Personality Couch

Ep 30: Paranoid Personality | The 6 Subtypes Explained

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) continue our discussion about paranoid personality disorder, exploring its three severity levels: Mild, Borderline, and Paraphrenic. We unpack the six subtypes of paranoid personalities as outlined by Dr. Theodore Millon: The Self-Righteous Mistrustful, The Obdurate Mistrustful, the Querulous Paranoid, the Insular Paranoid, the severe Fanatic Paraphrenic, and Malignant Paraphrenic. We highlight the fragility of Paranoids at all levels of severity, noting they can easily deteriorate with stressors and setbacks. We emphasize the importance of understanding these very common personality dynamics in all settings, especially with increasing paranoia in the post-pandemic world.
Are you a clinician stuck on a case? To schedule a consultation, please visit the practice website, which will guide you to the email address to use. www.questpsych.org
Chapters00:00 Introduction to Paranoid Personality Disorder03:44 Paranoid Personality Disorder Symptoms06:03 Historical Examples    06:09 Timothy McVeigh - Oklahoma City Bombings    06:36 Richard Farley - Erotomania07:52 Explaining the 3 Severity Levels09:30 Mild Paranoid Personalities: Mistrustful Types10:16 Self-Righteous Subtype14:28 Obdurate Subtype17:14 Moderate Paranoid Personalities: Disorder Level    17:44 Querulous Subtype    21:32 Insular Subtype23:52 Severe Paranoid Personalities: Paraphrenic Level    25:44 Fanatic Subtype    30:57 Malignant Subtype36:12 Summary & Conclusion

Ep 29: Paranoid Personality or BPD? | The Unstable Duo

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) help differentiate between paranoid and borderline personality disorders. We explore the similarities and differences between these two disorders, discussing their core characteristics, emotional responses, symptoms, and how our own intuition helps us more than we realize. We specifically look at the instability unique to these two personality disorders and how both express anger, shame, and fear. As both disorders can have fleeting episodes of psychosis, we also discuss how delusions can show up in each, but how their triggers are vastly different. We further discuss our own personal experiences treating both disorders and ways we use our intuition to guide diagnosis. We end by highlighting the need for empathy in treatment and welcome other providers to reference this information or to contact us directly if in need of a consultation.
To schedule a consultation, please visit the practice website for more information! www.questpsych.org
Chapters00:00 Intro to Paranoid vs Borderline Personality Disorders01:59 What is an Unstable Personality Structure?03:34 Borderline Personality Symptoms Explained06:50 Paranoid Personality Symptoms Explained08:30 Comparing and Contrasting BPD and Paranoid PD    08:32 Anger    11:40 Shame    13:03 Fear    14:15 Paranoia & Psychotic Episodes    15:54 Fluidity vs. Rigidity17:21 Using Intuition with Paranoid and Borderline Personalities    17:35 Dramatic Narratives    19:44 Dependent and Avoidant Attachment Dynamics    23:35 Countertransference    25:20 How they Present to Treatment    26:31 Suicidality & Trauma28:47 Summary, Learning, and Conclusion

Ep 28: The Post Pandemic Narcissist | Unmasking Paranoid Personality

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) reveal the complex, dangerous, and often misdiagnosed Paranoid Personality Disorder (PPD). We discuss the rising prevalence of PPD in the post-pandemic world, the clinical challenges in identifying and treating these individuals, and the critical differences between Paranoid Personalities and narcissism. We believe you’re seeing more of these types in your circles as well, and we want you to be equipped with knowledge so you can best protect yourself! Thus, we unpack not only the DSM-5-TR characteristics of Paranoid Personality Disorder, but we also reveal our clinical experience with these types. We include common themes such as: lack of trust, severe gastrointestinal issues, sadomasochism, medical self-sabotage, shedding identities, and the paranoid character’s unique relationship with aggression towards the same-sex. We reveal why we think this type is popping up even more in our circles, what the pandemic had to do with it, and how you can identify these types to keep yourself safe!  
Chapters00:00 Intro & Dangers of the Paranoid Personality04:10 Clinical Observations & Post-Pandemic Trends08:20 Defining Paranoid Personality Disorder16:35 Warning Signs of PPD Beyond the DSM27:00 Comparing Paranoid Personality and Narcissism29:25 Why the Post-Pandemic Narcissist?

