An Overview of Paranoid Personality Disorder

The International Classification of Diseases (ICD-10) originating from the World Health Organisation (WHO), and Diagnostic and Statistical Manual (DSM-5) produced by the American Psychiatric Association (APA) have grouped personality disorders into three ‘clusters’: A, B, and C. Cluster A types are categorised as ‘suspicious’ or ‘odd, bizarre,eccentric’ and include; antisocial, paranoid, schizoid and schizotypal personality disorders. This article will give an overview of Paranoid Personality Disorder.

The main characteristics of Paranoid Personality Disorder (PPD) are pervasive distrust and suspicion of other people. When someone is suffering from PPD they often believe that people want to hurt them, use and abuse them or humiliate them somehow. They spend their time trying to protect themselves from these phantom attacks. They will also often preempt an assumed attack on themselves by mistakenly attacking others as a defence mechanism. People with PPD struggle to let go of old grievances and consequently are very resentful and hold grudges for a long time. They also tend to be excessively jealous and obsessive. It is obvious to see how their thinking is distorted as they regular read malicious intent into genuinely harmless situations or behaviour.

Often people with this condition will not develop close personal relationships as they do not trust anyone. This may make it harder to spot and subsequently treat.

The predominant symptoms of this disorder are:

  • Believing that others have hidden malicious motives or are out to harm them.
  • Doubting others intentions and loyalty.
  • Unable to take criticism .
  • Unable to work with others.
  • Easily angered and often hostile.
  • Detached and isolated.
  • Unwilling to confide in others die to lack of trust
  • Feels often attacked by others.
  • Resentful.
  • Unjustified suspicion and resulting jealousy of partners.

According to the DSM5, PPD often first becomes apparent in childhood or early teen years. Although direct causes are unknown, research has shown links to both biological factors – such as a history of schizophrenia in the family, and environmental factors, such as adverse childhood experiences like neglect, abuse or a generally unstable home environment. More likely than not, a combination of these factors will be what leads to the development of the disorder. Triggers that may bring on symptoms of this disorder can be harmless actions from others that are misinterpreted by the sufferer as malevolent. When a sufferer starts to become suspicious and paranoid, the decline can be rapid. Often the more suspicious and paranoid they become, the more they will isolate which in turn allows their distorted thinking to go unchallenged and take a stronger hold.

Treatment for those suffering from PPD is often difficult due to the severe trust issues and suspicion sufferers will often feel towards mental health professionals. This usually results in them being unwilling to seek treatment or take on board any advice from a professional. For any psychiatric treatment to be successful the professional must build a good relationship with the client that is based on trust and will put the patient at ease. This must be done before the patient is likely to confide in them.

For this reason it’s vital that the individual suffering from PPD is connected to a dedicated professional. Long term residential programmes are ideal for people looking to find support and recovery from PPD because in such a setting they will have the time to develop the needed rapport and trust needed to maintain recovery. At Khiron Clinics, our staff understand that clients suffering from this personality disorder will need time to ease into the process of treatment in order to achieve the most positive outcomes.

We know that in order for recovery from PPD to begin, the client needs to believe they are in an environment with a treatment team who really cares and where they will be heard and taken seriously. Time is needed to establish the necessary groundwork to develop the critical sense of trust in order for progress in treatment to be made.

This disorder is more difficult to treat in an out-patient setting or with short term treatment, because patients suffering with Paranoid Personality disorder are often unable to stick with the treatment process due to their paranoid feelings mistrust and unease. If a person refuses treatment then it is likely the condition will get gradually worse, almost feeding itself with each paranoid thought. This will inevitably lead to a breakdown in personal relationships and hugely impact the person sufferings ability to lead a functional life.

In cases where the individual accepts treatment it can often be very successful. Depending on the case a combination of psychotherapy and medication is often used. At Khiron our main aims with individuals suffering from PPD would be to help them understand more about their disorder, learn how to communicate with others about how they are feeling and to aim to reduce the feelings of paranoia through mind and body work such as meditation, yoga, and somatic experiencing.

If you have a client, or know of someone who is struggling with a diagnosis of Paranoid Personality Disorder, or is experiencing symptoms described in this article – reach out to Khiron. We believe that we can stop the revolving door of treatment and misdiagnosis by providing effective residential and out-patient therapies for underlying psychological trauma. Allow us to help you find the path to effective, long lasting recovery. For information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).