MENTAL HEALTH - Persecutory Delusions

Persecutory Delusions

What Are Persecutory Delusions?
     Persecutory Delusions, sometimes called Querulant delusions, are when a person believes (wrongly) that they are being picked on, or threatened by someone/something else.

     This can be someone familiar to them (e.g. a family member, friend, group), someone in the media (e.g. a film star), an organisation (e.g. the CIA), or even aliens.

It is classed under a group of Disorders known as the Delusional (Paranoid) Disorders.

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Paranoia/Definition
     Paranoia is an unfounded or exaggerated distrust of others, sometimes reaching delusional proportions. Paranoid individuals constantly suspect the motives of those around them, and believe that certain individuals, or people in general, are "out to get them."

What is Paranoia?
     Paranoia involves feelings of persecution and an exaggerated sense of self-importance. Paranoia occurs in many mental disorders and is rare as an isolated mental illness. Since the delusions involve only one area, a person with paranoia can usually work and function in everyday life, however, their lives may be limited and isolated. There are different types of paranoia including conjugal paranoia, erotomania, hypochondriacal paranoia, and different types of paranoid disorders such as paranoid personality and paranoid schizophrenia.

Description
     Paranoid perceptions and behavior may appear as features of a number of mental illnesses, including depression and dementia, but are most prominent in three types of psychological disorders: paranoid schizophrenia, delusional disorder (persecutory type), and paranoid personality disorder (PPD).

     Individuals with paranoid schizophrenia and persecutory delusional disorder experience what is known as persecutory delusions: an irrational, yet unshakable, belief that someone is plotting against them.

     Persecutory delusions in paranoid schizophrenia are bizarre, sometimes grandiose, and often accompanied by auditory hallucinations. Delusions experienced by individuals with delusional disorder are more plausible than those experienced by paranoid schizophrenics; not bizarre, though still unjustified. Individuals with delusional disorder may seem offbeat or quirky rather than mentally ill, and, as such, may never seek treatment.

     Persons with paranoid personality disorder tend to be self-centered, self-important, defensive, and emotionally distant. Their paranoia manifests itself in constant suspicions rather than full-blown delusions.

     The disorder often impedes social and personal relationships and career advancement. Some individuals with PPD are described as "litigious," as they are constantly initiating frivolous law suits. PPD is more common in men than in women, and typically begins in early adulthood.

Causes and symptoms
     The exact cause of paranoia is unknown. Potential causal factors may be genetics, neurological abnormalities, changes in brain chemistry, (tumors- lesions etc) and stress. Acute, or short term, paranoia may occur in some individuals overwhelmed by stress.

     The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), the diagnostic standard for mental health professionals in the United States, lists the following symptoms for paranoid personality disorder:

suspicious; unfounded suspicions; believes others are plotting against him/her

preoccupied with unsupported doubts about friends or associates

reluctant to confide in others due to a fear that information may be used against him/her

reads negative meanings into innocuous remarks bears grudges

perceives attacks on his/her reputation that are not clear to others, and is quick to counterattack - or quick to spread her 'beliefs' of such (mental) occurances - taking the delusional aspect and manifesting it into "real life".


maintains unfounded suspicions regarding the fidelity of a spouse or significant other - family , friends, collegues (etc).


Key Terms

Persecutory delusion:
     A fixed, false, and inflexible belief that others are engaging in a plot or plan to harm an individual.


For Your Information

Resources/Organizations

     American Psychiatric Association. 1400 K Street NW, Washington, DC 20005. (888) 357-7924.

     American Psychological Association (APA). 750 First St. NE, Washington, DC 20002-4242. (202) 336-5700. ttp://www.apa.org.

     National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264.

     National Institute of Mental Health. Mental Health Public Inquiries, 5600 Fishers Lane, Room 15C-05, Rockville, MD 20857. (888) 826-9438

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PARANOID PERSONALITY DISORDER


Suspicious
     An unmistakable sign of paranoia is continual mistrust. People with paranoid personality disorder are constantly on their guard because they see the world as a threatening place. They tend to confirm their expectations by latching on to any speck of evidence that supports their suspicions and ignore or misinterpret any evidence to the contrary.

     They are ever watchful and may look around for signs of a threat. Anyone in a new situation--beginning a job or starting a relationship, for example--is cautious and somewhat guarded until he or she learns that the fears are groundless.
     People suffering from paranoia cannot abandon their fears. They continue to expect trickery and to doubt the loyalty of others. In a personal relationship or marriage, this suspiciousness may take the form of pathological, unrealistic jealousy.


