Paranoid personality disorder (paranoia)

Causes

Paranoid personality disorder occurs equally in men and women. It can manifest itself in a person whose relatives include people with schizophrenia or who had communication limitations in childhood (living in a family of emigrants, the deaf, under a strict totalitarian regime, etc.). There is no information on how widespread this disease is in the world.

There are several reasons contributing to the development of paranoid psychopathy:

1. Evolutionary theory. According to her followers, suspicion helps to survive in any era. Focusing on the assertion that only the strongest will survive divides the world strictly into friends/foes, black/white - this becomes the foundation of paranoia.
2. Hereditary theory - the disease is transmitted by genes from generation to generation.
3. Psychoanalytic theory. If an individual grew up in a family where he was overprotected, physically punished for any offense, humiliated, and a lot was demanded of him, then he is at risk.

Paranoid Self

The paranoid client despises his own humiliated personality. He has a high degree of fear, which leads to the fact that he constantly “monitors those around him,” observes their reactions, “keeps his finger on the pulse.” Paranoids believe that they are the target of everyone around them, that people think and talk only about them.

It is also important to note that paranoids have a high sense of guilt.

Statistically, a connection has been found between thoughts about homosexuality and paranoid personalities, this has been confirmed by some studies.

Paranoids can fight against existing authorities. Revenge and triumph provide a temporary and shallow sense of security and moral clarity.

Paranoid personality

People suffering from paranoid personality disorder do not understand jokes at all - they have no sense of humor. They are unable to experience any failures; they are overwhelmed with negative emotions for any reason. These individuals are suspicious of favorable relationships, which is why they are unable to create normal, friendly relationships. At the same time, such a person is quite active and cannot sit in one place for a long time.

Psychiatrist Pyotr Borisovich Gannushkin, describing his patients, argued that paranoid individuals think monotonously, illogically, “twisting” everything in their own way. They do not accept criticism due to their high self-esteem. Paranoid people react to it with sharp physical aggression, abuse, and harbor anger and resentment for a long time.

Colleagues, relatives and friends of the paranoid suffer from his negativism. It is very difficult to be intimate or married to such a person, since he is constantly oppressed by pathological suspicion and the ensuing jealousy.

Paranoid people have the following characteristics:

• negative emotionality;
• hypervigilance;
• infantilism;
• they see the negative sides in everything;
• one-sided thinking;
• high self-esteem;
• conflict;
• aggressiveness;
• increased activity;
• pedantry.

P.B. Gannushkin identified the formation of overvalued ideas as the basis of paranoid personality disorder, and the most common of them is the patient’s conviction of his own hypersignificance. The individual thinks only about this, is unable to switch to something else, cannot control his own thoughts when they “rule” his mind. Based on this, the scientist proposed to classify paranoids according to the prevailing overvalued ideas: fanatic, litigious (slander, querulant), inventor, etc.

People with paranoid personality disorder neglect their health. Having received a diagnosis of any physical illness, they do not take any measures to recover: they refuse to take prescribed medications and follow the doctor’s recommendations. This affects their idea of ​​someone’s bad attitude towards their personality.

There is also a classification of paranoid individuals according to the type of nervous system (according to Ernst Kretschmer, a German psychologist and psychiatrist):

1. A sensitive paranoid is an unhappy person, a victim (as he himself believes). Those around him, in his opinion, treat him with malice, unfairly, and feel that he is an enemy. He is unsure of his abilities, closed, vulnerable, has low self-esteem, experiences failures greatly, is critical, but from time to time a sense of self-esteem flares up in him. A person suffering from this type of psychopathy accumulates negative emotions that can suddenly burst out through inappropriate actions: self-mutilation and beating others.
2. An expansive paranoid is a very self-confident leader, and considers those who disagree with him to be dangerous. Suspicious, excitable, assertive, aggressive. He is quite pleased with himself, considers himself exceptional, ideal, perfection, does not recognize indications of shortcomings, considers himself the best in a certain matter and builds a successful career only so that others envy and admire him. Such a person can be called “two-core” - he almost never gets tired, is active at any moment, and his mood is always elevated.

Treatment and therapy

Psychoanalytic

Psychoanalytic therapy of paranoid individuals is a rather labor-intensive task that requires the therapist to have high professional qualities and, above all, the ability to tolerate negative emotions directed at themselves. A paranoid client tends to project his negative (in the client’s opinion) qualities onto the therapist, suspect the therapist of all mortal sins and actively seek evidence of his fantasies, including provoking the therapist to have a negative attitude towards himself (the so-called “projective identification”).

