The paranoid person is a suspicious, distrustful, hostile character who sees most of the people in his world as being against him, bent on his humiliation, and organized to a greater or less degree in a plan to see that his desires are thwarted. By the time this person has become a hospitalized paranoid patient these characteristics are seen in more pronounced forms. Suspicions have become certainties; doubts have become delusions; imagined thoughts have become hallucinations; blame and responsibility for what the patient has experienced have undergone a shift and are now attributed to others.
How does one go about beginning psychotherapy with a person whose words and demeanor say in effect: “I want little or no part of you. There is nothing the matter with me. ‘They’ are responsible for my being here. All I want is to get out, and if you
BULLARD DM. Psychotherapy of Paranoid Patients. AMA Arch Gen Psychiatry. 1960;2(2):137-141. doi:10.1001/archpsyc.1960.03590080013003