Hypersensitive
     Because persons with paranoid personality disorder are hyperalert, they notice any slight and may take offense where none is intended. As a result, they tend to be defensive and antagonistic.

     When they are at fault, they cannot accept blame, not even mild criticism. Yet they are highly critical of others.

Other people may say that these individuals make "mountains out of molehills."


Cold and Aloof
     In addition to being argumentative and uncompromising, the people with paranoid personality disorder are often emotionally cut off from other people. They appear cold and, in fact, often avoid becoming intimate with others. They pride themselves on their rationality and objectivity.

     People with a paranoid outlook on life rarely come to the attention of clinicians--it is not in their nature to seek help. Many presumably function competently in society. They may seek out social niches in which a moralistic and punitive style is acceptable, or at least tolerated to a certain degree.


DELUSIONAL (PARANOID) DISORDER
     Psychiatrists make a distinction between the milder paranoid personality disorder described above and the more debilitating delusional (paranoid) disorder. The hallmark of this disorder is the presence of a persistent, nonbizarre delusion without symptoms of any other mental disorder.

     Delusions are firmly held beliefs that are untrue, not shared by others in the culture, and not easily modifiable. Five delusional themes are frequently seen in delusional disorder. In some individuals, more than one of them is present.

     -- Ruth is a clerk typist who is efficient and helpful. Her employers and co-workers value her contribution to the office. But Ruth spends her evenings writing letters to State and Federal officials. She feels that God has opened her mind and given her the cure for cancer. She wants some leading treatment center to use her cure on all its patients so that the world can see she is right. Many of her letters go unanswered, or she receives noncommittal replies that only make her feel that no one understands that she can save all cancer patients if only given the chance. When one of her letters is answered by an employee of the official to whom she wrote, she is sure that the official is being deliberately kept unaware of her knowledge and power. Sometimes she despairs that the world will ever know how wonderful she is, but she doesn't give up. She just keeps writing. Ruth suffers from one of the delusional disorders, grandiose delusion.

     The most common delusion in delusional disorder is that of persecution. While persons with paranoid personality might suspect their colleagues of joking at their expense, persons with delusional disorder may suspect others of participating in elaborate master plots to persecute them.

     They believe that they are being poisoned, drugged, spied upon, or are the targets of conspiracies to ruin their reputations or even to kill them.

     They sometimes engage in litigation in an attempt to redress imagined injustices. Another theme seen frequently is that of delusional jealousy. Any sign--even a meaningless spot on clothing, or a short delay in arriving home--is summoned up as evidence that a spouse is being unfaithful.

     Erotic delusions are based on the belief that one is romantically loved by another, usually someone of higher status or a well-known public figure. Individuals with erotic delusions often harass famous persons through numerous letters, telephone calls, visits, and stealthy surveillance.

     * Persons with grandiose delusions often feel that they have been endowed with special powers and that, if allowed to exercise these powers, they could cure diseases, banish poverty, ensure world peace,or perform other extraordinary feats.

     Individuals with somatic delusions are convinced that there is something very wrong with their bodies--that they emit foul odors, have bugs crawling in or on their bodies, or are misshapen and ugly. Because of these delusions, they tend to avoid the society of other people, share no photos, memories (etc, and spend much time consulting "others" for their imagined condition. (be it MD - Counselor- Religious Pratictioner - Confidant... etc..)

     Whether or not persons with delusional disorder are dangerous to others has not been systematically investigated, but clinical experience suggests that such persons are rarely homicidal.

     Delusional patients are commonly angry people, and thus they are perceived as threatening.

In the rare instances when individuals with delusional disorder become:violent, verbally abusive, revengeful, instigators, plotting...

Their victims are usually people who unwittingly fit into their delusional scheme. (conviniently)

     The person in most danger from an individual with delusional disorder is a spouse/lover, family, or friend.

How to Resolve Conflict Online

Conflict in Cyberspace:
How to Resolve Conflict Online

Kali Munro, M.Ed., Psychotherapist

www.KaliMunro.com

Have you ever noticed how conflict can get blown out of proportion online? What may begin as a small difference of opinion, or misunderstanding, becomes a major issue very quickly. Conflict can be difficult at the best of times, but what is it about online communication that seems to ignite ?flaming? and make conflicts more difficult to resolve?