Another tendency the therapist may encounter is temporary idealization. Typically, a paranoid client, denying those qualities of his that seem negative to him, perceives himself as a victim of external aggression, and sees those around him (including the therapist) as aggressive carriers of many vices. However, in the initial stages of therapy, he may identify with the therapist and idealize him along with himself. The more painful it will be for the therapist to face the inevitable wave of negativity when the period of idealization ends.

Successful psychoanalytic therapy requires the client to recognize that the qualities and desires that he does not like in others are his own qualities and desires. One of the main means of achieving this awareness is through transference analysis, during which the client can see that his fantasies about the therapist have no objective basis. To do this, the therapist needs to actually not give such reasons - to successfully withstand the client's provocations and to cope well with his feelings, especially negative ones.

Paranoid clients' reliance on denial has a significant impact on the speed of therapy. This defense mechanism works by categorically refusing to acknowledge something (and not by forgetting, as with repression). Direct interpretations of transference run into even greater denial. It takes considerable time and support from the client's observing position for him to begin to accept the very possibility that what he sees in others may come from within himself.

Despite all these difficulties, Nancy McWilliams, in her book, notes that the therapy process turns out to be extremely significant for such clients who, despite the fact that they express a huge number of reproaches and complaints to their therapists, stubbornly continue to attend sessions. McWilliams suggests that for a person with a paranoid personality type, who sees the whole world in dark, anxious tones, psychotherapy sessions in which someone listens to his negativity without responding with retaliatory attacks are a rare and very valuable outlet.

Symptoms

As mentioned, paranoid personality disorder begins to manifest itself in childhood. Its first signs: straightforwardness, stereotypical thinking, distrust. The child often gets into a showdown with peers, gets offended, remembers the insults and tries to take revenge for them. He is not interested in the feelings and needs of other people.

After 20 years of life, it becomes difficult for a paranoid person to adapt to changes; he begins to see life exclusively in black and white, and to think the same way. It seems to him that people around him are hostile and want to appropriate his achievements and property. He is “gnawed” by doubts about the loyalty of his friends and partner, jealousy. The patient considers every word and deed of those around him to be filled with hidden meaning that is harmful to him. For example: children in the apartment upstairs stomp loudly, because their parents taught them this specifically to annoy the neighbor below.

The person suffering from paranoid disorder is sensitive to insult and harm, even if an apology has been made for it. With his help, even the smallest offense grows into a big conflict and irreconcilable enmity.

If a paranoid person is treated with disrespect or seems to be disrespectful, then an instant “response” will follow in the form of an outburst of anger or a counterattack. Suspicion does not allow such a person to share intentions or feelings with those close to him, so that no one can use the information received against him.

Paranoid people suspect others of various terrible offenses, interpreting their behavior using their imagination. They can even construct a completely logical confirmation of their statements, convincing the listener of the indisputability of the facts they have invented.

Emotions in patients are strong, but one-sided: dissatisfaction, disappointment, anger, and irritability prevail. Responsiveness, warmth and sense of humor are alien to them. They love only themselves; possession of power and strength deserve their admiration, and weakness deserves contempt.

A hypervalued obsession is formed (this was discussed above). It becomes a goal, and its objectivity or subjectivity is completely unimportant, although it may be completely absurd - in the opinion of the paranoid, this is socially important. That is, a person is ready to fight to the end for the public good in his personal opinion, showing a kind of messianism. When achieving a goal, he only needs recognition of merit, and not joy for bringing any benefit to society. The main thing is to be called irreplaceable and very necessary.

Paranoid individuals work diligently, but only if their work activity coincides with a super idea. They do not accept any criticism, since they consider themselves experts and great specialists in a certain topic. Compromise with colleagues of equal or lower rank is excluded, although minor concessions to superiors are possible.

The people around him, even his close ones, in the patient’s opinion, should contribute in every possible way to achieving his goal; for his own benefit, he often uses lies and manipulation.

There have been many people in history with characteristic paranoid signs: Lenin, Peter the Great, Thomas Edison, Bobby Fischer.

