Paranoid personality disorder
We recognise that the system of personality disorder diagnosis can be considered controversial. It is completely your choice which term, if any, you want to use, knowing that your doctor or care team may use another.
We appreciate that the feelings and behaviours associated with personality disorders are very difficult to live with, and everyone deserves understanding and support. We recognise the diversity in understanding of experiences and preferences around terms individuals may wish to use. We are also aware that some professionals disagree with the system of personality disorder diagnosis, and that some people given the diagnosis find it unhelpful and stigmatising.
The terms used on Counselling Directory are those that are generally used in the UK, currently. We refer to these terms throughout, with the hope of reaching and supporting as many people as possible.
Paranoid personality disorder is defined by a distrust of others and a continuous suspicion of their intentions. The individual lives in a hostile world and firmly believes that others have sinister motives that are threatening or demeaning. This is usually without good evidence and those suffering from paranoid personality disorder will often dwell on trivial things.
Sufferers will often avoid any close relationships with others, and tend to have extreme trust in their own knowledge and capabilities. Perceptions of how others are behaving may lead to angry or aggressive outbursts, as sufferers are hypersensitive and unforgiving.
This disorder eventually leads to the individual appearing cold and distant, constantly challenging the loyalties of friends and loved ones. They may also be jealous, secretive and scheming. This can result in social isolation as the individual may stay at home, planning how to react to a perceived attack. Any attempt of communication may be rejected as the sufferer becomes more reclusive.
Although those suffering from this disorder do not generally lose touch with reality, they are usually unable to recognise their own negative feelings. They will not confide in others as they fear betrayal, even if that person proves trustworthy and honest. Men are usually diagnosed with this disorder more than women.
On this page
Symptoms of paranoid personality disorder
- poor sense of humour
- concern with hidden motives
- expects to be exploited by others
- social isolation
- poor self image.
Causes of paranoid personality disorder
The cause of paranoid personality disorder is still unknown. However it appears to be found more common in families with other disorders such as schizophrenia, suggesting a genetic connection. Other research suggests negative childhood experiences, such as a threatening atmosphere, can also prompt the disorder. Condescending parental influences that create child insecurities may also contribute to the development of paranoid personality disorder.
Psychotherapy and medication are the most effective treatments for this disorder. Medication is not generally encouraged though, as the sufferer may be suspicious of the doctor. In circumstances where the disorder begins to impede normal functioning, however, medication is encouraged but should be used for the briefest time possible. Without treatment, paranoid personality disorder may become chronic. Psychotherapy appears to be the most hopeful method of treatment for paranoid personality disorder; sufferers of this disorder have deep-rooted issues that require intense therapy.
What should I be looking for in a counsellor or psychotherapist?
Whilst there are currently no official regulations in place that stipulate what level of training and experience a counsellor needs to treat paranoid personality disorder, we do recommend that you check your therapist is experienced in the area for which you are seeking help.
The NHS recommends psychotherapy as a form of treatment for personality disorders.
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What our experts say
- Emotionally abusive relationships: Survivors of narcissistic parents
Amanda Perl MSc Psychotherapist Counsellor MBPsS BACP (Accred) CBT Practitioner16th May, 2017
- Just because he's paranoid doesn't mean they're not out to get him
Brian Shand BA, MSc, Ph.D, M.Inst GA, UKCP. Analytic Psychotherapist12th April, 2017
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