The Diagnostic and Statistical Manual of Mental Disorders, or DSM, currently recognizes ten different personality disorders. These are divided into three groups: A, B and C.
Before looking at cluster A in detail, it may help to summarize the other two. The cluster B personality disorders (narcissistic, histrionic, borderline and antisocial), though they differ a great deal, all involve excess emotion. People in this group also tend to think and behave in a colorful and dramatic way. Those in cluster C (dependent, avoidant and obsessive-compulsive), on the other hand, are reserved and withdrawn. This is the fearful, or anxious, group. The dependent, for example, need the comfort and reassurance of others and often cling to one person. The avoidant, who usually have dependent traits, fear social interaction and have as little to do with the world as possible. The obsessive-compulsive use rules and rituals to help them cope instead.
The personality disorders in cluster A all involve distorted thoughts and perceptions. People with cluster A personalities do not see the world as others see it. And that makes it hard for them to communicate. Often, they behave and speak in odd, eccentric ways, which also makes it difficult to establish intimacy.
The Paranoid Personality Disorder
Someone with a paranoid personality disorder is, as the title suggests, suspicious and mistrustful. They also tend to be hyper-vigilant. Since the world is a dangerous place, they must be forever on their guard. To make it worse, they look for confirmation of their fears – and they usually find it.
This disorder often exists alongside others, such as the avoidant or dependent. The paranoid consider the world hostile, and so naturally they do what they can to avoid it, which in turn leaves them isolated, clingy and dependent. It also leaves them lonely, since they avoid intimacy whenever possible.
The World Health Organization lists several traits. For someone to qualify they need to exhibit at least three. First there is suspicion. But the paranoid take this even further. Not only are they suspicious of people’s behavior and motives, they re-interpret them to fit their suspicions. For example, Julie walks into the office one hot, sunny morning, and her co-worker remarks on the heat. Most people would just nod, smile and think no more of it. But Julie decides it was a reference to her weight: her colleague was insinuating that she is fat and that the heat makes her sweat. In other words, it was an insult! So she dwells on this all morning, and by lunchtime she is furious.
Neutral and even friendly actions come to be seen as dismissive or hostile. And the lengths to which a paranoid person can take this is astonishing. To take another hypothetical example, you meet up with old friends and one of them makes a joke. You laugh out loud and say “Ah, John, you always could make me laugh.” John stares at you in silence and then flushes. “What do you mean by that,” he yells “you mean I look weird? Do you think I’m just some kind of court jester here for you to laugh at?”
Second, the paranoid cannot bear setbacks or failures. When the average person fails their driving test, for example, they shrug and hope they’ll be luckier next time. The paranoid see it as an insult, or even a hostile act, by the examiner. He took a dislike to me, they decide, because of my race or nationality. Or they suspect that the examiner had been criticized for passing too many people and needed to fail someone.
And when the paranoid are insulted or humiliated they do not forget. Some will harbor a grudge against the school bully, or against an ex-girlfriend, for 50 years. Unfortunately, they see insults and rebuffs everywhere. Even the most harmless or friendly comment can be misinterpreted.
Fourth, they tend to be self-righteous, often aggressively so. When they experience an insult or threat, they go into overdrive. Again, this can only be understood by entering the paranoid mind. If you have been living with paranoia for years, the world seems a dangerous, threatening place. And so you develop a combative attitude. After all, if everyone is out to hurt or exploit you, you must fight!
The fifth trait is sexual jealousy. The paranoid find romantic relationships hard, often assuming that everyone is out to seduce their partner. They will search his or her social media accounts, looking for comments and then demanding to know who made them. Or they will ask for a list of former lovers and where they are now. A certain amount of sexual jealousy is normal, but the paranoid take it to an extreme. And nothing reassures them. Someone whose wife once cheated on him may be forgiven his jealousy. The paranoid usually have no grounds for their suspicion.
Finally, they have a conspiratorial view of the world. Those who trade in 9/11 conspiracy theories, for example, or who believe Princess Diana was murdered, etc., often experience extreme paranoia. Unfortunately, such theories spill over into their ordinary lives, especially their work. If a paranoid person is beaten to promotion, they assume the colleague has bribed someone, or that the boss owes them a favor.
The Schizoid Personality Disorder
People assume that those with a schizoid personality have schizophrenia. But this is not the case. They may be more likely to develop schizophrenia, but it isn’t the same.
As with the paranoid personality, the schizoid struggle to establish intimacy, in part because others find them unapproachable. A schizoid personality often appears cold and aloof. They also seem indifferent – and it isn’t only their demeanor. Schizoid personalities find communication difficult and may seem detached or remote. They are aware of this, however, and find it frustrating. Many consider themselves observers. When they visit a therapist, they say things like “I feel as though I’m looking in through a window at a party I can’t join.”
Related to this is a sense of depersonalization. The individual observes their own thoughts, feelings and memories, as if from the outside. Many will say that they do not feel connected to anything. For others, life feels like a dream. Some even feel like they are floating above themselves, watching their body go through its daily routine of speech and movement without their conscious control.
People with schizoid personalities find the real world threatening and dangerous. In part, that is because their sense of self is fragile or weak. The British psychiatrist R. D. Laing described this as “ontological insecurity”: the sense that stronger or more stable personalities are dangerous. They fear being overwhelmed or, to use Laing’s word, “engulfed,” so they keep their true self hidden and present a series of false selves. They also withdraw into a fantasy world. This then forms the basis of a substitute or vicarious life, free from the dangers of intimacy.
The Schizotypal Personality Disorder
The schizotypal personality is often combined with social anxiety and low level depression. It is also found alongside other personality disorders, especially the paranoid and avoidant.
The World Health Organization lists nine different traits. First, their emotional life is constricted and they appear cold and detached. That in turn means poor relationships and a tendency to withdraw. Like most withdrawn people, the schizotypal also become suspicious and paranoid. And they chew things over, often obsessively.
Perhaps the most obvious trait is their odd or eccentric behavior. They may wear bizarre clothes, for example. And their conversation can also be strange. The schizotypal often talk to themselves, for example, or simply drop out of the conversation altogether.
The schizotypal also practice magical thinking. According to the French psychologist Jean Piaget, this is common among children. In the schizotypal, however, it continues into adulthood. In essence, they believe their thoughts can affect the world. For example, someone wishes cancer or a road accident on their enemy. When that actually happens, they dismiss it as a coincidence; the schizotypal believe they somehow willed it into being.
Depersonalization and derealization are also common. With derealization you become alienated not from yourself (as in depersonalization) but from the external world. Nothing seems real, and life feels like someone else’s movie. You also feel detached from the world around you, as though you are not involved – not in it. This is most noticeable when returning somewhere familiar. There may also be a distortion in one’s sense of time. For example, something that happened a day ago feels like it occurred in the distant past. It also seems completely unrelated to you.