Abstract
The paper is a report that is devoted to the case of Pablo Escobar who was one of the most famous criminals and drug dealers of the twentieth century. In this report, I analyze his personality and lifestyle and find out that there are certain symptoms of paranoid personality disorder manifested in his behavior. Then, I present the most important information related to this condition including the primary signs that indicate it, possible reasons why it occurs, and typical behavior demonstrated by individuals suffering from this disorder. Also, I focus on certain research gaps that exist in the field. In the end, I review two methods that can be applied in order to manage this disorder, evaluate their effectiveness, and make an assumption concerning measures that could help the discussed patient.
Character
The person I would like to discuss is Pablo Escobar who has become famous because of his crimes. He is known as one of the richest drug dealers in the world and one of the most violent criminals from Columbia who lived in the twentieth century. His cruelty is difficult to be overestimated; apart from being one of the most famous drug lords in the world, he was involved in hundreds of murders that he or his helpers committed. The following facts related to his life will help to better understand the symptoms demonstrated by the person.
There is little information on the childhood of this person; it is known that Escobar was born in a multi-child family. Also, it cannot be stated that his conduct at school was abnormal or strange. As an adolescent, he was spending a lot of time in the street with his friends. What is more, it is known that he smoked weed; nevertheless, there is no information that teachers and other adults had problems with him during that period.
This person was born in Colombia in the middle of the twentieth century. At the beginning of the 1970s, Escobar and his criminal gang took famous industrialists as a hostage. Despite the fact that he was really dangerous, Escobar became a kind of hero for his countrymen; just like one famous English character, he robbed rich people and used the money in order to build houses for those living in need. Therefore, people from his hometown respected him even though his activity could pose a threat to their lives as well.
When he was only 21 years old, Escobar had already been regarded as the most famous criminal in Medellin, and the number of people who supported him and wanted to become a part of his criminal gang was constantly increasing. He made attempts to become a politician at the beginning of the 1980s; although people knew that he was related to illicit trafficking in drugs, he managed to become a congressman. The government of the United States was very worried about illegal trafficking, and its representatives proposed an agreement requiring the Columbian government to deliver Columbian drug kingpins and allow American authorities to punish them. Trying to react to these new measures and protect his criminal business, Escobar created the terrorist group whose members were killing a lot of policemen and government servants. During the next few years, Escobar committed a lot of organized crimes and terrorist attacks that claimed the lives of many common people as well. A few members of his gang together with Escobar were extirpated in Columbia in the middle of the 1990s.
As it is clear from the biographical information discussed, there are a few symptoms displayed by the patient that is the most important. To begin with, he started demonstrating aggressive behavior when he was a young adult. Unfortunately, there is a lack of information on his behavior as a child, and this is why it becomes more difficult to make a diagnosis. What is more, it is obvious that his aggressiveness was a kind of defense mechanism helping him to withstand the dangers of the cold reality. Also, it is known that the patient smoked weed for his entire life, and it may also help us to determine the reasons for his behavior. At the same time, I suppose that it is extremely important to understand that it is difficult to suppose that this patient was mentally incompetent; insane criminals are usually unable to conduct their illegal business for such a long time. Therefore, I suppose that the most important information related to this person that may be used for further analysis is connected to the patient’s inclination to aggression, constant use of drugs, suspiciousness, and a thirst for power. The case of the patient whose life is discussed in the paper becomes even more difficult considering that there is no exact information related to Escobar’s mental health and medical advice that he received during his life. What is more, I strongly believe that it is necessary to note that he had a wife and two children, and the way that he behaved being with his family was really different from the conduct demonstrated by him in his criminal “work”.
I suppose that I could be asked to work with this patient due to many reasons. To begin with, his aggressive behavior and willingness to take the upper hand using all the possible means including robbery, intimidation, kidnapping, and tortures could be regarded as the primary concern. Also, I suppose that his drug addiction could become an additional reason why specialists could be asked to work with him.
As for the reasons why this very patient could ask me to work with him, I suppose that the primary reason that can encourage such people to seek for psychological assistance is related to their willingness to change their lives, sort out their feelings, and eliminate the cause that makes them commit crimes. Speaking about this particular case of Pablo Escobar, I suppose that he could ask me to provide him with the help due to his desire to conquer his weaker self and start living like a common man although the latter remains almost impossible because such crimes cannot be forgiven.
