Paranoia

Introduction

Paranoia is a psychotic disorder characterized by highly systematized delusions of persecution or grandeur with little deterioration. In either case, they are persistent, defended strongly by the patient, and incapacitating.

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Kraepelin reserved it for cases showing delusions and impaired contact with reality but without the severe personality disorganization characteristic of schizophrenia.

There are three main types of paranoid disorders: paranoia, acute paranoid disorder and a third type-shared paranoid disorder (also known as folie a deux).

    1. Paranoia. Delusional system develops slowly. It becomes, intricate, logical, and systemized. It centers around delusions of persecution and/or grandeur. The individual’s personality remains intact, no disorganization, and no hallucination. 2.Acute paranoid disorder. The delusions are transient and changeable. The disorder lacks logical and systematic features of paranoia or bizarre fragmentation and deterioration found in paranoid schizophrenia. Paranoid states, often, appear in other types of psychopathological reactions. 3.Shared paranoid disorder (folie a deux). One person copies and incorporates into one’s own personality the delusions and psychotic patterns of another person. These incidents occur in near relatives.

Clinical features

One who is singled out; taken advantage of; mistreated; plotted against; stolen from; spied upon; ignored; and mistreated by enemies.

“An engineer made attempt to write detailed plans for eliminating the fog in cities with the aid of a system of reflectors. The air will be heated by solar radiation and cause the fog to lift.The company, in which, he was working examined the plans and found them fit. He resigned from the post as he was upset and stated the reason for resignation that the engineers in the company were not qualified to pass the judgement on really complex and advanced engineering projects like his. Thereafter, some other engineering firms were contacted. The vision and technical proficiency to know the great potentialities of his idea were present in many but he would become highly suspicious and hostile on questioning about the feasibility. He was convinced that a conspiracy among a large number of engineering firms is being hatched to steal his plans and make profit. He, then, went to the police threatening he would take action against firms if they do not take action. Consequently, he was hospitalized for psychiatric observation and found that he was suffering from paranoia.”

Sequence of events in paranoid mode of thinking:

  1. Suspiciousness. Do not trust others` motives. Fear of advantage, that’s why, remains alert.
  2. Protective thinking. Others`actions confirm suspicions, blame others for one’s failure.
  3. Hostility. Injustice and mistreatment cause anger and hostility, suspicion increases.
  4. Paranoid illumination. Understands strange feelings and events when everything is O.K.
  5. Delusions based on some truth put forth in a very logical and convincing mode. The delusions of grandeur develop later

Causal factors in paranoia

It is a disorder of conception. The individual overconceptualize one`s experience in the absence of attention to the actual data. It seems a systematic plot. Paranoid forms of thought is the outcome of psychosocial factors. If the individual is unable to function on a day-to-day routine, paranoia cannot be an effective coping strategy.

Faulty learning and development. Inadequate socialization, an air of superiority, an underlying lack of self-acceptance, feelings of inferiority, deeper social isolation and mistrust plus self-important, rigid,arrogant individuals who long to dominate others, and ready to blame others for own failure are a few factors.

Failure and inferiority. The lives of paranoid individuals are filled with failures in critical life situations-social, occupational and marital. Inability to understand the causes, unrealistic goals and inability to get along with other people, and their feelings of inferiority are masked behind their air of superiority are things to pave the way for disorder.

Elaboration of defenses and the “Pseudo-community.” Defensive structures, humorless, unprepared for the “facts of life,” search for hidden meanings, like a detective over the “clues”, singled out for some obscure reason, and other reasons, like something is not wrong with me etc.

Treatment with group psychotherapy if an individual seeks voluntarily professional assistance, behavior therapy, aversive conditioning, removal of factors in the person`s life situations that force maladaptive behavior and development of more effective coping patterns may help.