Paranoia is the erroneous idea that people are targeting you for harm.We don’t talk about it nearly enough, but every day each of us must decide whether or not to trust other people. There’s no way around these decisions: they’re an inevitable part of life. Real threats do exist, so not to consider risks would be naive. The difficulty is that we seldom know what another person is actually thinking, least of all when we are the topic. It is easy to misread the intentions of others. But when we are overly suspicious, too mistrustful, then we are advancing along the paranoia spectrum.
It is increasingly being accepted that paranoid thoughts are much more widespread than previously thought
There are daily reminders that the modern world is dangerous: news bulletins, CCTV cameras, and public security announcements are just several of many constant reminders to be wary. But paranoia has always been with us. Francis Bacon, the Renaissance philosopher, captured the danger of tilting our worldview to the mistrustful: “Suspicions amongst thoughts are like bats amongst birds – they ever fly by twilight. Certainly they are to be repressed, or, at the least, well guarded. For they cloud the mind, they lose friends, and they check with business, whereby business cannot go on currently and constantly. They dispose kings to tyranny, husbands to jealousy, wise men to irresolution and melancholy.”
Excessive mistrust ends in the psychologically painful position of isolation; Graham Greene, in The Ministry of Fear, describes how, “it is impossible to go through life without trust: that is to be imprisoned in the worst cell of all, oneself.”
You’re not the only one
No one who is troubled by unfounded suspicions need feel ashamed or embarrassed: most of us, at some point in our lives, will experience them. (You can read vivid accounts here).
A major UK mental health survey in 2007 found that almost one in five respondents felt that people were against them. Some 8% of those questioned reported feeling as though people were deliberately trying to harm them or their interests. And 2% suspected that a group of people was plotting to cause them serious harm or injury. Self-report surveys cannot distinguish between mistrustful misinterpretations and actual experiences of hostility (or the substantial hazy ground between).
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So virtual reality was used to present members of the public with exactly the same computer simulations of social situations. The computer characters were programmed to behave neutrally, but, nonetheless, one in three people perceived hostility from the avatars. Those reporting paranoia about the avatars were also reporting such fears in daily life. The evidence is clear: many people have a few paranoid thoughts, and a few people have many paranoid thoughts.
Paranoia carries a confusing array of meanings. Hippocrates (born about the year 460BC) is credited with coining the word. He used the term – combining the Greek words for “beside” (para) and “mind” (nous) to create a word meaning “out of one’s mind” – to describe the delirious ramblings during a fever. In everyday conversation, paranoia is sometimes used to refer to any fear, including about a partner’s potential infidelity. Excessive jealousy is a form of mistrust but in psychiatry it is not labelled as paranoia. What is typically missing is the key element that the partner is deliberately trying to cause harm.
Why people get paranoid
Recent studies in the field have meant a transformation in the understanding of paranoia. It is clear that multiple, interacting causes are at work. Nature and nurture are equally important. Little is known about the individual genes linked to paranoia, but environmental risks have been identified. For example, paranoia is more likely to occur if others have actually been bad to you, and cannabis use can be one contributory factor for vulnerable individuals.
The psychological state of the individual in which paranoia thrives is well-established. Paranoia feeds on the feelings of vulnerability created by low self-esteem. A tendency to worry brings fearful but implausible ideas to mind. Poor sleep exacerbates anxious and fearful emotions, and a range of subtle perceptual disturbances are easily misinterpreted as signs of danger from the outside world. Reasoning biases such as jumping to conclusions, failing to consider alternative explanations, and focusing only on events that seem to confirm the paranoid thought, lock fears into place. The use of defensive countermeasures – such as avoiding feared situations – means that we don’t get to learn that things are actually OK.
Reducing paranoid thoughts
At the heart of paranoia is the mistaken idea of a current threat. To overcome it, we need to relearn that we are safe, that things are all right. For some people, it is enough to re-evaluate the initial fears, perhaps with feedback from trusted friends. The strongest learning comes from direct experience: going into the feared (but safe) situations to find out that nothing untoward occurs. Once we know that paranoia is a poor guide, it becomes easier to dismiss.
A sense of trust is more likely to take hold if the key psychological factors have been tackled; paranoid thoughts are, for example, much less likely when we are feeling self-confident, spending less time engaged in worrying, sleeping well, and are immersed in meaningful activity. Sometimes it is necessary to find ways to prevent past bad experience clouding the view of the present.
When paranoia is particularly severe – when we believe the fears strongly, are significantly distressed, and they impact on our lives – then professional help can be needed. Cognitive behavioural therapy (CBT) specifically tailored for paranoia can be helpful, while antipsychotic medication is typically prescribed for severe paranoia in the context of psychiatric diagnoses such as schizophrenia.
The questions to ask yourself
If you’re struggling to decide whether your suspicious thoughts are justified, you should ask yourself these 10 questions:
1. Would other people think my suspicions are realistic?
2. What would my best friend say?
3. Have I talked to others about my worries?
4. Is it possible that I have been oversensitive and exaggerated the threat?
5. Is there any indisputable evidence for my suspicions?
6. Are my worries based on ambiguous events?
7. Are my worries based on my feelings rather than indisputable evidence?
8. Is it very likely that I would be singled out above anyone else?
9. Is there any evidence that runs contrary to my suspicions?
10. Do my suspicions persist despite reassurance from others that they are unfounded?
The probability that your fears are unrealistic increases the more you feel that: no one else fully shares your suspicions; there is no indisputable evidence to support your worries; there is evidence against your suspicions; it is unlikely that you would be singled out; your fears persist despite reassurance from others; and your fears are based on feelings and ambiguous events.
It is increasingly being accepted that paranoid thoughts are much more widespread than previously thought. The stigma attached to them has begun to lessen. Encouragingly, we are beginning to not only Google paranoia but to talk about it. This openness is likely to help us to take a calm, measured, and judicious approach to balancing appropriately our levels of trust and mistrust.
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