There are a number of reasons to explain why conflict may be heightened online. One is the absence of visual and auditory cues. When we talk to someone in person, we see their facial expressions, their body language, and hear their tone of voice. Someone can say the exact same thing in a number of different ways, and that usually effects how we respond.

For example, someone could shout and shake their finger at you, or they could speak gently and with kindness. They could stand up and tower over you, or they could sit down beside you. How you feel, interpret, and respond to someone?s message often depends on how they speak to you, even when it?s a difficult message to hear.

In online communications, we have no visual or auditory cues to help us to decipher the intent, meaning, and tone of the messenger. All we have are the words on a computer screen, and how we hear those words in our head. While people who know each other have a better chance at accurately understanding each others? meaning and intentions, even they can have arguments online that they would not have in-person.

Projections and Transference

While many people are convinced that how they read an email is the only way it can be read, the truth is, how we read a text, or view a work of art, often says more about ourselves than it does about the message or the messenger.

All of our communications, online and in real-time, are filled with projections. We perceive the world through our expectations, needs, desires, fantasies, and feelings, and we project those onto other people. For example, if we expect people to be critical of us, we perceive other people?s communication as being critical - it sounds critical to us even though it may not be. We do the same thing online; in fact we are more likely to project when we are online precisely because we don?t have the visual or auditory cues to guide us in our interpretations. How we ?hear? an email or post is how we hear it in our own heads, which may or may not reflect the tone or attitude of the sender.

We usually can?t know from an email or post alone whether someone is shouting, using a criticizing tone, or speaking kindly. Unless the tone is clearly and carefully communicated by the messenger, and/or we are very skilled at understanding text and human communication, we most likely hear the voice we hear, or create in our head and react to that. This is one of the reasons why controversial or potentially conflictual issues are best dealt with by using great care and explicit expressions of our tone, meaning, and intent.

Where do projections come from? They come from our life experiences - how we?ve been treated, how important figures in our lives have behaved, how we felt growing up, how we responded and coped, etc. All of us project or transfer our feelings and views of important figures in our lives onto other people.

To take a look at your own projections or transference with people online, think back to the last time you felt angry at someone online. What was it about them or their email that made you so angry? What did you believe that they were doing to you or someone else? How did you react internally and externally? Was your reaction to this person (whether spoken or not) influenced by someone or something from your past? While it certainly happens that people are treated with disrespect and anger online, if there are any parallels between this experience and any of your past experiences, it?s likely that how you felt and responded was coloured by your past. When our past is involved, particularly when we are unaware of it happening, we invariably project and transfer old feelings onto the present situation.

Disinhibition Effect

Conflict can be heightened online by what is known as the ?disinhibition effect?, a phenomenon that psychologist, Dr. John Suler, has written extensively about. Suler writes,

?It's well known that people say and do things in cyberspace that they wouldn't ordinarily say or do in the face-to-face world. They loosen up, feel more uninhibited, express themselves more openly. Researchers call this the "disinhibition effect." It's a double-edged sword. Sometimes people share very personal things about themselves. They reveal secret emotions, fears, wishes. Or they show unusual acts of kindness and generosity. On the other hand, the disinhibition effect may not be so benign. Out spills rude language and harsh criticisms, anger, hatred, even threats.? (Suler, 2002)

Suler explains that the disinihibition effect is caused by or heightened by the following features of online communication:

a) anonymity - no one knows who you are on the net, and so you are free to say whatever you want without anyone knowing it?s you who said it.


b) invisibility - you don't have to worry about how you physically look or sound to other people when you say something. You don't have to worry about how others look or sound when you say something to them. ?Seeing a frown, a shaking head, a sigh, a bored expression, and many other subtle and not so subtle signs of disapproval or indifference can slam the breaks on what people are willing to express.? (Suler, 2002)


c) delayed reactions - you can say anything you think and feel without censorship at any time, including in the middle of the night when you?re most tired and upset, leave immediately without waiting for a response, and possibly never return - in the extreme this can feel to someone like an emotional ?hit and run?.



d) the perception that the interaction is happening in your head - with the absence of visual and auditory cues you may feel as though the interaction is occurring in your head. Everyone thinks all kinds of things about other people in their minds that they would never say to someone?s face - online, you can say things you?d otherwise only think.



e) neutralizing of status - in face-to-face interactions, you may be intimidated to say something to someone because of their job, authority, gender, or race. Because this is not visible to you online, you feel freer to say what ever you want to anyone.



f) your own personality style may be heightened online - for example, if your communication style tends to be reactive or angry, you may be more reactive or angry online.

