This paper seeks to improve the understanding of paranoia in psychotic illness with a history of severe early childhood maltreatment. There has been speculation that in some cases the psychosis can be a manifestation of dissociation. In the case of paranoia it can be a specific aspect of a subcategory of dissociation known as derealization, where the individual relies on the ability to separate from the actual world replacing it with an imaginary less threatening world. Eventually, as the real world becomes more chronically threatening, the fantasy world (full of magical thinking) becomes more sinister and frightening. It is at this time that the individuals will often present for treatment. A case series that highlight this phenomenon will be present as well of a discussion of some of the literature that pertains to this topic. These patients could represent a subset of psychotic individuals who are currently given the diagnosis of schizophrenia.
Heather Hall– Attending Psychiatrist, Heather Hall MD LLC, Elk Grove, California
Heather Hall MD LLC
Elk Grove, California
Dr. Hall is a psychiatrist who sees adults and adolescents aged 14 and older. She specializes in working with patients from diverse backgrounds by developing an individual, personalized treatment plans. She completed her medical education at Hahnemann University (now Drexel University) in Philadelphia, PA, and her psychiatric residency training at the Institute of Pennsylvania Hospital. She is certified by the American Board of Neurology and Psychiatry.
Dr. Hall is an attending psychiatrist at TMS Health Solutions, where she treats audiences and adults. She specializes in both medication management and psychotherapy. Dr. Hall has additional expertise in working with patients who have a history of early childhood trauma.
As a former Associate Clinical Professor at the University of California in the school of medicine at both UCSF and UC Davis, Dr. Hall taught community psychiatry, cultural diversity, and competency to psychiatry residents and medical students. Her clinical duties involved medical leadership and treatment at the UC San Francisco Medical Center’s Cultural Focused Units and Turning Point Community Program.