Ep 27: What's Worse Than a Narcissist? | The Baddest of Them All

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unveil the darkest aspects of personality, focusing on narcissism at its most severe forms. We explore the spectrum of personality types that range from mildly unpleasant to dangerously malignant, discussing examples and case studies that illustrate their risk in relationships. We specifically unpack narcissistic and paranoid personality disorders, malignant narcissism, antisocial personality disorder, psychopathy and sociopathy, and sadistic personalities. While further exploring the characteristics, overlaps, and distinctions among these disorders, we end with a discussion about terrorism and extreme manifestations of sadism.
Chapters01:02 Stone’s Spectrum of Darkness01:23 Level 1: Negative Traits04:35 Level 2: Narcissistic & Paranoid Personality Disorders07:23 Paranoid Personality Disorder10:48 Level 3: Malignant Narcissism13:47 Level 4: Antisocial Personality Disorder15:08 Antisocial vs Narcissistic Personality Disorder17:24 Antisocial Personality vs Psychopath18:38 Level 5: Psychopathy21:27 Level 6: Sadistic Personalities28:54 Summary & Closing

Ep 26: Malignant Narcissists in Politics | Their Rise and Fall to Power

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the dangerous dynamics of malignant narcissism in political leadership. We first explore how these leaders rise to power, the psychological factors that enable their ascent, and the societal conditions that make populations susceptible to their charm. We introduce the narcoticizing and honeymoon phases of their reign where the malignant charmer woos their adoring audience. We then explore the characteristics that define malignant narcissist leaders, including how they navigate crises, the corruptibility of their conscience, and their devolution into psychotic thought processes. Further expounding on the dangers of their paranoia and their need for enemies, we share how no one escapes unscathed from these types in leadership. Our discussion concludes with reflections about the aftermath of the malignant narcissist’s reign, and the recovery and healing process from the trauma they inflict.
Chapters00:00 Intro to Malignant Narcissism in Leadership02:56 Factors Enabling their Rise to Power06:51 The Appeal of the Authoritarian Leader08:46 The Narcoticizing Phase11:13 The Honeymoon Phase13:56 Characteristics of Malignant Narcissist Leaders   17:24 Decision Making and Crises   20:30 Corruptible Conscience   21:08 Paranoia and Psychosis in Power   24:20 The Need for Enemies27:04 Life Cycle and End of their Reign33:21 Rising from the Ashes of Narcissism

Ep 25: The Malignant Narcissist's Mind | Stairway to Evil

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) delve into the complex and dark characteristics of malignant narcissism, exploring its origins, characteristics, and using examples from popular culture, particularly the film 'American Psycho'. Citing Eric Fromm’s original work on defining evil, we discuss his triad of: necrophilious orientation, incestuous symbiosis, and malignant narcissism. Using connections to historical figures and Alfred Hitchcock's ‘Psycho,’ we briefly explore what this triad looks like. After drawing on research across the decades to define characteristics of malignant narcissism, we further discuss the spectrum of antisocial behavior, aggression, sadism, and paranoia prominent in these types. While discussing how malignant narcissists operate in personal relationships and positions of power, we end by exploring the overlap of malignant narcissism and psychopathy.
Chapters00:41 History of Malignant Narcissism's Path to Evil01:16 Fromm's Triad of Evil Overview03:35 Alfred Hitchcock's Psycho Example06:23 Early Research on Malignant Narcissism09:24 The 4 Characteristics of Malignant Narcissism09:43 Symptom 1: Narcissistic Core12:36 Symptom 2: Antisocial Behavior14:27 Malignant Narcissism vs Antisocial Personality Disorder16:25 Symptom 3: Sadism or Aggression21:58 Malignant Narcissism in Relationships23:01 Symptom 4: Paranoia and Verge of Psychosis25:02 Malignant Narcissism vs. Psychopathy26:41 Where We Find Them and Why We Follow Them

Ep 24: The Communal Narcissist's Altruistic Illusion

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the tricky topic of communal narcissism, exploring its characteristics, behaviors, and the environments in which these individuals thrive. We discuss the distinction between agentic and communal traits, the illusion of selflessness, and how communal narcissists often deceive themselves and others. We further highlight the presence of communal narcissism in charities, social media, and religious organizations. By examining the darker aspects of this personality type, we discuss insights about collective narcissism and the potential for harmful group dynamics. The episode concludes with insights on recognizing communal narcissism in relationships and its correlation with wealth and power.
Chapters00:00 Intro & History of Communal Narcissism03:40 What is Communal Narcissism?05:39 Where Communal Narcissists Show Up09:22 Social Media in Communal Narcissism12:15 Communal Narcissism in Religious Settings13:36 Cults and Collective Narcissism18:31 Communal Narcissism in Politics19:42 Recognizing the Signs of Communal Narcissism23:17 Communal Narcissism in Relationships26:37 Summary and Key Takeaways

Ep 23: The 4 Narcissistic Subtypes You Need to Know

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the complex world of narcissism, focusing on its various subtypes. We unpack grandiose narcissism, its characteristics, as well as fun names in history. Our conversation transitions to communal narcissism, highlighting its deceptive nature and how it can manifest in social settings and religious communities. Next, we examine malignant narcissism, the most severe form, characterized by antisocial, paranoid, and sadistic traits. Lastly, we uncover vulnerable narcissism and the tricky, inside-out way they show up in relationships. The episode concludes with a comparative analysis of danger in these narcissistic subtypes, urging listeners and viewers to beware!
Chapters00:00 Introduction to Grandiose Narcissism12:00 Understanding Communal Narcissism22:04 The Complexities of Malignant Narcissism32:18 Exploring Vulnerable Narcissism40:32 Most Dangerous Subtypes Ranked