Tips for Resolving Conflict Online

What can be done to prevent unnecessary conflict in cyberspace? The following are tips for handling conflict online with respect, sensitivity, and care:

Don?t respond right away

When you feel hurt or angry about an email or post, it?s best not to respond right away. You may want to write a response immediately, to get it off your chest, but don't hit send! Suler recommends waiting 24 hours before responding - sleep on it and then reread and rewrite your response the next day.

Read the post again later

Sometimes, your first reaction to a post is a lot about how you're feeling at the time. Reading it later, and sometimes a few times, can bring a new perspective. You might even experiment by reading it with different tones (matter-of-fact, gentle, non-critical) to see if it could have been written with a different tone in mind than the one you initially heard.

Discuss the situation with someone who knows you

Ask them what they think about the post and the response you plan to send. Having input from others who are hopefully more objective can help you to step back from the situation and look at it differently. Suler recommends getting out of the medium in which the conflict occurred - in this case talking to someone in person - to gain a better perspective.

Choose whether or not you want to respond

You do have a choice, and you don?t have to respond. You may be too upset to respond in the way that you would like, or it may not be worthy of a response. If the post is accusatory or inflammatory and the person?s style tends to be aggressive or bullying, the best strategy is to ignore them.

Assume that people mean well, unless they have a history or pattern of aggression

Everyone has their bad days, gets triggered, reacts insensitively, and writes an email without thinking it through completely. It doesn?t mean that they don?t have good intentions.



On the other hand, some people pick fights no matter how kind and patient you are with them. They distort what you say, quote you out of context, and make all sorts of accusations all to vilify and antagonize you. Don't take the "bait" by engaging in a struggle with them - they'll never stop. Sometimes, the best strategy is to have nothing more to do with someone.

Clarify what was meant

We all misinterpret what we hear and read, particularly when we feel hurt or upset. It?s a good idea to check out that you understood them correctly. For example, you could ask, ?When you said...did you mean...or, what did you mean by...?? Or, ?when you said...I heard...is that what you meant?? Often times, what we think someone said is not even close to what they meant to say. Give them the benefit of the doubt and the chance to be clear about what they meant.

Think about what you want to accomplish by your communication

Are you trying to connect with this person? Are you trying to understand them and be understood? What is the message you hope to convey? What is the tone you want to communicate? Consider how you can convey that.

Verbalize what you want to accomplish

Here are some examples, ?I want to understand what you?re saying.? ?I feel hurt by some stuff that you said. I want to talk about it in a way that we both feel heard and understood.? ?I want to find a way to work this out. I know we don?t agree about everything and that?s okay. I?d like to talk with you about how I felt reading your post.? ?I hope we can talk this through because I really like you. I don?t want to be argumentative or blaming.?

Use ?I? statements when sharing your feelings or thoughts

For example, ?I feel...? versus ?You made me feel...?

Use strictly feeling statements

Feeling statements include saying you felt hurt, sad, scared, angry, happy, guilty, remorseful, etc. In everyday conversations, we describe our feelings differently than this. For example, we say that we felt ?attacked?, ?threatened?, ?unsafe?, or ?punched in the stomach?. When the person we?re upset with is not present, or able to read our words, this is an understandable way to express the full depth of our feelings and experience. Generally though, these statements are not simply feeling statements because they contain within them unexpressed beliefs. For example, you believe that you were attacked by the person, not that it just felt that way. If you want to communicate with the person involved (or they can read your words), it is best to stick to simple feeling statements otherwise they will hear you as accusing them of attacking them and be angry or upset with you. Some people get confused why other people get upset with them when they think they are only expressing their feelings; usually in these cases there were unstated beliefs expressed which the person reacted to.

Choose your words carefully and thoughtfully, particularly when you?re upset

Do your best to keep in mind that the person will read your post alone. You are not physically or virtually present with them to clarify what you meant, and they can?t see the kindness in your eyes. They must rely entirely on your words to interpret your meaning, intent, and tone. This is why it?s important to choose your words carefully and thoughtfully. You can still be real and honest while being selective.

