In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) continue our discussion about paranoid personality disorder, exploring its three severity levels: Mild, Borderline, and Paraphrenic. We unpack the six subtypes of paranoid personalities as outlined by Dr. Theodore Millon: The Self-Righteous Mistrustful, The Obdurate Mistrustful, the Querulous Paranoid, the Insular Paranoid, the severe Fanatic Paraphrenic, and Malignant Paraphrenic. We highlight the fragility of Paranoids at all levels of severity, noting they can easily deteriorate with stressors and setbacks. We emphasize the importance of understanding these very common personality dynamics in all settings, especially with increasing paranoia in the post-pandemic world.

Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website, which will guide you to the email address to use. www.questpsych.org

Chapters 00:00 Introduction to Paranoid Personality Disorder 03:44 Paranoid Personality Disorder Symptoms 06:03 Historical Examples 06:09 Timothy McVeigh - Oklahoma City Bombings 06:36 Richard Farley - Erotomania 07:52 Explaining the 3 Severity Levels 09:30 Mild Paranoid Personalities: Mistrustful Types 10:16 Self-Righteous Subtype 14:28 Obdurate Subtype 17:14 Moderate Paranoid Personalities: Disorder Level 17:44 Querulous Subtype 21:32 Insular Subtype 23:52 Severe Paranoid Personalities: Paraphrenic Level 25:44 Fanatic Subtype 30:57 Malignant Subtype 36:12 Summary & Conclusion

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) help differentiate between paranoid and borderline personality disorders. We explore the similarities and differences between these two disorders, discussing their core characteristics, emotional responses, symptoms, and how our own intuition helps us more than we realize. We specifically look at the instability unique to these two personality disorders and how both express anger, shame, and fear. As both disorders can have fleeting episodes of psychosis, we also discuss how delusions can show up in each, but how their triggers are vastly different. We further discuss our own personal experiences treating both disorders and ways we use our intuition to guide diagnosis. We end by highlighting the need for empathy in treatment and welcome other providers to reference this information or to contact us directly if in need of a consultation.

To schedule a consultation, please visit the practice website for more information! www.questpsych.org

Chapters 00:00 Intro to Paranoid vs Borderline Personality Disorders 01:59 What is an Unstable Personality Structure? 03:34 Borderline Personality Symptoms Explained 06:50 Paranoid Personality Symptoms Explained 08:30 Comparing and Contrasting BPD and Paranoid PD 08:32 Anger 11:40 Shame 13:03 Fear 14:15 Paranoia & Psychotic Episodes 15:54 Fluidity vs. Rigidity 17:21 Using Intuition with Paranoid and Borderline Personalities 17:35 Dramatic Narratives 19:44 Dependent and Avoidant Attachment Dynamics 23:35 Countertransference 25:20 How they Present to Treatment 26:31 Suicidality & Trauma 28:47 Summary, Learning, and Conclusion

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) reveal the complex, dangerous, and often misdiagnosed Paranoid Personality Disorder (PPD). We discuss the rising prevalence of PPD in the post-pandemic world, the clinical challenges in identifying and treating these individuals, and the critical differences between Paranoid Personalities and narcissism. We believe you’re seeing more of these types in your circles as well, and we want you to be equipped with knowledge so you can best protect yourself! Thus, we unpack not only the DSM-5-TR characteristics of Paranoid Personality Disorder, but we also reveal our clinical experience with these types. We include common themes such as: lack of trust, severe gastrointestinal issues, sadomasochism, medical self-sabotage, shedding identities, and the paranoid character’s unique relationship with aggression towards the same-sex. We reveal why we think this type is popping up even more in our circles, what the pandemic had to do with it, and how you can identify these types to keep yourself safe!

Chapters 00:00 Intro & Dangers of the Paranoid Personality 04:10 Clinical Observations & Post-Pandemic Trends 08:20 Defining Paranoid Personality Disorder 16:35 Warning Signs of PPD Beyond the DSM 27:00 Comparing Paranoid Personality and Narcissism 29:25 Why the Post-Pandemic Narcissist?