over the presumed abuse. Some paranoid personalities, however, may additionally experience constant anxiety over the perceived threats. This painful anxiety is often the prod for their seeing therapy.

As you can see from the DSM-IV diagnostic criteria to follow, individuals with PPD are characterized by a persistent, unrealistic tendency to interpret the intentions and actions of others as demeaning or threatening, but they are free from persistent psychotic symptoms, such as delusions or hallucinations.

Paranoid individuals have a strong tendency to blame others for interpersonal problems, usually can cite many experiences that seem to justify their convictions about others, are quick to deny or minimize their own problems, and often have little recognition of the ways in which their behavior contributes to their problems. Individuals with PPD are typically quite vigilant, tend to interpret ambiguous situations as threatening, and are quick to take precautions against perceived threats. Others frequently perceive them as argumentative, stubborn, defensive, and unwilling to compromise. They also may manifest some of the characteristics they perceive in others, being seen by others as devious, deceptive, disloyal, hostile, and malicious.

POSSIBLE INDICATIONS OF PARANOID PERSONALITY DISORDER

• Constant vigilance, possibly manifested as a tendency to scan surroundings and/or glance frequently out the window.

• A tendency to attribute all blame for problems to others and to see himself or herself as being mistreated and abused.

• Recurrent conflict with authority figures.

• Unusually strong convictions regarding the motives of others and difficulty considering alternative explanations for their actions.

• A tendency to interpret small events as having great significance and thus react strongly, apparently "making mountains out of molehills."

• A tendency to counterattack quickly in response to a perceived threat or slight, or a tendency to be contentious and litigious.

• A tendency to receive more than his or her share of bad treatment from others or to provoke hostility from others.

• A tendency to search intensely and narrowly for evidence that confirms his or her negative expectations regarding others, ignoring the context and reading (plausible) special meanings and hidden motives into ordinary events.

• Inability to relax, particularly when in the presence of others, possibly including unwillingness or inability to close his or