So, we list the main signs of paranoid psychosis:

• provoking conflict;
• idealization of oneself;
• inadequate perception of criticism;
• self-isolation;
• dissatisfaction with everyone and everything;
• an obsessive desire to fight for your rights anywhere;
• taking mistakes and failures to heart;
• pathological jealousy, distrust;
• looking for negativity in the words and deeds of other people;
• the desire to focus everything on oneself;
• exaggeration of one's own importance.

Psychological characteristics of the paranoid personality type

The leading characteristics of the paranoid personality type are suspicion, wariness, absence or a dull sense of humor.

A paranoid person treats his qualities as negative, projecting them externally. And then they are perceived as an external threat. We can say that everything that this person worries and worries about is within herself. For example, such a person may not realize that in some of his manifestations he is quite aggressive and, projecting this quality onto other people, notes these traits in them.

Also often in paranoids one can observe a consciousness of their own greatness.

A paranoid person must suffer greatly in order to seek psychological help; they are not inclined to trust strangers. And in this regard, they tend to avoid consultations with psychologists and trust few people.

Paranoid individuals often play political roles where their projective traits may be opposed to existing views. They can “climb onto an armored car” to prove something to someone. True, it is important to note that such people do not always exaggerate the real danger. However, they can also be ironic and suspicious.

Therapy

The diagnosis of “paranoid personality disorder” is made on the basis of characteristics characteristic of this disease that are observed in the patient throughout his life. The psychiatrist should exclude the presence of delusional disorder, paranoid schizophrenia, consequences of organic brain pathology, skull injuries, drug addiction and alcoholism.

To treat the disorder, medications and psychotherapy are used in combination. Sedatives, tranquilizers, and antipsychotics are prescribed as medications. However, since this is negatively perceived by the patient due to his suspicion (refusal to take it, complaints about ineffectiveness), the courses are usually prescribed very short.

To conduct successful psychotherapy, a specialist needs to establish a trusting, frank relationship with the patient in order to choose the appropriate technique. This can be behavioral psychotherapy, psychoanalytic or Jungian depth psychoanalytic therapy.

Such treatment lasts quite a long time, since the patient’s negativistic life position does not allow him to interact normally with the doctor. Therefore, the latter needs a lot of experience and patience. The paranoid person is aggressive towards the specialist, splashes out negative emotions on him, but this must be endured and everything possible must be done so that the patient realizes and overestimates the conflict artificially caused by him, extinguishes the aggression and gets rid of the overly valuable idea.

We are also working with relatives. They should be taught to turn the upcoming conflict into a humorous side, to make sure that there is as much positivity in the patient’s life as possible, and to avoid critical remarks towards the patient.

Unfortunately, paranoid disorder cannot be completely cured. With age, its symptoms become stronger, but if therapy is started on time and it is adequate and professional, then it is quite possible to achieve stable remission.

Stages of development of paranoid personality disorder

From childhood, these individuals are prone to one-sided interests, passions, stubbornness, and straightforward judgments. Increased activity and overestimation of one's own abilities determines the desire for leadership and self-affirmation, often despite the resistance of others. They are extremely touchy and vindictive, extremely sensitive to disagreement with their opinion. At the same time, they do not forgive anyone even the most insignificant offenses. Paranoid psychopaths usually treat other people with disdain and contempt. Typical signs of overvalued ideas and paranoid reactions are formed in such subjects by the age of 20-25.

As they grow older, their character traits intensify. Patients become inert, conservative, rigid.

Treatment of paranoid personality disorder

Drug therapy is usually ineffective.

Among the methods of psychotherapy, one can highlight the theory of psychodynamics of object relations (in this case, the doctor tries to explain to the patient what is behind his anger, and works on the person’s hidden desires to have a satisfactory relationship) and behavioral and cognitive psychotherapy, which are aimed at organizing help for such people in controlling anxiety and improving interpersonal problem solving skills. Patients are helped to interpret other people's actions and intentions more realistically and to better understand others' points of view.

Features of communication with a patient with paranoia

If a loved one has a paranoid disorder, then an important point in the treatment process is the correct approach to communicating with him. Under no circumstances should the patient be allowed to drink alcohol. Monitoring by loved ones over compliance with all doctor’s recommendations and timely attendance at psychotherapy sessions is important.

