Paranoid Personality Disorder
People with psychological difficulties such as depression, anger control disorder, anxiety, obsessive-compulsive disorder, and panic visit the counseling center. Many of them do not have a single problem, but a variety of complex psychological problems. Therefore, in counseling, various aspects should be considered, even if it is depression or major depression. The clients who present the greatest challenge for counselors are those with paranoid symptoms. Paranoid clients don't trust their counselors because they have a lot of doubts. Therefore, it is very difficult to form a Rapport. In many cases, paranoid clients are unwilling to accept that they have a problem, that they must seek counseling, and that they must be prescribed medication. In other words, people with paranoia look at everything with suspicion and look for the cause of all problems in others, not themselves. They tend to feel and think of each other's gaze toward them and the kind words they give them as negative things that are hostile to them. If these paranoid symptoms are so severe that they interfere with not only home and work, but also general life, it is called Paranoid Personality Disorder. Caution should always be taken, especially as they may have brief but highly violent psychotic episodes under severe stressful situations.
A paranoid personality disorder is a group A personality disorder characterized by bizarre thoughts and behaviors. It generally begins in adulthood and is more common in men than women, affecting 1.5% of the general population in Korea, 2.3-4.4% in the United States, and 1.21-4.4% of the world's population.
Diagnosis of Paranoid Personality Disorder:
DSM-5 provides diagnostic information for paranoid personality disorder as follows.
A. A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
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.
3. Is reluctant to confide in others because of unwarranted fear that the information will be used 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 others and is quick to react angrily or to counterattack.
7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
B. Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.
Note: If criteria are met prior to the onset of schizophrenia, add “premorbid,” i.e., “paranoid personality disorder (premorbid).”
Symptom:
People with Paranoid Personality Disorder have an unfounded belief that others constantly demean, harm, or threaten them. Therefore, it is not easy to form close relationships with others. In many cases, problems always arise in relationships and social life, which can lead to legal problems.
They believe that others are taking their advantage and deceiving them, and they, therefore, doubt the commitment, loyalty, or credibility of others.
They feel that they may be used by others and are reluctant to divulge secrets or disclose personal information to others.
They do not forgive and hold grudges.
They do not accept criticism well and are sensitive.
Reads hidden meanings in other people's light stories or facial expressions.
Recognize attacks on one's personality that others are not aware of.
They get angry easily and retaliate.
Be suspicious of their spouse or lover for no reason.
They generally have cold relationships with others, distance themselves from others, exercise control to avoid being betrayed, and in some cases become jealous.
They cannot play a role in resolving problems or conflicts and always believe that only they are right.
They are hostile, stubborn, and controversial.
Negative stereotypes about people of different cultures.
Causes of Paranoid Personality Disorder:
The exact cause of paranoid personality disorder is not known. It is generally known that a combination of biological, psychological, and environmental factors influence this disorder. The fact that paranoid personality disorder is more common in people with close relatives suffering from schizophrenia or delusional disorder suggests a genetic link between the two disorders. Early childhood experiences, including physical or emotional trauma, also play an important role in the development of this disorder. For example, experiences of domestic violence, strict discipline, or rejection by peers are important factors contributing to the development of a paranoid personality, distrusting and suspicious of others.
Treatment of Paranoid Personality Disorder:
Most people with Paranoid Personality Disorder don't think they have a problem. For this reason, they often come to counseling centers or psychiatric departments for other mental health problems such as depression, obsessive-compulsive disorder, or anxiety.
In general, psychotherapy including counseling, especially cognitive behavioral therapy, should be given priority. In particular, programs for dysfunctional change of beliefs, social interaction, communication, and improvement of self-esteem play an important role. In addition, they should be careful not to be placed in a stressful situation, and furthermore, help them to learn their own appropriate stress management. It should be noted that people with Paranoid Personality Disorder are not easy to treat because they do not trust others, that is, they do not trust their therapists either. Therefore, the counselor must carefully form a rapport with the client so that the treatment can be carried out within trust.
If people with paranoid personality disorder suffer from psychological problems such as extreme anxiety or depression, anti-anxiety medications, antidepressants, or antipsychotics may be prescribed.
If a family has a client with Paranoid Personality Disorder, family members tend to suffer too much. Because he or she constantly doubts, it often negatively affects his wife, her husband, and even children. When a particularly severe stressful situation comes, or when he or she has a lot of stuff piled up in his or her mind, the violent side like a fire is expressed outward. So, it can always be said that the family lives life like walking on glass. How can we overcome this? As a counselor, I try to plant the seeds of faith in my clients through various programs. However, rather than the role of a counselor, I believe that the help of family members is absolutely essential for people with paranoia. Sharing love between family members and expressing this love naturally to each other in everyday life is the most powerful remedy for overcoming this obstacle. The best medicine for this disorder is to melt the distrust of family members with the disorder and help them develop positive thoughts through explanations and stories that convey the family's warm loving eyes and hearts.
