All About Paranoid Personality Disorder (Part 2)

In our previous post, we’ve learned quite a lot of things about Paranoid Personality Disorder. In today’s article, we’ll go more in-depth with the different types of PPD and its treatment! Let check them out!

What are the types of paranoid personality disorder?

Currently, there are five different types of paranoid disorder, depending on their characteristics. These are:

#1. Fanatical paranoid disorder

It is a combination of different paranoid and narcissistic traits. People with this disorder do not trust others, have feelings of superiority, and are presumptuous; they often need to exercise a high level of control over them. Zealous paranoids tend to hold grudges for a long time and do not forget insults, real or fabricated. They also often blame others for their mistakes, given the inability to face them themselves.

#2. Malignant paranoid disorder

In this case, we are talking about a combination of paranoid and sadistic traits. People with this condition believe that they will be assaulted or harmed; as a defensive mechanism, they decide to attack before they can be the victims. They generally project their belligerent or cruel attitude onto other people to not face their own shortcomings. Malignant paranoids tend to be envious and use sarcasm and irony to harm those around them. They tend to belittle others’ successes and impose their wishes and way of seeing things in their social environment.

#3. Stubborn paranoid disorder

In this subtype, paranoid and compulsive characteristics are conjugated, which usually leads to rigidity and the need for control; This results in a permanent need for self-assertion. They look to compliance with rules as a way to reinforce themselves. They continuously seek compliance with order or perfection, although they are more flexible than obsessive-compulsives. As a consequence, they tend to look down on others as undisciplined or weak.

#4. Querulant paranoid disorder

This is a combination of paranoid and negativistic traits. People with this pathology are usually picky, negative, critical, and resentful. They tend to feel jealous when they think they are not understood, which leads them to be in permanent conflict. Due to these negative factors, they often harbor feelings of envy and a desire for revenge. Since they believe that they have been mistreated, they do not put up with other people’s achievements, which they consider unnecessary. As a reaction to the social rejection that they generate, they end up denying having affective needs.

#5. Isolated paranoid disorder

This last subtype consists of the combination of paranoid and avoidance traits. Since they feel permanently threatened, they opt for isolation as a defensive mechanism. These are people who are extremely sensitive to criticism and hypervigilant. As a consequence of their isolation, these people end up having severe difficulties in differentiating reality from fiction. They have a very intense level of insecurity, as well as an exacerbated fear of feeling controlled.

So, how is paranoid personality disorder treated?

One of the main difficulties in treating people with paranoid disorders is that they do not accept their condition as patients since they usually go by imposing a third party (parents, partner, etc.) This makes the treatment very more complicated since the patient is not fully involved. To a large extent, this difficulty is given because the paranoid also distrusts the psychologist or doctor; thus, instead of thinking that they are helping you, you tend to believe that they want to harm you in some way. For this reason, psychological therapy usually has limited effects unless it is the patient himself who decides to do it voluntarily.

In cases where a good therapeutic alliance is established between patient and psychologist, the most effective techniques to treat this disorder are various. In the first place, it is essential to develop a cognitive restructuring; With this, the patient will realize that his paranoid ideas are not real but fictitious. Secondly, it is necessary to train them in social skills to improve their social integration. This is of special importance since, on the one hand, it reduces their paranoid feelings by trusting more in the people around them, and on the other hand, it reinforces their social circle, which will allow them to have more support.

Sometimes it may also be necessary to use pharmacology as a method to control some of the symptoms. However, this will always be done under the prescription and monitoring of a medical professional.