Place yourself in the other person?s shoes

How might they hear your message? To avoid unnecessary conflict or a lot of hurt feelings, it helps to take into account who you?re writing to. One person might be able to hear you say it exactly how you think it, and another person would be threatened by that style of communication. Think about the other person when writing your email or post. Do your best to communicate in a way that is respectful, sensitive, and clear to them. People often say, to do that feels like they?re being controlled and why shouldn?t they just write it the way they want to. Of course you can write it any way you want, especially online, but if you want to communicate with this person and have them hear and understand what you?re saying, it helps to think about how they will hear it.

Use emoticons to express your tone

In online communication, visual and auditory cues are replaced by emoticons, for example, smiles, winks, and laughter. It helps to use emoticons to convey your tone. Additionally, if you like the person, tell them! Having a conflict or misunderstanding doesn?t mean you don?t like the person any more, but people often forget that reality, or don?t think to say it. It may be most needed during a tense interaction.

Start and end your post with positive, affirming, and validating statements

Say what you agree with, what you understand about how they feel, and any other positive statements at the beginning of your email. This helps set a positive tone. End on a positive note as well.

The Paradox of Online Communication

Handling conflict constructively is hard at the best times, and it can be even harder online. It can take a great deal of effort, care, and thoughtfulness to address differences, tensions, and conflicts online. Paradoxically, some of the same things that contribute to heightened conflict online can contribute to peaceful resolutions as well. The internet is an ideal place to practice communication and conflict resolution skills. Just as the absence of visual and auditory cues, the anonymity, invisibility, delayed reactions, and neutralizing of status free us to say what ever negative thing we want, they can also free us to try new, and more positive communication styles and to take all the time we need to do that. As with any new technology, the internet can be used to enhance our personal growth and relationships, or to alienate us from each other. It?s our choice.

Kali Munro, © 2002

Dealing With Pathological Liars

Dealing With Pathological Liars

How to Deal with Liars
Tips for Coping when Friends and Family Members Lie
© Venice Kichura

When close friends and family members continue to lie, it can be devastating. Here are some tips on how to deal with liars, as well as how to help them.

There’s nothing more frustrating than knowing someone is habitually lying to you. When it’s a small child, it’s considered immaturity. But after a parent has tried to teach basic honesty and the child grows up and continues to lie, creating a fantasy world that you know isn’t real, the lying surpasses immaturity, becoming a serious problem. Both the liar and those close to him (or her) suffer if the lying persists.

Hold Your Tongue
Although you’re tempted to lash back, letting the liar know you don’t believe a word he says, it’s better to hold your tongue. Of course, you do want to let him know you don’t believe the lies, but try to keep your words soft and few, although it’s not easy. Calmly state (resisting the urge to use harsh words) what you know to be true.

State Only the Truth
Be sure you tell only the truth. If you’re known for being an honest person, then others can see the lie for what it is. Also, weigh your words carefully, as you don’t want to be accused of telling any untruths yourself.

Share Your Concerns with the Liar
In a gentle way, meet with the liar to share that you’re concerned about him. Tell him that you have proof of his lying and that you’re concerned for his welfare if he doesn’t change. If you know this approach probably won’t work, then maybe you’ll need to plan a confrontation where other friends and family members confront him in a surprise meeting, urging him to get professional help. Explain how it’s possible he may have a mental illness and need therapy. Be sure to convey that you really care about his welfare.

Seek Counseling Yourself
If your friend or loved one refuses to get professional help, or a confrontation doesn’t work, then you get help yourself, either professional counseling, or with a trusted friend, church elder, or minister with whom you can confide. Often when you associate with a liar, you can feel like you’re losing your mind, so to protect your own sanity, seek help.

Pathological Lying
A pathological liar is someone who exaggerates his stories to impress people. While a normal liar knows he’s lying, a pathological liar may actually come to believe his own lies. This is a serious mental disorder that needs to be corrected. On the other hand, some pathological liars know they’re lying, but continue to do so, as they get rewards in the form of sympathy, attention, etc.

How do you know if someone is a pathological liar? There are several red flags. For example, the liar….

Changes his stories
Acts defensively when questioned
Lies about minor things
Often actually believes his own lies
Exaggerates to an extreme degree about everything
Uses manipulation
Never admits she/he’s wrong

If all Else Fails, Disassociate
If the liar persists in telling untruths, then you may have break off all ties with him until he realizes the seriousness of his problem. Don’t give up on him, but when the opportunities arise, continue to let him know you’re concerned about his mental health. Meanwhile, pray for him, as you go on with your own life.

The copyright of the article
How to Deal with Liars in Personality/Anxiety/Mood Disorders
is owned by Venice Kichura.