Living With a Paranoid Alcoholic
How to Cope With Paranoid Personality Disorder in Your Home
Oct 4, 2009
Not all alcoholics are paranoid and not all paranoids are alcoholics but there is a definite statistical correlation between the two. Living with alcoholism and/or paranoia is not easy. Those who love alcoholics often wear themselves out emotionally, mentally, spiritually and physically trying to arrange their lives around a paranoid alcoholic’s troubling behaviors.
The Behavioral Symptoms of Paranoid Personality Disorder
Whether or not an alcoholic has been diagnosed by a mental health professional as having PPD, he is likely to exhibit certain behaviors. According to the DSM-IV-TR, patients must display four of the following seven symptoms
- A pattern of suspiciousness about, and distrust of, other people when there is no good reason for either. This pattern should be present from at least the time of the patient's early adulthood.
- The unfounded suspicion that people want to deceive, exploit or harm the patient.
- The pervasive belief that others are not worthy of trust or that they are not inclined to or capable of offering loyalty.
- A fear that others will use information against the patient with the intention of harming him or her. This fear is demonstrated by a reluctance to share even harmless personal information with others.
- The interpretation of others' innocent remarks as insulting or demeaning; or the interpretation of neutral events as presenting or conveying a threat.
- A strong tendency not to forgive real or imagined slights and insults. People with PPD nurture grudges for a long time.
- An angry and aggressive response in reply to imagined attacks by others. The counterattack for a perceived insult is often rapid.
- Suspicions, in the absence of any real evidence, that a spouse or sexual partner is not sexually faithful, resulting in such repeated questions as "Where have you been?" "Whom did you see?" etc., and other types of jealous behavior.
Other behaviors not listed above but common in the paranoid personality are the inability to accept compliments (because they think other people are faking them), a tendency to bring lawsuits against others at the slightest provocation, an underdeveloped sense of humor, social isolation, emotional detachment and failure to recognize that they have a problem. They tend to blame others for all their problems.
Family Members and Friends Can “Detach with Love”
Unfortunately, friends and family members often contribute to the problem when they respond normally. Paranoid people are not delusional and they usually don’t have hallucinations. They are often intelligent people, but they grossly misinterpret the motives and actions of other people.
The most important thing a member of this kind of household can do is to “detach with love,” as suggested by Al-Anon, a fellowship of men and women who share their experience, strength and hope with each other in order to solve their common problem. Detaching with love means taking a business-like approach to the alcoholic most of the time.
Other Things to Remember When Dealing with a Paranoid Alcoholic
Most family members and friends are not mental health professionals, and they should remember that when dealing with any personality-disordered person. Whether the alcoholic is drinking or sober, diagnosed or undiagnosed, male of female, young or old, here are a few tips:
- Don’t bring up the past. Work only on the present situation or issue, because paranoids will be looking for signs that you are out to get them, hurt them or ridicule them.
- Don’t hide anything from your significant other. The more transparent you can be, the better chance you have of developing a sense of trust in your loved one. Show him any notes you take, tell him about phone calls, visits with friends, etc. Even though it may seem invasive to you, it will go a long way towards helping your loved one.
- Don’t make jokes. Most paranoid individuals have a grossly underdeveloped sense of humor and will feel ridiculed by humor even if it is not directed at them in any way.
- Encourage the alcoholic to attend some classes on “life skills” or “time management” or some other non-threatening activity. He will resist the idea of therapy or alcoholic treatment, but if you call it “coaching” he may agree to participate.
- Don’t respond to him with any show of hostility. When you do, the toxic cycle is perpetuated and nothing is gained for anybody concerned.
As a final, last-ditch tactic, some family members will feel obliged to have their loved one hospitalized against their will under the Mental Health Act of 1983.
Attend Al-Anon Meetings and Work on Your Own Sanity
If all these suggestions sound too daunting for you, but you sincerely love your alcoholic and want to learn to help the situation, Al-Anon can provide a safe place for you to work on your own issues. It takes a great deal of emotional maturity to detach emotionally, avoid mentioning the past, remain completely transparent, squelch your sense of humor and your anger, and follow all these suggestions.
Unfortunately, no medications have been proven to relieve the symptoms of paranoia on a long-term basis. No laboratory tests have been devised to confirm a diagnosis. Since paranoid personalities resist therapy and refuse other kinds of help, families are often destroyed by this aspect of alcoholism.
References:
American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR, American Psychiatric Publishing, Inc. 2000
Shannon, Joseph W. “Understanding and Treating Personality Disorders”, unpublished seminar materials, 2009
Brannon, Marie, "Living With an Alcoholic Who Constantly Blames", Suite101.com 2009
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