Session 7: Paranoid Personality Disorder (PPD)

Self-Image =
P; between impotent, D self and
O V self

Polar, despised, omnipotent vindicated

View of Others =
“On G against a H world”

guard, hostile

Relationships =
Quick to take O, slow to F and always ready to C (if didn’t already issue P strike)

offense, forgive, counterattack, preemptive

Issues with Authority =
Will exert interpersonal power out of fear of
D & loss of I (complaints,
intense C & litigation)

domination, independence, confrontations

Behavior =
○ can be easily aroused to A
○ May appear T & G
○ Inclined to c and/or D others
○ Difficulty expressing W
○ Righteousness & R causes
○ Exaggerated C

agitation, tense, guarded, criticize, devalue, warmth, righteous, competitiveness

Affect =
○ internally afraid & U (Oriented toward safety
always) but do not appear fragile E
○ can rarely R or experience contentment

uncertain, externally, relax

Defenses =

○ built on necessary I, S & A
○ Disown U traits (P on others)
○ Active F world with self-E image
○ Reduction of stress through control & P

independence, superiority, autonomy, undesirable, projection, fantasy, enhanced, predictability

Self-Created World (Alternate Reality)
○ P > authenticity
○ Distance > C
○ Common beliefs:
● People should P for what they do
● People have to be W; trusting others + self-destruction
● “Never let them see you B”
● People respect what they F

Predictability, closeness, pay, watched, bleed, fear

Protective Factor =
loss of C = undesirable

control

Risk Factors =
○ Desire to “feel P”; “dominant”
● C, A & A
○ Need to feel A, strong and ready for battle
● amphetamines
○ Desire to “be someone”, “be big/important”
● cocaine, alcohol & marijuana
○ E and unending vigilance
● B & H

powerful, cocaine, alcohol, amphetamines, alert, Exhausting, benzos, heroin

Treatment Recommendations =
-Expect T behavior and greet with honesty &
openness
-Incorporate psycho-E in tx (eg. loss of autonomy in drug use)
-A attitude with suggestions for alternatives
-“C E” approach (Carroll)
(therapist and client J examine client’s beliefs in light of objective information)
-S skills enhancement: assertiveness, communication and empathy (Carroll)
-Manage hostility without R or being V
-Adhere to strict B and conservative interpretations of ethics
-seek support (peer S)
-Allow higher power = highest Self (self-generated strength

testing, education, Agreeable, collaborative empiricism, jointly, Social, retaliation, victimized, boundaries, supervision,

Things to Avoid in Treatment:

-E or D “so why do you ask that question”
-Direct C and R of paranoid assertions
-Skilled interpretation (feeds P)
-G therapy
-D questions about drug & alcohol use
-A required programming
-Termination policy for R

Evasion, deflection, confrontation, refutation, paranoia, Group, Direct, Abstinence, relapse

Difference between Paranoid PD and
Paranoid Schizophrenia (Ahktar)

-Person with paranoid schizophrenic displays a serious B with reality, bizarre delusions of persecution, grandeur, jealousy or infidelity, auditory H, symptoms of thought control, incongruous affect, and gross
peculiarities of behavior.
-N of these are characteristic of an individual with paranoid personality disorder.

break, hallucinations, None

Overt & Covert features of
Paranoid PD (Ahktar)

-Seemingly C aspects of the disorder that permeate self-C, S adaptation, L life, morality and cognitive attitudes

-Individuals with a paranoid personality disorder are "O" arrogant, mistrustful, suspicious of others, driven, industrious,
and even successful in solitary professions, unromantic, idiosyncratically moralistic and sharply vigilant towards external environment

-Individuals with a paranoid personality disorder can also be
"C" frightened, T, gullible, chronically experiencing interpersonal difficulties in the work situation, corruptible,
vulnerable to erotomania and sadomasochistic perversions,
and cognitively unable to grasp the totality of actual events in
their proper context.

contradictory, concept, social, love, overtly, covertly, timid,