It is important for those who live next to a paranoid person to expect that they will need a lot of patience. You cannot show aggression towards the patient or excessively express your emotions. You need to have a conversation with him, as with a healthy person, but do not laugh at him. The tone of the conversation should always be confident and calm. You cannot humiliate a patient. On the contrary, you should convince him that there is truth in his words, since attempts to convince a person are doomed to failure. But the most important thing is to contact a specialist in time who will help develop treatment tactics.

What types of paranoia are there?

The classification of individual types of paranoia is based mainly on the prevailing fixed idea. Depending on this, the most common forms of paranoia are distinguished: • Involutional paranoia, which develops at the mature age of 45-60 years, in women often coinciding with the menopause. It is characterized by systematized delusions of persecution, jealousy, and, less often, grandeur. The onset is usually acute, the course is long, and treatment is inpatient. • Paranoia of grandeur, or megalomaniacal with ideas of reforming society, science and art, as well as invention and “great” discoveries. • Paranoia of jealousy is based on the dogma of adultery or adultery. Moreover, betrayal does not need to be recorded and proven, but is accepted as an axiom. No arguments from the other half can shake the confidence of a pathological jealous person that he is right. Initially, the patient accuses the partner of coquetry, the desire to attract the attention of people of the opposite sex, cheeky behavior, shameless snuggling while dancing, and even a bashful reaction to compliments. This continues for several years, after which suspicions develop into a firm belief in treason. • A religious form that develops against the background of religious beliefs. • Erotic paranoia, in which the main content of delusional ideas is erotic fantasies. It develops mainly in women between 40 and 50 years of age. • Persecutory form – paranoia with systematized delusions of persecution. • Senile paranoia of old age, often coinciding with senile dementia, Alzheimer's disease, Parkinson's disease and other degenerative diseases of the brain. • Alcohol paranoia, which is a chronic psychosis caused by alcoholic encephalopathy. Most often it occurs in men and is manifested by delusions of jealousy and/or persecution. There are other types of paranoia, for example, with delusions of a complainer or hypnotic charm, but they are much less common.

The identification of paranoid personality disorder, or the paranoid type of psychopathy (the first name corresponds to ICD-10, the second - to the domestic classification), as an independent constitutional type is associated with the need to distinguish it from constitutional anomalies of other types, as well as psychogenically and procedurally determined conditions. There are transitional states between paranoid psychopathy and other types of personality disorders (narcissistic, dissocial). Paranoid psychopathy is especially closely linked (as shown by clinical studies and confirmed by psychometric studies of W. J. Livesley and M. L. Schneider (1990) with a group of schizoids of both the expansive and sensitive poles. Some authors [Gannushkin P. B., 1933; Molokhov A. N., 1934; Shostakovich B.V., 1971] share the point of view according to which readiness for paranoic development and delusional formation can arise not only on the basis of the personal predisposition of the same name, but also on the basis of other constitutions.Difficulties in identifying the group of paranoid psychopathy are also due to the complexity clinical distinction between constitutional forms and delusional states of another etiology. The absence of such a distinction or, conversely, the identification of paranoic psychopathy with paranoia and some other endogenously or psychogenically caused protracted delusional psychoses (as done by R. Gaupp and some of his followers) leads, according to T. I. Yudin, to qualify the symptoms of an already expressed disease, and not the characteristics of the constitution on the basis of which the disease develops.

Paranoid individuals are people of a special type, capricious, unfrank, lacking a sense of humor, capricious, irritable, with one-sided but persistent affects that take precedence over logic and reason. They are characterized by increased activity, often combined with high spirits, excessive accuracy, conscientiousness and intolerance to injustice. As a rule, they are rigid, prone to “getting stuck”, fixation on certain concepts and ideas, which is greatly facilitated by the great emotional intensity of experiences that are significant to them. They are distinguished by a narrow outlook, one-sidedness and limited interests. They do not set big goals for themselves, but objectively insignificant problems can obscure the whole world for them. Their judgments are immature, too straightforward, extremely specific, primitive and not always consistent. S. A. Sukhanov (1912), who classified such persons as a group of “logopaths,” emphasizes their characteristic tendency from adolescence to reasoning and flaws in thinking in the form of an abundance of one-sided and logically incorrect (paralogical) conclusions.

