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Paranoid Personality Disorder: Patrick’s Story

In previous discussions about this disorder, we looked at how the sufferer of paranoid personality disorder (PPD) differs from individuals who experience an episode of paranoia as a result of a schizophrenic or a manic depression episode. Unlike the latter, PPD is a pervasive disorder of the personality, meaning that it is always present and colors the life outlook and beliefs of the sufferer. This is turn causes enormous interpersonal problems, which may or may not be present in the other disorders mentioned above.

Patrick is a typical sufferer of PPD. Obsessively religious, he has taken to heart that God is watching his every move and monitors his behavior in such a way that he will not be punished for the slightest misdemeanor. However, like all of us, Patrick is not perfect and “sins” from time to time. This causes him inordinate problems because he is unable to tell the difference between a “big” sin and a “little” sin – the former being murder, for example, and the latter being a white lie.

He winds himself up into a lather of anxiety and worry which manifests in constant movements to ease his dis-ease. But the main problem for Patrick is that he basically lives in a world so colored by paranoia that even a sale item in the local store “must” be damaged to his mind. Although well into his 60s, his sex drive is high and he believes that women find him attractive and that their boyfriends or husbands are insanely jealous of his presence.

He once approached a married vocalist with a song he had written for her and she agreed to listen to it. When the song was not accepted, Patrick believed that it was the husband who put an end to his hopes of becoming a well-known songwriter because he was jealous of Patrick and his ability. The woman concerned was 21 years old.

His paranoid behavior continues to permeate through every aspect of his life, including the problems his aging house displays (it wasn’t built properly), through to governmental conspiracies and a propensity to interpret harmless comments by people into direct abuse.

Again, as with all personality disorders, Patrick’s early life may have contributed to its presence. Although signs of impending problems were clearly there in his teens the presence of the disorder was clear by his mid 20s. He has been unable to hold down a steady job because of the arguments between himself and both staff and management. He has also been unable to find a life partner despite his numerous infatuations. Not surprisingly all of them ended when each woman found out just how difficult it was to live with Patrick.

But Patrick sees it all differently, through the paranoid lens of his own world. All the women who left him had insurmountable problems of their own, in his words, and he left them. Unable to see what others see from inside his own limited personality type, he is trapped in a lonely world where he often feels depressed. But that is of course someone else’s problem, not his. Life is lonely and painful for the sufferer of PPD until they can accept that it is they who have a problem. With the help of a therapist and trusted family and friends, Patrick does have some hope of leading a happier life but he must submit to the opinion of others who at this point in time are better able to see reality than he can.


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