From suspiciousness to paranoid delusion

Suspiciousness underlies many discomforts, and few diseases are as popular as "social phobia." Along a continuum, which can become uncontrolled, suspiciousness ranges from shyness to delirium, from discomfort, which does not severely compromise the quality of life, to overt pathology, with impeding effects on everyday life.
Those who suspect fear, without well-founded evidence, only on the basis of simple clues, real or presumed, that a person, an event, or a higher entity (God, destiny, fate ...) results in damage or danger to one's person or for your own interests. The suspicious attitude is that of one who perceives reality with fear and hostile feelings, matured, these, from negative experiences actually lived or even just imagined.

Those who suspect are forced to always be vigilant, ready to defend themselves against something that could happen at any moment. And the "something" is always negative. The paranoid has the certainty that his suspicion is sensible and justified: he does not have the doubts, typical of the obsessive, he has unshakable certainties. It is precisely doubt versus certainty that constitutes the discriminating factor between obsessive ideation and a paranoid one. Certainty is the source of paranoid thinking, which converts subjective knowledge into objective, that is, into absolute Truth.

Many scholars (Fischhoff, Thinès, Costall, Butterworth etc.) have highlighted how the human mind tends to "see" certainty rather than uncertainty. Man needs, in fact, to heal the doubt and fear that this entails, to anchor himself to the apparent security that a certainty, even presumed, entails.

Everything is rationally interpreted with a single categorical logic, which produces a structured belief that does not need to be verified but only confirmed. The certainty of the bad faith of others supports suspicious, avoidant or aggressive behavior which, inevitably, stimulates distrust or aggression in the interlocutor: the proven proof that one's suspicions are well founded!

Paranoia it is by definition characterized by distrust in the relationship between self and others. The mixture of fear and doubt, which become distrust and suspiciousness, sometimes seasoned with anger and / or shame, can be expressed in three reactions:

the reaction of those who defend themselves in advance, with avoidance or isolation;
of those who defend themselves by attacking, both verbally and physically;
of those who are delirious.

La attempted solution (i.e. the dysfunctional thought and / or behavior that the subject acts, in the belief it is the best reaction to be used in that situation) fundamental and typical, which supports the structure of the paranoid disorder - according to what emerged from our research - is the anticipated or excessive defense towards others.
That is, the person reacts excessively to the slightest provocation as he feels it, or decodes it, as an aggression, or he perceives in a qualitatively erroneous way something that, in fact, is neither an aggression nor a refusal. in his regards.

Paranoia of self. Paranoid certainty can affect not only the relationship between Self and Others, but also the relationship that the person has with himself. People who fall into this variant constantly feel wrong and whatever they do, even if it is positive, will be experienced negatively: for them "success is zero and failure is double". The mood is often depressed, as a result of a linear and above all safe ideation: "I can't trust me."

The delusion. The person defends himself against something that does not exist, if not in his mind (he suspects plots, sees enemies everywhere, picks up clues where there are none). The paranoid delusion constructs an invented reality that produces the concrete effect of defending oneself from something that is not there.

The difference between health and psychic pathology - between suspicion - understood as a habit of suspicion - obsessive distrust and trespassing into full-blown delirium - is then in a quantitative increase, rather than in the qualitative difference of dysfunctionality. The same “mechanisms”, in different doses, create dysfunctional or frankly psychopathological pictures that need different, targeted, tailor-made interventions.
Also for this disorder / pathology, the results show, in fact, the greater efficiency and effectiveness of this model of intervention compared to the variegated "market" of psychotherapy, confirming what has already been published with respect to other pathological areas.

Dr. Emanuela Muriana (Official Psychotherapist of the Strategic Therapy Center)
Dr. Tiziana Verbitz (Official Psychotherapist of the Strategic Therapy Center)

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