Paranoid psychopaths are distinguished by increased self-esteem, a heightened sense of self-esteem, combined with “hypersensitivity” to failures and negative evaluation from others. For a paranoid person, everything that is in one way or another connected with his own personality and affects his interests acquires special meaning and significance. They are deeply indifferent to phenomena outside the sphere of “attraction” of their “I”, simply excluding them from the area of ​​active attention. “Everything that is not closely related to his “I” seems to the paranoid little worthy of attention” [Gannushkin P. B., 1964].

In this aspect, it is necessary to emphasize one more feature of paranoids, which is hardly noticeable in everyday life, but clearly appears in the conditions of a somatic hospital - egodystonism in relation to one’s own bodily sphere. Psychopathic personalities in this circle are not only indifferent to a number of events in external life, but also to the problems of their somatic state. The news of a serious somatic illness often leaves them indifferent - it does not entail anxiety, fear of the harmful consequences of the disease, fear of death, or decreased mood, which remains within the limits of constitutionally characteristic hyperthymia. Such resistance to severe somatic illness, defined in psychoanalytically oriented literature by the term “elasticity,” is sometimes interpreted in a positive way as a well-developed ability to self-control. However, often a defect in bodily self-awareness is revealed by hypo- or even anosognosic reactions with inadequate, sometimes self-destructive behavior (neglect of medical recommendations, refusal to take medications, life-threatening exercises and physical activity).

Constantly opposing oneself to others, perceiving the world as an opposite and even hostile phenomenon is manifested in paranoids by such traits as “hypervigilance” (constant search for a threat from the outside, readiness to respond to any alarm signal) and distrust of people. Fears of attacks on their rights, their property, or their spouse or sexual partner are often at the forefront. Such distrust of the intentions of others easily turns into suspicion in paranoid individuals. Thoughts arise that others treat them unfairly, without due respect, are jealous, or even want to humiliate or insult them; they are being undermined and their authority is being infringed upon. An incorrect, one-sided interpretation of the words and actions of others leads a paranoid person to unfounded and, for the most part, suspicions devoid of even the slightest reason. Any trifle that is not directly related to them can be interpreted as a manifestation of bad intentions, negative (or even hostile) attitude of others (usually relatives and colleagues).

In many cases, starting from early adolescence, throughout the life of a paranoid person, the described manifestations remain persistent and change little in intensity. However, in some abnormal individuals, character traits do not essentially change, but give, according to the definition of S. A. Sukhanov (1912), “pathological growths” of one or another characteristic characteristic of a given individual. According to J. Lange (1927), in such cases there is a biologically fixed readiness for a pathological response. The key to understanding such more pronounced mental anomalies lies in the clinical definition of paranoid psychopathy, owned by P. B. Gannushkin. The most typical, according to P.B. Gannushkin, property of paranoids is the tendency to form overvalued ideas, in the power of which they then find themselves. Overvalued ideas subjugate the entire personality and determine the behavior of the individual; It is not the paranoid person who controls his thoughts, but his thoughts that control him.

Depending on the topic of super-valuable ideas, several types of paranoid individuals are distinguished: jealous people, inventors, querulants, fanatics, etc. However, a taxonomy based only on the content of super-valuable formations cannot reflect the structure of psychopathy as a whole.

The foundations of the clinical typology of paranoid psychopathy are laid in the works of O. Bumke (1924), T. I. Yudin (1926), E. Kretschmer (1930), N. Binder (1967). To date, this typology has not been completed, but it seems legitimate to distinguish (as separately as in the group of schizoids and psychasthenics) at least two polar variants of paranoid psychopathy: expansive and sensitive. This differentiation to a certain extent coincides with the division of the paranoid constitution into 2 subtypes proposed by S. Akhtars (1996): 1) stronger, active, defiant, angry, litigious; 2) weak, passive, secretive, touchy.

