PsychotherapyHELP

Paranoid Personality Disorder: A Brief Profile and Questionnaire

Paul J. Hannig, Ph.D., MFCC

According to the DSM-IV, published by the American psychiatric Association, the essential feature of Paranoid Personality Disorder is a pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent. This pattern begins by early adulthood and is present in a variety of contexts. It is in the context of a love relationship that this excerpt addresses.

Relationship Disasters...

The Paranoid Personality Disordered person (PP) is a disaster in relationships. The PP can vacillate between being warm, concerned, loving and attentive to being abusive, suspicious, projecting, accusing, blaming, critical, demanding, belittling and downright cruel. The warmth and concern of a PP cannot counterbalance the damage and hurt that can be inflicted upon significant others. Long term intimates report that the damage inflicted by the PP is so horrendous that it is almost impossible to recover from it without shedding enormous amount of pain.

The jealousy of the Paranoid Personality is so intense that s/he denies the true personhood of the partner. Distrust is combined with intense need and dependency, while the person's blaming, attacking and verbal rage drives the partner into a self-protective world of self-denial, "you" statements and intellectualization. The PP is an angry person whose rage is destructive to him/herself and others.

Paranoid Personalities are hypersensitive to any hint of hurt, betrayal, rejection or attack. There is no awareness that they may actually set up or manipulate others into accidental hurt or rejection. Persecution is seen even where it does not exist. Normal events are misperceived as harmful. Negatively narcissistic, PPs believes that somehow they are the object of people's dislike. There will also be job problems, especially when Paranoid Personalities work with authority figures who are perceived as being antagonistic.

Perceptual distortions will cause innocuous, harmless events to be seen as threatening to one's very being. At one time in the PP's life, there might have been a paranoid schizophrenic episode. Perceived threats to the person's well being may have produced critical, punitive, auditory hallucinations and delusions of persecution. Such acute episodes may precipitate or be part of the ongoing chronic personality structure of the Paranoid Personality.

The Paranoid Personality may appear to behave in strange, unusual, deviant, peculiar ways. Thinking can be very idiosyncratic and filled with defensive logic. The PP may appear to be hostile, stubborn, resistant, defensive and manipulative. S/he will give peculiar reasons for being constantly late for meetings. The PP tends to influence others with intense, biting anger and may show deficits in consistently expressing love and affection.

According to Othmer (1989), the paranoid personality is triggered by close interpersonal relations where the perception is "people sneak up on me and harm me". There is guarded distance, debilitating self-protectiveness, secretiveness, devious and dishonest behavior, scheming and counter-attacking. The person appears suspicious, distrustful, jealous, angry, hostile, negative and hypervigilant.

Paranoid people are very hurt individuals who require enormous amounts of empathy and understanding. Unfortunately, it is difficult for other people to supply that empathy if they are the targets of the paranoid's exaggerated responses to minor slights, benign remarks and insignificant events. The PP assigns hidden, hurtful, damaging meanings to objectively harmless situations and events (DSM-III-R, 1989). The internal injuries are so enormous that the PP feels harmed and exploited without a sufficient reality basis. The internal destroyer/annihilator creates the pain and the havoc, but the ego will not take responsibility for the injury to the fragile, vulnerable self. Thus, the inner object finds and locates an external object upon which to blame, accuse and project.

Not all people are made into bad, harmful objects by the paranoid person. Some individuals are deemed trustworthy by the inner arbitrator. But sooner or later even trusted others will inadvertently trigger off the internal domain of persecution and harmfulness.

Because the paranoid person feels harmed by others, faulty logic, misinterpretation and misperception are not apparent to the sufferer. One's feelings justify one's accusations and suspicious questioning. The paranoid is convinced that his/her feelings are sufficient basis for accusing others of harm. Here and now reality is intruded upon by earlier unexpressed pain and only by careful processing can the PP learn to correct paranoid interpretations. It is important to remember that it is not the paranoid person's feelings that are distorted. The feelings are legitimate. It is the cognitive processing that is disturbed. Repression causes faulty information processing and the paranoid person suffers a serious break with reality.

