In cognitive principle therapy [CPT] we look at the process of PPD and the treatment of PPD based on principles.

What is PPD

Paranoid personality disorder (PPD) is classified as a type of eccentric personality disorder. People with eccentric personality disorders display behaviors that may seem odd or unusual to others. They mistrust the motives of others and believe that others want to harm them. The cause of PPD is unknown. However, researchers believe that a combination of biological and environmental factors can lead to it.

The disorder is present more often in families with a history of schizophrenia and delusional disorder. Early childhood trauma may be a contributing factor as well


The primary characteristic of this condition is a chronic and pervasive distrust and suspicion of others. Other symptoms of paranoid personality disorder include:

  • Feelings that they are being lied to, deceived, or exploited by other people
  • May believe that friends, family, and romantic partners are untrustworthy and unfaithful
  • Outbursts of anger in response to perceived deception
  • Often described as cold, jealous, secretive, and serious
  • Overly controlling in relationships in order to avoid being exploited or manipulated
  • Look for hidden meanings in gestures and conversations
  • Find it difficult to relax
  • Often hold negative views of other people
  • Overly sensitive to criticism
  • Overreacts in response to perceived criticism

On the CPT scale of 16 dysfunctional personality types, the PDD as a generalisation would be overly negative [no trust], overly controlling [to feel safe] and overly avoidant [not to disclose details of self]. Could be equally left of right brain.

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Process of PPD

  • The PPD client has experienced major negative experiences in the four relationship principles of trust, respect, acceptance and commitment, which for the basis of engagement with others. In polyvagal theory, this means the client will be continually triggered to down regulate to fight [controlling behaviour and or anger], flight [anxiety] or freeze [avoidance- non disclosure]
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  • There will be past unresolved issues relating to trust and strong negative core beliefs and strong defensive positions to protect the Experiencing self [Ego]. The conflict is deep within the subconscious mind, between the Real self [conscience] and the Remembering self. The conscious mind may not be aware of this conflict.
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  • The subconscious mind has created strong negative comparative-predictive loops, which the conscious mind can't control. In CPT this is called a very bad habit and a loss of control in the four brains [head, heart, gut and spirit]
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To stop this automatic process an intervention needs to be inserted between the comparison and the prediction.

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CPT treatment of PPD

  1. Build trust with the client and create hope that life can be better. This is slow, medium-long term process.
  2. Provide awareness of the process as described above. The three areas of life are control, attachment and meaning. In polyvagal terms, PPD is a control problem, which must be addressed first.
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3. Create an intervention to break the negative comparative-predictive loop. CPT has developed a specific technique, called the Stop, Find Method to do this.

4. Find the negative core belief and challenge that in a slow, gentle way, over time.

5. Strength the influencing principles. These are courage, assertiveness, self-control, calmness, patience and persistence. Influencing principles and core beliefs are in the gut brain and regulate the heart brain through the vagal brake.

6. The PPD client is stuck in column 1, in paranoid fear [diagram below] and needs to move slowly across the groups of principles . It is not done in a straight line, but a continual loop from left to right as each issue is addressed. Every "Challenge" step, must have an equal "Support step." Spiritual principles are used to support the process, eg forgiveness, hope, etc.

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