Expansive paranoid individuals are pathological jealousy, litigious people, people prone to conflicts, truth-seeking and reforming. From childhood, they are deceitful, vindictive, often slander and complain, they notice the shortcomings of others, but do not recognize them in themselves. As V.F. Chizh points out (1902), they are always satisfied with themselves, failures do not bother them. We are convinced that only they master this specialty, only they understand everything perfectly. They do not want to obey, limit themselves to a modest role, and usually fight with their personal enemies, and not for a common cause. Having devoted themselves to scientific activity, they essentially do not like science; they engage in it only in order to shame their enemies. Fighting opponents and asserting their importance fill their lives. As a rule, these are sthenic and even exalted individuals with an accelerated pace of mental activity and a constantly elevated background mood. They are energetic, active, sometimes fussy, do not know what fatigue is, and do not feel the need for rest. The group of fanatics also belongs to expansive paranoid individuals. Fanatics are people who, with exceptional passion, devote all their interests, activities, time, and ultimately their entire lives to one cause, one idea. The strength of their obsession is such that they are able to captivate, at least temporarily, other people with their idea. It must be emphasized that we are talking about blind faith (for example, religious fanaticism), which does not require logical justification. Although fanatics, unlike other paranoid individuals, do not put themselves in the foreground, they are far from true altruism, devoid of direct love for their neighbors, soulless, and often cruel. When describing a group of fanatics, P. B. Gannushkin emphasizes that such cases are not always easy to distinguish from schizoids and “dreamers”; there are many transitional forms between these groups of psychopathy. T. Bilikiewicz (1973) describes this type as a variant of schizoid psychopathy (paranoid schizoids). Such transitional types, close to schizoids, include, in particular, psychopathic personalities, defined by K. Schneider (1959) as sluggish fanatics. Sluggish fanatics, in contrast to expansive ones who actively strive to implement their program, are people prone to fantasy, eccentric, turned away from reality. Their obsession with an idea is very close to autistic hobbies (collecting, vegetarianism) and is realized only in their personal lives. They do not fight to spread their ideas, they do not look for supporters and followers.

The description of paranoid psychopathy of the sensitive pole belongs to E. Kretschmer (1930). A. E. Lichko (1985) identifies these rather rare personality anomalies as an independent - sensitive type of psychopathy. In terms of personality structure, sensitive paranoids during the period of compensation show similarities with certain variants of sensitive schizoids [Yudin T.I., 1926].

A characteristic feature of the sensitive version of paranoid psychopathy is a combination of contrasting personality traits: asthenic, sensitive (awareness of one’s own inferiority, vulnerability, false modesty) and sthenic (ambition, increased self-esteem). Sensitive paranoids are no less characterized by insufficient ability for mental and affective discharge (impaired conductivity, according to E. Kretschmer), leading to stagnation of affect. These people are timid, shy, fearful and at the same time suspicious and irritable, prone to introspection, self-criticism and even self-torment. They are distinguished by a heightened sense of humiliating failure in relation to the standards (professional, everyday, etc.) that they have set for themselves. As E. Kretschmer (1930) writes, “the content of their mental life is characterized by complexes of shameful ethical insufficiency.” Their most significant property is deep and long-lasting sensitive reactions that arise in connection with certain ethical conflicts. These reactions were defined by E. Kretschmer as relational neurosis - a feeling of relating everything to oneself, based on internal complexes of insufficiency. Conflicts of conscience or feelings of inferiority, which have certain and typical starting points, lead to sensitive experiences. These can be not only the sexual complexes described by E. Kretschmer (for example, masturbation, carefully hidden and suppressed love of old maids), but also various... professional failures (delay in promotion, etc.), family grievances. During this period, the entire surrounding world seems to the sensitive paranoid to be colored by traces of that affect, which in reality only he is tormented by. He gets the impression that his shame should be made public, that everyone knows about his painful experiences.

Causes and etiology of the disease

The psychodynamic concept, as the cause of the development of paranoid personality disorder, speaks of disturbances in the upbringing of a child from early childhood. In the development of such a disease, an important role is played by relationships with relatives, who in childhood demand too much from their child, especially if the father does not take proper part in his upbringing and is cruel, and the mother overprotects the child, but at the same time rejects him.

As a result of excessive demands from parents, the child becomes unfriendly and does not trust the people around him, accumulates negative emotions (irritability, anger) and projects this onto weaker people.

There is also a theory that paranoia is transmitted genetically. Those who developed evolutionary psychology argue that paranoid psychopathy is characterized by a repeated pattern of not trusting people and an unfounded belief that they are always deceiving and harming.

Such people harbor a grudge in order to quickly and unexpectedly strike back, or begin to attack the perceived enemy in advance. This repetitive pattern of behavior is often characteristic of animals that are weaker in the hierarchy.

Aggression and wariness can be acquired in the process of adaptation to society when some kind of threat comes from other people. The division into “us and others” creates negative stereotypical thinking, which manifests itself in extreme forms in paranoid psychopaths.