The inherent difficulty in working with clients with paranoid personality disorder (PPD) is that these individuals are incapable of truly trusting anyone. People with PPD are most frequently involved in litigation.
The individual with PPD has a basic mistrust of others that manifests itself in four or more of the following ways:
- Expectation, without sufficient basis, that others are deceiving or taking advantage of him or her;
- Preoccupation with doubts as to the loyalty or trustworthiness of friends and associates without sufficient basis;
- Reluctance to confide in others because of possible harm to self;
- Finding negative messages in benign remarks or events;
- Bearing grudges;
- Perceiving personal attacks on his or her reputation that are not apparent; and
- Suspecting infidelity without justification.
The strategy for working with the PPD client is to stick with the facts of the case scrupulously. Do not attempt to argue or reason with this client. Debating is futile. Merely recite the facts and the law as applied to them. Document all of your activities in the case, particularly your billing.
Describe in fine detail your proposed actions and the various options available to the client. His or her course of action may not be what you would consider prudent or reasonable. Once again, it would be fruitless to attempt to sway his or her decision. You can either accommodate to their requests or resign. In addition, this individual has a tendency to “cry wolf” so that his or her claims are suspect as to their validity. You are not there to judge, but to represent. Everyone deserves his or her day in court.
The individual with PPD is to be distinguished from the individual with paranoid schizophrenia, who is truly out of touch with reality. The individual with PPD is relatively shrewd and knows most of the angles. He or she will be cheated if not meticulous in the awareness of procedures. You must be patient and thorough in your explanation. Since you probably charge by the hour, this should not be a hindrance. Understand that the person is not stupid. He or she wants to be thorough. Indeed, most individuals with PPD are of above-average intelligence.
Individuals with PPD are never appreciative of your work, so do not expect compliments. All transactions are strictly business. Reimbursement should be your sole expectation. In many instances you can become another target of this individual’s mistrust. Be careful about having this client pre-sign on all of your actions. Never defend your actions. This will be taken as a sign of disingenuousness and only make the situation worse. Take an “it is what it is” attitude and go about your work in a professional manner.
Many professionals refuse to work with individuals with PPD. Others enjoy the challenge. In either case, it is essential that you know what you’re working with. One mistake can mean a board complaint.
Study the symptoms of PPD and adjust your practice accordingly. If he or she is demanding, listen and adjust to the demands. If you cannot, calmly say so. If he or she becomes accusatory, do not be insulted. Merely cite the facts, and therefore the truth.