From Normality to Abnormality

It may again be time to assuage your medical student syndrome. From the preceding descriptions, you may have identified aspects of yourself that match with the paranoid pattern. However, paranoid-style thinking, when appropriate to the realistic demands of your environment, is healthy. In this form, you may think of these as your system of defenses, without which you would most certainly be very vulnerable to the random whims of potentially harmful events and interactions. Most readers will agree that the world is sometimes a dangerous place and that mistrust, when not carried to extremes, has definite survival value. In fact, there is a period of mistrust that is a vital part of human development. Young children go through a genetically programmed stage of stranger anxiety, during which they become anxious when confronted with unknown others and seek the comfort of familiar faces. Stranger anxiety thus functions as a means of keeping children close to the tribe, or at least to caretakers, and away from those that might do them harm, perhaps members of other tribes competing for scarce territory or food resources in the same area. Nature has provided a way of keeping children safe before they can understand or be told what they should do or not do.

Stranger anxiety is only a single example. In general, evolution favors those who can more easily recognize danger over those who cannot. On the whole, individuals who were alert to threat left more offspring than those who were oblivious to such matters, that is, the gullible and naïve (either extreme of trust is maladaptive). Moreover, the threats were not only physical but also social and economic, requiring an alertness to anyone who would lie or deceive to steal or control precious resources or gain some other advantage, all of which influence the number of offspring and their total evolutionary fitness, perhaps for generations. Paranoid mechanisms, then, are a natural part of our psychoevolutionary matrix, an adaptive and necessary extension of our most basic instinct of survival. Consequently, a tendency or vulnerability to paranoid thinking should be present in most human beings. When amplified beyond what is socially adaptive, the result is a paranoid personality disorder, of which Ron is but one example.

Oldham and Morris (1995) have proposed a "normal" variant of the paranoid: the vigilant style. Vigilant persons are highly independent, value their freedom, and are sensitive to issues of power, authority, and domination. They are cautious and reserved in dealing with others and enter relationships only after careful consideration. According to these authors, they not only listen to what others say but also pick up subtle meanings and expectations at multiple levels. When under attack, they quickly defend

Focus on Culture

When Paranoids Become Spies Can a Disordered Personality Take on the Nemesis Role?

Although paranoids are notorious for believing that they are being spied on, sometimes they succeed in becoming spies themselves. Such was the case with J. Edgar Hoover, part of a fascinating study on the paranoid personality completed by Hampton and Burnham (1990).

As noted by these authors, paranoids often have rigid, compulsive traits, especially perfectionism and a sense of earnestness. Hoover was no exception. A bright and hardworking student, he chose to walk six miles to attend the best high school, took some of the toughest courses, and finished with the highest honors. He turned down a scholarship to the University of Virginia, took a job at the Library of Congress, and graduated from the night program at George Washington University with a degree in law.

Hoover's career might have been unremarkable except for an unusual turn of events that would determine the character of his life. After obtaining his law degree, Hoover went to work for the Justice Department as a clerk. At the time, World War I had just begun, and German secret agents were at work in the United States subverting attempts to export arms to the allied powers. Moreover, the Russian Revolution was still fresh, and the specter of revolutionary communism loomed over the world. As his career took off, Hoover was tapped again and again to rout the forces of evil. Communists were rounded up and deported. Even the terrorism of the Ku Klux Klan was held at bay, though Hoover had to disobey orders to do it.

In 1924, he became head of the FBI. Like any good paranoid, however, Hoover accepted the position conditionally. He had to be able to draw up harsh rules, be separated from outside political influence, and be allowed to grow the agency according to his own high moral principles. Hoover demanded absolute control. And he got it, establishing rigorous standards of efficiency and merit, ridding the agency of corruption, and requiring the utmost secrecy concerning all its activities.

