T0 refers to the symptoms at the beginning of therapy, while T1 shows the symptoms after. SCL90-R is the list of symptoms that Saul was showing. RCI indicates the change in symptoms from the before (T0) and after (T1). As shown, he had a great decrease in his paranoid and hostile symptoms. 

Graph of Results of the Case of Saul

Saul has shown exceptional growth in his empathy and control over his fear of weakness. He was able to have therapy sessions to rebuild his relationships with his wife and daughter. He had control over his paranoid thoughts and hostility when presented with challenging situations.

Butler University

Saul is an older man who was irrationally believing that his wife and daughters were trying to take over his business and cut him out. He started thinking that his lawyers were even working against him and that he was the only one he could trust. He was finally convinced to go to therapy by his wife and he began Metacognitive Interpersonal Therapy for his Paranoid Personality Disorder. This therapy was over 24 sessions with the therapists over the course of 6 months. Saul showed heavy disapproval for the sessions at the beginning, claiming he is only there to gain intel on his "lying" family. At the end of the sessions, he showed great improvements in his paranoid thoughts.

Case Study of Paranoid Personality Disorder- The Case of Saul Overview

Cheli, S., Cavalletti, V., Popolo, R., Dimaggio, G. (2021). A case study on a severe paranoid personality disorder client treated with metacognitive interpersonal therapy. Journal of Clinical Psychology, 77 (8), 1807-1820. https://www.semanticscholar.org/paper/A-case-study-on-a-severe-paranoid-personality-with-Cheli-Cavalletti/6f228ff0604788598394b57e5281ee193ee5a698

Reference

Saul shares how he seeks approval from his parents. He wished to be approved by his father in the business realm and has felt as though he is weak now that his father has passed. He shares how his mother was often condescending and would pin him against someone else to belittle his achievements and worth. Because of these actions, he now has a mindset of "eat or be eaten" and works towards climbing the social ladder so that he can never be belittled by others around him. He viewed love as conditional and that people need to earn respect and trust. At the beginning of his sessions he often tried to test his therapist's trustworthiness and showed acts of aggression. 

The recalling of Saul's Life Events Using Metacognitive Interpersonal Therapy 

After analyzing life events that may cause him to have these aggressive and irrational thoughts, he was then instructed to practice breathing techniques for when he starts to feel angry. He shared how there was a direct effect of the breathing technique on the lowering of his heartbeat and also an indirect effect on his mind. The therapists also used imagery techniques that allowed them to revisit past episodes and analyze what may have caused the episodes to start and the level at which they were at. This imagery helped link the fear of betrayal with the fear of weakness. This weakness was derived from his life experiences of his mom constantly reaffirming his weakness as a child. Towards the second half of sessions, the patient was able to become self aware of the tendencies and what caused them. The last sessions was when the patient was able to learn how to strengthen relationships and grow apart from his past notions. 

Learn Before

Related

Learn After