‘Mass movements can rise and spread without belief in a God, but never without belief in a devil.’ Eric Hoffer
Paranoid personality disorder is one of a range of personality disorders classified in the Diagnostic and Statistical Manual of Disorders of the American Psychiatric Association. It is characterised by pathological suspicion and an obsessive need to eliminate enemies, both real and imaginary.
Pathological paranoia played a dominant role in the mindsets of those responsible for the worst atrocities of the twentieth century.
In our contemporary world, reeling from global financial crisis, turmoil in the Middle East, and Russian aggression in Ukraine, the world is reacquainting itself once again with this deadliest of mental disorders.
What is it?
Personality disorders are mental disorders that are characterized by long-lasting rigid patterns of thought and behaviour.
A person with paranoid personality disorder holds a fixed preconception that everyone is out to harm them. Holding this suspicion with absolute conviction, they will not be persuaded otherwise. Indeed, anyone who tries to reassure them will not only fail, but will immediately become an object of suspicion themselves.
Suspicion is a normal part of healthy human functioning. For those who suffer from paranoid personality disorder, however, thoughts of conspiracy and victimisation dominate their every waking moment. Since their paranoid delusions often have a partial basis in reality, those around them may be entirely unaware of just how severely distorted the paranoid person’s thinking processes are.
How to recognise it
Hostility and aggression are the most recognisable features of the paranoid personality.
The paranoid is highly strung, constantly on the defensive, and extremely sensitive to slight. To be around a paranoid person is to feel like you are constantly walking on eggshells, afraid of unwittingly doing something that will trigger their anger.
Since the paranoid operates on the assumption that everyone is out to get them, they constantly scrutinise the behaviour of those around them for ‘proof’ to confirm their suspicion. A whispered remark or a private joke among colleagues will be interpreted as aimed at and negative about the paranoid.
The disorder is self-fulfilling, as colleagues respond by retreating from the paranoid and, as the relationship deteriorates, become genuinely negative towards them.
Paranoid personality disorder has a destructive impact on the paranoid person in terms of their state of mind and on their ability to form and maintain nurturing relationships. Paranoids also has a destructive influence on those around them as their relentless suspicion takes its toll.
The real destructive power of the paranoid, however, occurs in the context of politics whenever a paranoid personality achieves a position of power. Their enormous destructiveness in such situations arises from the fact that paranoids do not have rivals to be negotiated with; they have enemies who must be destroyed.
Examples of paranoid political leaders
Paranoid personality disorder has played a central role in the worst atrocities in human history. Hitler, Stalin, Mao and Pol Pot all exhibited the characteristics of paranoid personality disorder, and used paranoia as a central organising theme in their respective political projects.
For all of these paranoid leaders the destruction of an enemy was central to their political vision. For the communist leaders – Stalin, Mao and Pol Pot – the enemy to be annihilated was anyone who opposed the communist revolution. For Hitler, the enemies to be destroyed were both the nations that opposed his plans for conquest and the racial enemies – Jews, homosexuals, Gypsies, and the physically and mentally ill – who were ‘polluting’ the purity of the human race.
All of these leaders carried out brutal programmes of ‘cleansing’ aimed at eradicating the enemy – Hitler’s holocaust; Stalin’s purges and his unceasing campaigns of ethnic cleansing; Mao’s crusades to eradicate class enemies during the Great Leap Forward and the Cultural Revolution; and Pol Pot’s murderous attempts to cleanse Cambodian society of the vestiges of modernity after Year Zero.
In all of these cases, and many more, the psychology of a leader with paranoid personality disorder coincided with a culture receptive to the paranoid’s siren call to create a brighter future by eradicating the enemies of progress. This deadly formula resulted time after time in the deaths of millions of innocents.
But were these leaders really paranoid?
In its early stages, political paranoia is difficult to pin down. This is because, as Robert Robins and Jerrold Post describe in their book ‘Political Paranoia’, it begins as a distortion of an appropriate political response, which then goes too far.
As Robins and Post argue, it wasn’t delusional for Stalin to be thinking that other nations were plotting against the Soviet revolution, or to be alert to the possibility that subordinates were plotting to undermine him. But Stalin’s paranoid response to these reasonable suspicions was to orchestrate purges that claimed the lives of between 24 and 40 million citizens of the Soviet Union. 
The difficulties in diagnosing individual leaders as paranoid are the same as the difficulties in diagnosing the paranoid personality in the workplace or the home.
To begin with, science has only recently begun to diagnose and characterise personality disorders. Until now the basic scientific knowledge that humanity is divided into a majority with normal psychological functioning, and a minority whose psychological disorders make them a threat to peace and reason has simply not been available. This ignorance of the fundamental diversity of human psychologies has, until now, left us unable to diagnose the primary origin of human evil.
A second factor is that, even when armed with this knowledge, recognising people with personality disorders can be extremely difficult. It is deeply engrained within us to assume that everyone around us who looks normal is just like us – emotionally, cognitively and otherwise. When faced with paranoid behaviour, most normal people tend to search for rational explanations and interpret such behaviour in terms of common sense. Unless you are in close contact with someone with paranoid personality disorder for a long enough period of time to recognise the rigidity and extreme nature of their personality, their behaviour may easily be dismissed as simply ‘difficult’.
A final, disturbing reason why paranoid individuals often go unrecognised is that people with paranoid personality disorders can often appeal to psychologically normal people. The absolute certainty of paranoid individuals, and their easy solution of blaming an unpopular ‘enemy’, can resonate with many at times of political or economic uncertainty.
The fatal attraction of the paranoid personality means that, tragically, we often willingly place power in their hands.
 Political Paranoia: The Psychopolitics of Hatred, Robert S. Robins and Jerrold M. Post, Yale University Press, 1997, page 24