Ep 22: Vulnerable and Grandiose Narcissism | The Mirror Has Two Faces

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) delve into the complexities of pathological narcissism, exploring its various expressions, including covert, overt, grandiose, and vulnerable narcissism. We discuss how these themes of overt and covert narcissism appear in all narcissistic individuals, as do grandiose and vulnerable themes. We articulate how covert narcissism is under the surface in thoughts and fantasies, whereas overt narcissism is behavioral. We also highlight the shiny, extroverted themes of grandiose narcissism, while discussing the underlying emotional issues associated with vulnerable narcissism, including shame, anger, and moodiness. We overall emphasize the overlap between grandiose and vulnerable narcissism, detailing that both can coexist within a single individual, leading to a range of ways pathological narcissism can present.
Chapters00:00 Introduction to Pathological Narcissism03:26 Distinguishing Between Covert and Overt Narcissism09:39 Exploring Grandiose and Vulnerable Narcissistic Themes12:37 The Psyche of Grandiose Narcissism19:54 The Psyche of Vulnerable Narcissism30:10 Similarities Between Grandiose and Vulnerable Narcissism33:19 Summary and Closing
References
Akhtar, S. (2000). The shy narcissist. In J. Sandler, R. Michels, & P. Fonagy (Eds.), Changing ideas in a changing world: The revolution in psychoanalysis: Essays in honour of Arnold Cooper, (pp. 111-119).
Blaney, P. H., Krueger, R. F., Millon, T. (Eds.). (2014). Oxford textbook of psychopathology (3rd ed.). Oxford University Press.
Kernberg, O. F. (2009). Narcissistic personality disorders: Part 1[Editorial]. Psychiatric Annals, 39(3), 105–107, 110, 164–166.
Horowitz, M. (2009). Clinical phenomenology of narcissistic pathology. Psychiatric Annals, 39(3), 124–128.
Pincus, A. L., & Roche, M. J. (2011). Narcissistic grandiosity and narcissistic vulnerability. In W. K. Campbell & J. D. Miller (Eds.), The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments (pp. 31–40). John Wiley & Sons.
Wink, P. (1991). Two faces of narcissism. Journal of Personality and Social Psychology, 61(4), 590–597 Personality Couch Links Website https://www.personalitycouch.com/ Blog https://www.personalitycouch.com/blog/ Instagram https://www.instagram.com/personalitycouch/ Facebook https://www.facebook.com/personalitycouch #mentalhealthpodcast #mentalhealthprofessionals #mentalhealth #narcissisticpersonality #narcissism #narcissist #narcissitic #personalitydisorder #personality #personalitypsychology #narcissisticabuse #narcissismawareness #bpd #borderline #borderlinepersonalitydisorder #borderlinepersonality #toxicrelationships #vulnerablenarcissism #grandiose #covertnarcissist #overtnarcissist

Ep 21: Narcissistic Personality Disorder | The 9 Symptoms

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) delve into the complexities of narcissism and narcissistic personality disorder (NPD). We explore the historical origins of narcissism, the DSM criteria for diagnosing NPD, and the key characteristics of individuals with this disorder, including a lack of empathy and pervasive envy. Our conversation highlights the roots, characteristics, and the dual nature of narcissism, as well as the challenges in researching NPD. We highlight characteristics such as grandiose self-importance, the need for excessive admiration, and the interpersonal exploitation that can occur in relationships. We also give a preview on the vulnerable aspects of narcissism, highlighting how it can manifest as low self-esteem and social withdrawal, a topic that will be discussed in an upcoming episode!
Chapters00:00 Intro to Narcissistic Personality Disorder01:07 Historical Context of Narcissism06:02 Defining Narcissistic Personality Disorder09:32 First Symptom: Lack of Empathy     10:52 NPD vs Autism14:24 Second Symptom: Envy15:46 Third Symptom: Fantasies of Success, Power, Beauty16:33 Fourth Symptom: Grandiosity17:55 Fifth Symptom: The Need for Specialness20:54 Sixth Symptom: Excessive Admiration22:22 Seventh Symptom: Entitlement24:17 Eighth Symptom: Exploitation in Relationships26:25 Ninth Symptom: Arrogance and Haughty Attitudes27:37 Vulnerable Narcissism
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). https://doi.org/10.1176/appi.books.9780890425787 Blaney, P. H., Krueger, R. F., Millon, T. (Eds.). (2014). Oxford textbook of psychopathology (3rd ed.). Oxford University Press.
Blashfield, R. K., & Intoccia, V. (2000). Growth of literature on the topic of personality disorders. American Journal of Psychiatry, 157(3), 472-473.
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc.
South, S. C., Eaton, N. R., & Krueger, R. F. (2011). Narcissism in official psychiatric classification systems: Toward DSM-5. In Campbell, W. K. & Miller, J. D. (Eds.), The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments (pp. 22-30). John Wiley & Sons, Inc.. https://doi.org/10.1002/9781118093108.ch3