Paranoid Personality Disorder - Lab Report Example

Paranoid Personality Disorder Institutional Affiliation: Instructor: 21st November, 2012 Overview Case: Client Description History Joe was a third born in a family of four. He had two older brothers and a younger sister. Joe, his parents, siblings and grandmother, who was an invalid, lived in a lower middle class neighborhood. Joe seemed to be very bright. He was brighter than his elder brothers and right from elementary school all the way to high school; Joe exhibited a strong desire to excel by getting very good grades He acquired admission in one of the best high schools in the area. His school, in which most of the students always graduated to go to college or were admitted to Ivy league of schools ,was also known as ‘Pressure Cooker’, just depicting how good the school was. Joe was always the best in Science in his class as much as he was in the midst of students just as bright as he was. Whenever exams approached, other students would worry about the fear of failure but this wasn’t the thing in Joe’s case. Joe clearly exhibited confidence whenever he approached the exams, and indeed, he performed well. Joe always argued in his class especially in Mathematics and Science classes. Whenever a teacher made a mistake in class, Joe was always the first one to laugh, though this practise was common with other students as well. Joe always believed that he was right and could not make any mistake. This was too much that even if he failed a question, he always argued that the question was not set properly and that he was the one who was right. Unlike his classmates, he didn’t come from a very privileged background. Most of his classmates came from wealthy neighborhoods, but this did not seem to deter Joe’s desire to excel in his academics. Joe was not a very social person and he always maintained a small circle of friends. He was particularly very close to two boys in his classroom. He got along with women quite well, though he could express disappointment if he saw a woman he had gone with on a date talk to another man. He would in turn embarrass the man. As a result of this, most women could not offer him a second date. Having been very bright, Joe got admission into one of the Ivy League of Schools universities. While in sophomore, he had his first serious relationship with a lady named Carla, who however, dropped him later for another boy friend. This fact was very bitter for Joe and he made comments that he did not actually love her but was only interested in her body. Joe could not swallow the fact that Carla had dropped him and sought for ways of winning her back so that he would later drop him as a way of seeking revenge in order to look as though he, and not Carla was in control of the relationship. After the break up, he developed resentment towards women and never really dated another woman seriously. It is only after he met Ruth, a woman whom he did not perceive as being very threatening, that he became comfortable around a woman and ended up marrying her after one year. He pursued his undergraduate and later graduate studies thus obtaining a PhD. Thereafter he got a job to in a leading pharmaceutical company .He, however, preferred to do independent laboratory research lest others get credit for his own work. He did not get quite along with the rest of the workmates. His aim was that one day he would become the head of that company. Nonetheless, this tactic did not bear much fruit. He lost the job ungraciously. Soon enough though, he got another job with a state university. The job was, however, less prestigious than the one he had in the drug company. In the new job, he could get access to the laboratory and do his own experiments, something he loved so much. Sooner or later, Joe had to be relieved off his duties in the University. He strongly believed his workmates had conspired to finish him. Ruth, on the other hand, felt like he was overreacting, as he did not want him to lose this job as well. Joe however believed that Ruth, too, had conspired with his workmates to finish him. Meanwhile, Ruth, starting to fear for his life, took their two-year old daughter to live with her parents as she began processing divorce. Meanwhile, Joe had become very anxious and always panicked that at one point he had to stop the car beside the road while driving as he was sweating profusely. After ten minutes, he went back to drive and booked an appointment with his doctor whom he had earlier dismissed as he thought would not give him proper diagnosis. The doctor noticed no problem with Joe but put him on antidepressant drugs. With his vast research, Joe knew so much about these drugs. On asking the doctor why he had put him on such drugs, the doctor had little to tell Joe. Joe left the physician feeling he was incompetent as he could not clearly explain to him how the drugs would help him. His paranoid behaviour made him lose his job in the university and he later found a cab-driving job, a field in which he felt comfortable because no one in the field would match his intellect. He always bragged of carrying academic mediocre as his clients. On a fifteen-year follow up, Joe did not keep in touch with his daughter and still maintained a small circle of friends. He never visited a doctor again because he did not believe he had any psychological problems. He however, fell in love with another girl, Wendy, who held so much admiration for him, showed him off to her workmates and supported him in his quest for knowledge. Just as Ruth, Wendy was a shy girl and posed no threat to Joe; the kind of a woman he would be comfortable around. Joe’s most disappointing moment came when one day while driving his cab, he heard on radio that a former colleague at the University had been awarded the Nobel Prize for chemistry. He felt the former colleague had stolen his ideas and now attained world recognition for them; another form of deceit from those who wanted to finish him and this time round, one that involves world recognition. He, however, resigned to his fate and continued living with the rest of the community. Case Conceptualization & Provisional 5-Axial Diagnosis Case Conceptualization Joe clearly exhibits paranoid tendencies, a condition largely associated with low self esteem. He is very suspicious of the people around him and always believes others are out to finish him .He feels his intellect threatens his colleagues and therefore the colleagues want to finish him by stealing his ideas. He is insensitive to people’s feelings, arrogant, envious of other people, exploitative and requires too much admiration. This is why he cannot date a woman who poses any threat of any nature. He cannot conceive a situation whereby one person wants to feel better than him even intellectually. This is why he can never accept that he is wrong. Joe also tried to embarrass other men with their sexual orientations. Through this, we can conclude that he was concerned about his own sexual desires. He therefore uses Freud’s defense mechanism of projection to express these desires by embarrassing other men. Joe feared threatening conditions and hence he always had problems at work place. When he got a job as a cab driver, however, he felt comfortable. This is because in this field, no one could match his intellect. Paranoids always fear situations that may threaten or shame them. 5-Axial Diagnosis Axis I: Clinical Disorders/Conditions that Require Medical Attention Mistrust, Suspicion, Too much self Importance, Aggressiveness Axis II: Personality Disorders /Mental Retardation Borderline Personality disorder, Narcissistic personality disorder, Paranoid Personality Disorder Axis III: General Medical Conditions Delusion, Anxiety, Hypersensitivity Axis IV: Psychosocial and Environmental Problems Relationship problems, Family background Axis V: Global Assessment of Functioning GAF=30 Joe is very suspicious of the people around him because he believes they do not mean well for him. He therefore develops aggressive tendencies in self defense. Apart from being a paranoid, his personality also lies in line with narcissistic and borderline personality disorders. The narcissistic tendencies manifest in the way he feels the most important of all the people around him. He exhibits delusional tendencies, evidenced by when he believes that his colleague got the nobel prize because of him; his ideas. He also believes the people at work are out to finish him.As a result of mistrust for people, Joe cannot relate well with his colleagues at work and even his wife, Ruth, runs away for fear of her life. Treatment Plan Psychotherapy is used to treat most personality disorders. It is, however, difficult to use it to treat paranoid patients because it’s difficult to establish lasting relationships with them due to their untrusting nature, yet psychotherapy requires monitoring over a long period of time. A Client-Centered approach is good with such patients as Joe because the environment is less threatening. They feel the centre of the discussion. The therapist should, however, be careful not to show so much friendliness for the patient as it might be assumed to be deceptive. Cognitive therapy can also be adopted whereby the therapist works with the client to replace maladaptive beliefs such as ‘people are out to harm me or my enemies are after me’ with a goal of helping the clients adopt more adaptive thoughts over time. References Attachment, (Chapter 18, p.196).Paranoid Personality Disorder Case Studies in Abnormal Psychology. Read More