The Paranoid Personality Disorder

Have you ever worked with someone who took everything you said the wrong way? Someone who always believed they were being persecuted or insulted? If so, you may have encountered a paranoid personality.

The Personality Disorder

A paranoid personality is different to mere paranoia. Even the most relaxed individual harbours the odd grudge or mistakes a neutral act for an aggressive one. A personality disorder, on the other hand, is more fundamental. This occurs when a cluster of similar traits, such as dependency, fear, anxiety, etc, so dominate and overwhelm a personality that it becomes disordered. Crucially, they interfere with one’s ability to earn money and form relationships – in other words, to live a normal life.

Personality disorders are rarely clear-cut, however. The DSM recognises 10: the paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, obsessive-compulsive, avoidant, and dependent. However, few individuals tick every box in, for example, the histrionic while displaying none of the traits from the other nine. More often, people exhibit most of the traits from one disorder plus several from the others.

The paranoid personality disorder often co-exists with one or more others. Someone who is avoidant will be extremely socially anxious. They hate meeting new people and tend to cling to a partner or parent, as in the dependent personality. But the social phobia may combine with paranoia, leaving them certain that everyone is out to hurt them. Thus the social phobia feeds the paranoia and the paranoia feeds the social phobia.

The Paranoid Personality

Those with a paranoid personality fear and distrust others. Consequently, they are guarded, watchful and suspicious. They also take offence quickly.

Unsurprisingly, others find them hard work. Someone in a relationship with a paranoid personality would soon be reduced to a bundle of nerves. The paranoid trust no one and constantly suspect their partner of infidelity. For example, a man with a paranoid personality may discourage his girlfriend from seeing her male friends, or fear that her yoga instructor plans to seduce her.

The paranoid can also be a nightmare to work with. Even the most innocent comment or action will be misinterpreted. If they lose a file, or their manager warns them about their long lunch breaks, they assume a work colleague has gone behind their back.

The World Health Organisation lists seven traits. To qualify, the individual would need to exhibit at least three and find that they interfere with day to day life. First, the paranoid hold grudges. They do not forget and they do not forgive. In part, this comes from fear. If you forget a cruel or spiteful act, it will happen again.

Second, the paranoid cannot bear failure, especially when it involves rejection. For example, if they fail their driving test, they take it personally. They cannot just shrug their shoulders and think “Oh well, I wasn’t focussed enough.” Instead, they blame the examiner. Maybe he had passed too many that day and needed to fail someone.

Third, they misinterpret the actions of other people. The other person may be indifferent, or even wish them well, but they cannot see this; everything is filtered through a distorting lense. For example, a teenage girl with an eating disorder assumes that her aunt raises the matter out of spite. In fact, the girl’s parents have asked her to intervene, and she is worried.

Fourth, they are self-righteous. Others are spiteful and cruel, and only they can see through this. Question these suspicions and they will dismiss you as naive or childish. They may also become aggressive. And this combative stance will usually be inappropriate. The paranoid take back a malfunctioning TV, for example, and accuse the sales assistant of trying to cheat them. Others may be duped but not the paranoid – they know what you are up to!

Mistrust of one’s partner is also common and forms trait five. The paranoid assume their partner will cheat at every opportunity, or will at least be tempted. And they distrust others. As has already been noted, the paranoid find relationships difficult to sustain. Often they become controlling and even violent – many abusive partners suffer from some form of paranoia.

Sixth, they are self-aggrandising. They often believe they possess superior insight, that they are more perceptive and less easily duped. And they are proud of this.

Finally, the paranoid have a conspiratorial mindset. To the paranoid, nothing just happens. If a car crashes into them, they assume the driver was plotting an insurance scam. If their work colleague is promoted ahead of them, they suspect bribery, and so on. And they see conspiracies in the world at large as well. If the government declares war, they assume the reasons are all false (the President hopes to distract people from his mishandling of the economy).


The American psychologist Theodore Millon, who studied personality disorders in depth, distinguished five subtypes. Each displays the basics of paranoia, but with subtle differences.

First, there is the malignant paranoid. Such people are not only irritating and unpleasant but dangerous, and their paranoia is often mixed with sadism. If they believe that a certain individual is out to get them, their response can be savage. Not only are they aggressive, rude, and intimidating, they also project these traits onto others, meaning they see malignancy and viciousness everywhere.

The malignant take revenge at every opportunity and often delight in doing so. Those who lack the courage to carry this through, however, escape into fantasy and daydream, imagining all the dreadful tortures they’d inflict on their boss or neighbor if they had him in their power.

The insular paranoid are less scary. Such people often exhibit many of the traits found in avoidant and dependent personalities. Like the avoidant and dependent they experience a great deal of fear. The world is perceived as threatening and dangerous, best avoided if possible. This isn’t cowardice or weakness, by the way, merely a different way of seeing. For some, the world appears exciting, for others dreadful.

The insular, like the avoidant, protect themselves by hiding away. When they must deal with other people, they maintain hyper-vigilance. They usually experience a great deal of social anxiety as well. The socially anxious are themselves often paranoid, of course, assuming people wish to expose or shame them in some way.

The obdurate paranoid are stubborn and implacable. Once an idea is fixed in their mind (that their manager persecutes them, for example), they do not let it go. Indeed, they often resort to legal threats and will pursue something through the courts if necessary. They also tend to be self-righteous and to see themselves as victims of a cruel and unjust society.

The fanatic paranoid seems out of touch with reality. All paranoid personalities are slightly out of touch, but here the problem is especially bad. Such people have grandiose delusions, convinced that they know the truth and that that is why they are persecuted. Those who develop strange conspiracy theories and then claim the government is tapping their phones, or that someone is following them home, etc, fall into this group.

There is often an undercurrent of arrogance, even narcissism, to the fanatic. He or she feels blessed with greater insight – smarter, more observant, special even. Others seem stupid, herd-like, and oblivious to what is really going on. The fanatic alternates between arrogance and low self-esteem. When their self-esteem is threatened, they re-establish lost pride by absurd claims and fantasies.

Finally, there is the querulous paranoid. These are especially unbearable: petty, snappy, argumentative, fault-finding, and quick to take offence. They are irritable and often jealous, but their jealousy is combined with a sense of outrage, of having been cheated or abused by their richer and more successful neighbor. The querulous respond with passive-aggressive behavior, retreating into silence or sarcasm.

The paranoid personality disorder is more common than people realize. Indeed, most know someone with paranoid traits. The good news is that effective treatments exist, in particular cognitive behavioral therapy, which teaches people to monitor their thoughts and behavior, re-wiring the brain in the process.

Such treatments are certainly worth the effort, since paranoia undermines relationships, drives away friends, and transforms the world into a dark and threatening place.

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