Personality is the continuous characteristics and tendencies that determine the differences in the feelings, thoughts and behaviors of individuals (Linda, 1999). It covers the cognitive, emotional, social and physical characteristics of the individual. Behavior patterns that distinguish one person from others. A personality disorder can be mentioned if the person goes out of the norms of the society he is in, experiences a disruption in his emotion, thought and behavior patterns, and goes beyond what is expected. He can also get an injury at any time and in this case, he must protect himself constantly. They interpret the behavior of others as malicious. They are always very careful and very alert to their surroundings. They doubt even the honesty of their closest relatives and are dedicated to seeking proof of their suspicions. The image they show towards the outside world is rational, cold and logical. They usually do not show affection or positive emotions.
The DSM-V Diagnostic Criteria Handbook defines paranoid personality disorder as follows:
1) Suspicion that others are cheating or doing harm without sufficient evidence.
2) Questioning the loyalty and trustworthiness of coworkers or friends.
3) Unable to confide in others for fear that what she says will be used against her later on.
4) Contempt for ordinary words or intimidation.
5) Always harbors grudges.
6) Perceives the behavior of others as an attack on one's personality or status for no apparent reason. He responds with anger.
7) He constantly questions his partner's commitment to him and experiences constant skepticism about his partner's loyalty. A distortion occurs in the processing system. They always tend to blame others for events. The reason for this is a psychological defense situation that the individual makes in order to protect the underlying low self-esteem (Bentall, 2006).
Mind in Theory; It is the ability to understand the intentions and mental states of others, and this skill is lacking in paranoid thinking (Kinderman, 1998). The inability to understand another person's perspective affects the paranoid person's social interactions.
DIFFERENCE FROM OTHER PERSONALITY DISORDERS
Although some symptoms of schizoid personality disorder and schizotypal personality disorder are similar to paranoid personality disorder, these disorders differ from each other. It has features (Carroll, 2009).
Schizoid personality disorder is characterized by social withdrawal. The person is far from close relationships and contact. They generally like to be alone. They are emotionally indifferent and cold. As in paranoid personality disorder, they have almost no interest in the outside world and little or no interpersonal contact instead of doubting others (Carroll, 2009). Unlike paranoid personality disorder, cognitive and perceptual distortions are common in these people. He has unrealistic beliefs and thoughts such as magical thinking, seeing the future, and believing that he has the power of telepathy. Disorders with psychosis; brief psychosis disorder, schizophrenia (schizophreniform) disorder, schizophrenia, schizoaffective (schizoaffective) disorder. The most common symptoms in a person with this disorder are delusions (delusions) and hallucinations (hallucinations), a disorganized speech pattern (frequently drifting off topic or speaking incoherently), a disorganized behavior pattern, and negative symptoms (lack of emotion, emotional introversion). In schizoaffective (schizoaffective) disorder, these symptoms are accompanied by depression symptoms.
The common symptoms seen in all of these disorders are the presence of delusions and hallucinations. Hallucinations are not found in paranoid personality disorder.
TREATMENT OF PARANOID PERSONALITY DISORDER
Treatment Steps
Long Term Treatment Goals (Bernstein, 2007) :
-Recognizing fragile feelings and
-Raising awareness of feelings of self-efficacy
-Developing a more trustworthy view of others
- Rather than avoiding others as intimidating, verbalize their distress
People with Paranoid Personality Disorder may show a strong defense and aggression towards the therapist in treatment. In this case, what the therapist should do is to stay away from counter-reactions that will activate the client's defense. The primary goal of the therapist should be to establish a close and empathetic relationship with the client and to display a supportive attitude. Another issue that the therapist should do is to set realistic therapy goals.
The therapist should avoid close physical contact with the client in the therapy environment and should give the client his/her own private space. Thus, the client will feel more comfortable. At the same time, one of the most important points that the therapist should pay attention to is to be aware of the client's mood changes.
Methods used in the treatment of people with Paranoid Personality Disorder; Cognitive Behavioral Therapy (Beck, 2004), Individual Supportive Dynamic Psychotherapy (Gabbard, 2000) and Schema Therapy (Young, 2003). The core cognitive schema that is the most fundamental in the individual with paranoid personality disorder is the feeling of inadequacy, and therefore the first aim of treatment is to increase the individual's sense of self-efficacy in the early stages. In parallel with this, social qualities such as communication and empathy should also be developed. In the next stages, what needs to be done is to ensure the change of malicious and suspicious / skeptical beliefs about others in the mind of the person. At this stage, the therapist and client should cooperate and question the client's dubious / skeptical beliefs. Suspicious beliefs are identified, and their accuracy and compliance with reality are tested.
Another method used in the treatment of people with Paranoid Personality Disorder is drug therapy. The most important point in drug treatment is that the therapist has gained the trust of the patient. If the relationship of trust cannot be established, the patient will not respond to drug treatment. Depression and/or anxiety can be seen together in people with paranoid personality disorder. is At this point, symptom-reducing drug treatment can be started with the cooperation of the client.
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