Paranoid Personality Disorder should be diagnosed only when these traits are inflexible, maladaptive, and persisting and cause significant functional impairment or subjective distress. The questionnaire below should give you some insight into the characteristics of the disorder.

Questionnaire: For Partners, Friends and Relatives of Someone Who is Afflicted With Paranoid Personality Disorder

This questionnaire can help you to identify those characteristics associated with Paranoid Inter-Person-Ality problems.

1.       Do you believe that               has a hidden, excessive fear of being abused, hurt and emotionally injured?

Yes                          No                 

2.       Does           appear to engage in unreasonable scanning and hypervigilant behaviors?

Yes                            No               

3.       Have you noticed that           appears to engage in projection, ascribing malevolent intentions, actions and motives to you and other people?

Yes                           No                

4.       Have you ever been the object or target of                  's fear, anger and distrust?

Yes                          No                 

5.       Does           seem to be negatively hypercritical?

Yes                           No                

6.       Does           appear to be negatively and disrespectfully judgmental?

Yes                           No                

7.       Do you sometimes feel that you are a symbolic representation of someone or something out of  's past?

Yes                           No                

8.       Do you sometimes feel that              displaces, externalizes feelings on to you that seem to belong onto someone else from the past?

Yes                           No                

9.       Do you sometimes feel that you are a bad parent to                ?

Yes                           No                

10.   Do you sometimes feel that you are being treated as if you are an abusing parent?

Yes                           No                

11.   Do you sometimes feel that you are being accused unfairly?

Yes                           No                

12.   Do you sometimes feel that              plays the victim and you are the victimizer?

Yes                           No                

13.   Do you sometimes feel that              identifies with abused children and sees you as the bad parent?

Yes                           No                

14.   Do you sometimes feel that              magnifies and exaggerates events and behavior?

Yes                           No                

15.   Do you sometimes feel that              misinterprets events and people's behavior and motives?

Yes                           No                

16.   Does           misperceive benign events and mislabel them as, "Terrible, Awful, etc."?

Yes                           No                

17.   Does it seem that                turns reality around into the opposite direction?

Yes                           No                

18.   Does it seem that                presents a positive image and then turns around into the opposite?

Yes                           No                

19.   When you spend time with                do you feel disordered afterwards?

Yes                           No                

20.   After you have spent time with                       do you feel like crying and screaming?

Yes                           No                

21.   Why don't you?                                                                                                                               

22.   Have you ever been emotionally involved with a suspicious and distrusting person before?

Yes                           No                

23.   Does           hold grudges?  Is there a family history of grudge holding?

Yes                           No                             Yes                     No                

24.   Does           keep reminding you of the skeletons in your family closet, but never talks about his/her own?

Yes                           No                

25.   Does           seem more negative than positive, most of the time?

Yes                           No                

26.   Are you afraid to end the relationship with                  ? Yes                   No                

Why?                                                                                                                                                                                             

27.   Does                       convince other people [including therapists] that you are the bad one?

Yes                           No                

28.   How does that make you feel?                                                                                                         

29.   Does                       make conclusions based on insufficient, arbitrary, unsubstantiated evidence?

Yes                           No                

30.   Does                       select certain information out of context and highlight certain details while ignoring other important information?

Yes                           No                

31.   Does           engage in polarized, all or none dichotomized thinking [good, bad, black, white, etc.]?

Yes                           No                

32.   Does           display tunnel vision; i.e., seeing only what he/she wants to see?

Yes                           No                

33.   Does           make automatic assumptions that you hold a negative ulterior motive for your actions?

Yes                           No                

Call Dr. Paul right now at 818 882 7404 if you are fairly certain that your loved one is afflicted by an INTER-PERSON-ALITY problem!

Copyright ©2003. This document is for informational and educational purposes only and is not intended for professional diagnostic uses.

Paul J. Hannig, Ph.D., MFCC  * PsychotherapyHELP  *  www.nvo.com/psych_help *  phannigphd@socal.rr.com  *  818-882-7404