Paranoid thinking is more common, and more normal, than most people realize. In fact paranoia is as common as the everyday worries and anxieties that most people experience. Some estimates suggest that at any one time up to 25 percent of the population is experiencing paranoid thinking. Unlike anxiety however, our society tends to frown upon open declarations of suspicion. This helps to mask the fact that most of us, at some points in our lives, will have a sense that someone is deliberately trying to upset, harm or irritate us. In fact these are some of the most common examples of paranoid thinking. They tend to be fleeting however and, for the most part, don’t cause undue distress.
The strongest form of suspicion is often referred to as the persecutory delusion. This tends to be associated with mental health problems. Persecutory delusions can take a whole variety of forms. For example, that food is being poisoned, money stolen, malicious rumors spread. Such examples highlight two of the central features of paranoid thinking. The first is that some form of harm is occurring or is about to and the second is that a persecutor is deliberately out to cause harm and distress.
People with more extreme forms of paranoid thinking tend to be more preoccupied with their delusions. When discussing their suspicions they typically use quite assertive and forthright phrases such as, ‘I know she’s out to get me’, or ‘he’s always causing trouble for me’. It’s no surprise perhaps that people who experience high levels of anxiety also tend to have more suspicious natures. Although this may appear an entirely negative situation, there is also a case for such characteristics to be considered adaptive. In times of potential danger or conflict, the increased vigilance and sensitivity of such individuals can act as a protective mechanism. Suspicions may make them less inclined to take risks and to avoid situations that appear potentially harmful.
Persecutory delusions are fixed false beliefs, so-called because even in the face of evidence to the contrary, they remain unshakable. Certain characteristics underpin such delusions. For example, the belief tends not to be shared by other people and seems to lack credibility. Persecutory delusions are nearly always self-referencing in the sense that an impending disaster or harmful situation is about to happen only to that person. The delusion itself becomes a major preoccupation and to the outside observer, is completely embedded with no attempt made to resist it.
Paranoia tends to occur within a context of emotional upset. Stressful events or life circumstances are known to trigger and help maintain paranoid thinking. As people begin to feel isolated they also feel more vulnerable and threatened. It is often the case that paranoia has at least some basis in reality. For example, being bullied, or living on the street and under constant threat of assault.
Paranoia can be treated. The process is broadly similar to that used for negative thinking that reinforces depression. The therapist offers alternatives to paranoid thoughts and in turn encourages the person to do likewise rather than automatically assuming every scenario is negative. Therapy is unlikely to stop the thoughts occurring but it may help to offer some insights into where they come from. Such insights are thought to help make thoughts less threatening and give the person some mastery over their environment.