Our sexual behavior expresses not only our psychosexual makeup but also the entirety of our personality. Sex is the one realm of conduct which involves the full gamut of emotions, cognitions, socialization, traits, heredity, and learned and acquired behaviors. By observing one's sexual predilections and acts, the trained psychotherapist and diagnostician can learn a lot about the patient.
Inevitably, the sexuality of patients with personality disorders is thwarted and stunted. In the Paranoid Personality Disorder, sex is depersonalized and the sexual partner is dehumanized. The paranoid is besieged by persecutory delusions and equates intimacy with life-threatening vulnerability, a "breach in the defenses" as it were. the paranoid uses sex to reassure himself that he is still in control and to quell is anxiety.
