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Paranoid Personality Disorder
Paranoid Personality Disorder
Kelly S. Stevens
Westminster College
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My interest in Paranoid Personality Disorder started several years ago when I befriended
a woman at work. At the time, I did not know that it had the “official” name of Paranoid
Personality Disorder”, but I knew this person suffered from paranoia. My friend Pam and I have
gotten to know each other quite well over the past two years. We worked together and we
started socializing at work and afterwards. We both have two children and they are around the
same ages and they got along really well. What I did not know at the time is that Pam's husband
may suffer from Paranoid Personality Disorder (PPD). This of course, is just my opinion. The
reason I feel this way is that his paranoia is pointed towards Pam and the belief that she is
unfaithful in their marriage. He is continuously accusing Pam of this, when there is not any truth
to the matter. I try not to be judgmental, but I have often wondered how she has put up with the
paranoia for seventeen years. Pam has referred to her life is like “walking on egg shells”, always
wondering when the next blow up will be and her only hope is that the paranoia will end, but
probably knowing that it will not. I just do not think that I could live my life like that. But due
to financial burdens and not wanting her kids to come a divorced family, she can not see herself
leaving him.
To begin my research, I wanted to define what exactly Paranoid Personality Disorder is.
The American Psychiatric Association (2000) identifies "the essential feature of the paranoid
personality disorder is a pattern of pervasive distrust and suspiciousness of others such that their
motives are interpreted as malevolent. (DSM-IV-TR, 2000, p. 690) The American Psychiatric
Association further expands on the diagnosis as follows:
1. Suspects, without sufficient basis, that others are exploiting, harming, or
deceiving him or her
2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of
friends or associates
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3. Is reluctant to confide in others because of unwarranted fear that the information
will be maliciously against him or her
4. Reads hidden demeaning or threatening meanings into benign remarks or events
5. Persistently bears grudges, i.e. is unforgiving of insults, injuries or slights
6. Perceives attacks on his or her character or reputation that are not apparent to
other and is quick to react angrily or to counterattack
7. Has recurrent suspicions, without justification, regarding fidelity of spouse or
sexual partner. (Personality Disorder Information Sheet, 2005, p. 1)
In reading, Understanding Paranoia, [A Guide for Professionals, Families, and
Sufferers], I felt I could get some insight to this disorder. My intention is never to share this
information and report with Pam or her husband, but it is for me to better understand why Pam's
husband acts this way. This is a personal and educational search for information and I don't feel
that in way would I force my findings on the friendship that I have established. Since my
information came from a book and not an article, I was not able to read the entire book, but
because of my interest in PPD, I did read a great deal of it.
In summarizing the parts of the book that I did read, I focused on characteristics, cause
and therapies. The first area was identifying prominent characteristics of paranoid individuals. I
thought to myself, could you actually look at somebody and identify this disorder? I thought not,
but as I read on I realized the characteristics were more in the nature of personality, but there are
some actual appearance characteristics that tend to appear in people with Paranoid Personality
Disorder. To name just a few, many people with PPD tend to be thin. They also appear to be
tense and excessively reserved.
I realize that I am not at all qualified to diagnosis Pam’s husband with PPD, but from the
evidence that Pam has restated to me, I feel he clearly could have this disorder. Pam has confided
quite a bit of information about his paranoid and abusive personality. I personally have not seen
in it first hand. I have heard a recorded phone message that leads me to believe she is not
exaggerating about his personal tyrants.
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"While society plays important roles in causing or facilitating individual paranoia, we
should not necessarily blame social factors exclusively for the paranoia of any given individual."
(Kantor, 2004, p. 105) The book goes on to say also that parents are so critical in creating and
developing paranoia. The book gave examples of abusive, traumatizing parents, excessively
critical parents, and unfair parents. I want to share a brief history of Pam's husband that might
have lead to his paranoid behavior towards his wife. The story is that the mother (of Pam’s
husband) cheated on his father on more than one occasion. It had been literally pounded in his
head that "all women cheat" by his father. Pam's husband loved his mother, but hated the fact
that she had cheated on his dad. Then to end things, his mother was murdered before he was able
to work through these issues with her.
In further reading, I learned that there is hope for people who suffer with PPD. But, a
high percentage never seeks therapy because of the nature of the illness. The book looks at four
different type of therapy: Psychodynamic/Interpersonal Approach, Cognitive Behavioral
Therapy, Affirmative Psychotherapy, and Pharmacotherapy. I will take a closer look at one of
these, and try to determine which I think would be the best therapy for Pam's husband and the
reasons why.
I chose to look at Cognitive-Behavioral Therapy, (even though I feel that he would never
go to a therapist). He feels no remorse at what he says or does and has never apologized for the
behavior. The reason I chose this therapy is because it works on “changing illogical thinking
that negatively affects behavior, anticipating one of two possible outcomes” (Kantor, 2004, p.
151) The outcome I hope could occur is that he is helped in way so that he begins to think in a
less delusional manner and over time and therapy the delusions would stop. The other outcome
the patient continues to be delusional, but recognize their behavior and respond in a less
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disruptive way. The book went on to look at how therapists should avoid confronting the patient
and challenging the delusional thinking. This, I feel could lead to distrust and the patient may
longer want to participate in the therapy.
In conclusion, and review, I enjoyed reading and researching Paranoid Personality
Disorder. It made me realize even more that living with a person that may suffer from PPD is
very painful and exhausting. I think it is fair to say that is very hard to reason with a person that
has a mental illness. I would not choose to be in a relationship like this, but everyone has
reasons for the choices they make in their life. I would hope that someday Pam’s husband seek
help and stops the craziness, but do not see that happening anytime soon. This disorder usually
destroys marriages, but this one seems to keep on surviving.
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Resources
Diagnostic and Statistical Manual of Mental Disorders. (2000). Washington: American
Psychiatric Association.
Kantor, M. (2004). Understanding Paranoia [A Guide for Professional, Families and Sufferers].
Westport: Praeger Publishers.
Personality Disorder Information Sheet. (2005, July 2). Retrieved July 18, 2007, from PsychNet-
UK: http://www. psychnet-uk.com/clinical_psychology/criteria_personality_paranoid.htm