Making a Diagnosis
Speaking about my work with the discussed patient, it is necessary, to begin with, diagnostic criteria that I was using in order to understand the situation better. Having analyzed the information concerning life and conduct of the given patient, I decided that the behavior demonstrated by him could be caused by such mental disorder as paranoid personality disorder. According to DSM-5 that remains one of the most credible sources providing information on mental disorders and specific signs that characterize them, paranoid personality disorder is a condition that occurs in early adulthood and makes it quite difficult for the person to communicate with other members of the community (American Psychiatric Association, 2013). As it is indicated by the authors of the discussed source, there are a few criteria that are used in order to make such diagnosis. To begin with, paranoid personality disorder makes people very suspicious; it may sometimes happen that their concerns are related to certain facts that exist in reality. Nevertheless, such people also tend to beware of the things that do not exist. Also, ones with this disorder are likely to interpret certain actions of people they are connected with as threats. What is more, such people tend to overestimate their importance and this criterion is manifested in the fact that they take everything that is said by other people personally. To continue, making a diagnosis, it is extremely important to pay attention to the fact that patients suffering from this mental disorder remain too sensitive to failures and denial expressed by other people.
There are many reasons why I believe that the behavior of the discussed person meets certain criteria for such condition as paranoid personality disorder. To begin with, I would like to mention that there have been many cases when Escobar committed murders with the help of his partners in crime. In fact, his activity required him to think a lot about the possible risks and threats, and this is why he believed it to be necessary to kill some people related to illegal business whose actions and behavior seemed strange to him. Also, Escobar was believed to be very suspicious and many people from his criminal network were killed due to his concerns and desire to eliminate a threat to his family. Apart from that, I suppose that the aggressive behavior of the patient was closely interconnected with his suspiciousness. To some extent, his crimes (especially murders) could be caused not only by his willingness to get more money but also by his feeling of uncertainty and his desire to protect himself from dangers by means of expanding his influence and intimidating other people. To me, it seems that his aggressive behavior was a kind of defence reaction caused by the fact that he saw threats everywhere and wanted to estrange them and protect himself in advance.
Disorder Etiology
Paranoid personality disorder is a condition included in DSM that is strictly connected with such symptoms as suspiciousness, prevalence of paranoid delusion, and distrust of other people (Triebwasser, Chemerinski, Roussos, & Siever, 2013, p.795). As it is clear from the facts reported by modern researchers, people suffering from paranoid personality disorder are likely to be too sensitive, swift to take offense, they tend to suppose that the world is quite a dangerous place full of threats to their health and life. Another important fact that needs to be considered when it comes to etiology of the disorder is that the ways that it is manifested in people’s behavior may be different; according to Iacovino, Jackson, and Oltmanns (2014), these differences are connected with the range of factors including unchangeable ones such as ethnicity.
To continue, there is the evidence that cases of paranoid personality disorder occur more often in Black individuals and in ones having problems with substance abuse (Raza, DeMarce, Lash, & Parker, 2014). As for the theories that are typically used in order to understand the reason of the disorder, there are different interpretations of such condition. According to ones who specialize in psychoanalytic therapy, this disorder tends to occur in people who fail to accept their negative features of character; trying to deny the fact that they may mean ill to somebody and be aggressive, such people project their weaknesses on others and this is why they start seeing assumed underlying motives in behavior of their friends and relatives. What is more, there is the suggestion that this disorder is genetic. Anyway, it is impossible to say that causes of this disorder are highly researched. Another research gap is related to the fact that there is no clear data on average number of people affected by this disorder. There is another reason that allows us to state that there is a lack of research on the topic; it is not known whether this disorder occurs more often in men than in women as the results of different studies contradict to each other (Silberschmidt, Lee, Zanarini, & Schulz, 2015). Speaking about the most common symptoms manifested in people suffering from this mental disorder, it is necessary to mention jealousy, inability to accept criticism, self-absorption, and propensity towards conflicts. Also, it is important to notice that the degree of manifestation of these symptoms varies because of comorbid conditions that patients have.