Hoover's story is that of a paranoid who succeeded in harnessing his idealism and dogmatic righteousness for the best purposes of the country. Continuing to track communist agents, Hoover would eventually identify and expose a variety of subversives. Hoover knew that the Manhattan Project discoveries were being reported to the Russians. Hoover knew about the activities of Ethel and Julius Rosenberg, Alger Hiss, and many others in high positions of government, but again and again Congress refused to act. Not surprisingly, only another paranoid, Senator Joe McCarthy, was eager to investigate his claims. When Hoover died in his sleep in 1972 during the Nixon administration, his moral dogmatism and natural suspicion had protected the country under 10 presidents. See Hampton and Burnham (1990) for greater detail on Hoover's interesting life.

themselves and are not shy about doing so. Further, they are touchy where criticism is concerned but not easily intimidated, and they readily defend what they see as inalienable rights. Fidelity and loyalty are among their highest values, and they thrive when communication is direct and nonthreatening. Many such individuals find a valued niche somewhere in society, where their keen nose for conspiracy serves them well (see "Focus on Culture: When Paranoids Become Spies").

Another way of developing a normal variant of the paranoid is by examining the DSM-IV criteria of an Axis-II disorder and noting how more adaptive intensities of these criteria may be adaptive (see Sperry, 1995). Whereas the disordered individual believes, without adequate foundation, that others are attempting to harm, exploit, or deceive him or her (see criterion 1), those with the style simply prefer to remain somewhat distant until others can be carefully appraised. Whereas the disordered individual suspects, with no adequate foundation, that close friends or associates have been disloyal (see criterion 2), an individual with the style places a premium on fidelity, frankness, openness, and honesty; is more open to the evidence; and does not alienate others on the basis of suspicion alone. Whereas disordered individuals are reserved about sharing confidential information with others for fear that it will be used against them (see criterion 3), those with the style have several trusted lieutenants or friends but nevertheless play their cards closely with those who are only acquaintances.

For each of the preceding applicable contrasts, Ron emerges more toward the pathological side. At the end of the interview, he appears to be building an argument that the therapist, the court, his coworkers, and perhaps even his children are conspiring against him. Whenever he encounters resistance, especially in the form of someone who might help him test reality, he becomes more adamant. He doubts the loyalty of his friends; his best friend, who is supposedly sleeping with his wife; and his coworkers, who are supposedly rigging the time clock to cheat him out of money. Far from having a few trusted friends, Ron cannot even bring himself to share information with his therapist. Instead, he prefers to keep his world closed to others. He puts up walls as a defensive strategy. "Knowledge is power," Ron would probably argue, and if others are given knowledge, their power over him can only increase.

Other diagnostic criteria can be put on a continuum with normality (see Sperry, 1995). Whereas the disordered individual interprets benign communications as containing hidden threats or demeaning messages (see criterion 4), the individual expressing the style is simply attuned to the subtleties and nuances of communication at many different levels. A disordered person nurses grudges and rarely forgives an insult (see criterion 5), while a more balanced individual would be perturbed by constructive criticism but would give it serious consideration without feeling unduly attacked. Whereas the disordered individual perceives attacks where none are intended and responds almost reflexively with angry counterattacks (see criterion 6), a more regulated personality would not invest in discovering hidden messages but would respond to negative comments assertively and with adequate restraint. Finally, whereas the disordered person suspects, again with no adequate basis, that a significant other has been sexually unfaithful (see criterion 7), the person demonstrating the style simply regards loyalty, trust, and fidelity as high virtues and has great respect for those who honor them.

Ron demonstrates the more pathological side of most of these contrasts. More than just being sensitive to messages across multiple levels, Ron tends to distort the communications of others in preconceived ways. For example, he is reluctant to share information with the therapist, even when assured of confidentiality, and interprets a request for information as a belittling skepticism. Neither can Ron respond in a nondefensive manner to criticism or give it constructive consideration. Because he believes that others are attempting to harm him without reason, he asserts that his memory is long and that he will never forget the injustices done to him. Moreover, he tends to perceive insults where none exist and holds grudges based on his misperceptions. Rather than exercising constructive restraint by speaking with his supervisor about his coworkers and the time clock, he instead fabricates their actions into a more generalized plot to socially humiliate him. Finally, far beyond valuing trust, loyalty, and fidelity and recognizing it in others, he forges his reality to say that his wife is cheating on him.

Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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