Evidence-Based Treatment
There are a few methods that can be used in order to treat people suffering from paranoid personality disorder. To begin with, it is possible to manage this disorder with the help of cognitive analytic therapy. The research article written by Kellett and Hardy (2014) presents the results of treatment with the use of this method. According to the discussed research, this method was able to remove the majority of the symptoms manifested in patients’ behavior. As for the particular measures that the use of this method involves, there are three major phases of treatment. During the first one, patients are supposed to deliver reports related to their mental condition, their fears, and important thoughts. Furthermore, in the beginning of the treatment, patients are required to reconsider themselves and keep track of unwanted symptoms manifested in their behavior. After that, psychotherapist starts working with the patient and the latter is supposed to have a look at the variety of reasons and mistakes that can prevent him or her from achieving the success. What is more, the specialist helps the patient to understand which factors make it more difficult to get rid of these symptoms and what can be done in order to mitigate the influence of these factors. In general, such method is quite complex and it cannot help the patient if the latter demonstrates certain unwillingness to change his or her behavior or tries to pretend that where is nothing wrong when a person behaves like that. As it is clear from the study mentioned, cognitive analytic therapy can be regarded as quite effective because it helps patients to understand the problem better and look at it from the outside.
Another method that can be used in order to help individuals suffering from such disorder is dynamic psychotherapy that involves a lot of particular measures allowing patients to understand their motivation better (Abbass, Town, & Driessen, 2013). When working with people using this method, specialists are required to focus their attention on personalities and previous experience of patients. Among other things, it is very important to track the process of development of the personality and put emphasis on certain periods and factors that caused changes. Therefore, it is necessary for specialists and their patients to hold meetings on a regular basis as constant work can really help patients to understand the primary reason why the disorder appeared. Nowadays, there are different opinions on this very method; some people tend to underestimate the degree of its applicability due to the lack of skilled psychotherapists. Despite the possible risks, this approach can really help patients to get to the bottom of their problems and this is why it is widely used in many countries.
Personally, I suppose that the first method would be more effective for the patient because it would be necessary to encourage him to conduct a thorough self-analysis that could help him to understand his mistakes. Furthermore, this method is used more often in order to treat patients with paranoid personality disorder, and this is why it can be regarded as more effective. As for the aspects that would specifically be targeted during treatment, I suppose that it would be necessary to focus on aggressive behavior demonstrated by the patient and encourage him to reduce it. Another important point is related to medications that can be taken by such patients in order to mitigate the negative influence of the disorder. As for the discussed client, I suppose that medications reducing anxiety would be really helpful because they would help him to calm down and be more objective while conducting self-analysis.
References
Abbass, A., Town, J. M., & Driessen, E. (2013). Intensive short-term dynamic psychotherapy: A treatment overview and empirical basis. Research in Psychotherapy: Psychopathology, Process and Outcome, 16(1), 6-15.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington, VA: American Psychiatric Pub.
Iacovino, J. M., Jackson, J. J., & Oltmanns, T. F. (2014). The relative impact of socioeconomic status and childhood trauma on Black-White differences in paranoid personality disorder symptoms. Journal of Abnormal Psychology, 123(1), 225.
Kellett, S., & Hardy, G. (2014). Treatment of paranoid personality disorder with cognitive analytic therapy: A mixed methods single case experimental design. Clinical Psychology & Psychotherapy, 21(5), 452-464.
Raza, G. T., DeMarce, J. M., Lash, S. J., & Parker, J. D. (2014). Paranoid personality disorder in the United States: The role of race, illicit drug use, and income. Journal of Ethnicity in Substance Abuse, 13(3), 247-257.
Silberschmidt, A., Lee, S., Zanarini, M., & Schulz, S. C. (2015). Gender differences in borderline personality disorder: Results from a multinational, clinical trial sample. Journal of Personality Disorders, 29(6), 828-838.
Triebwasser, J., Chemerinski, E., Roussos, P., & Siever, L. J. (2013). Paranoid personality disorder. Journal of Personality Disorders, 27(6), 795-805.