The psychology of paranoia

Recent reports on the study of paranoid thinking have supported the view that suspiciousness and anxiety of harm from others are common experiences, with possibly up to a third of the population being regularly bothered by suspicious or paranoid thoughts.

Daniel Freeman, Jason Freeman, and Philippa Garety have written a self-help guide to “Overcoming Paranoid and Suspicious Thoughts”, published by Robinson (2006) . Considering how common these concerns are in the general population a self-help guide that addresses paranoia and suspiciousness per se, rather than talk about it just in the context of psychosis, seems a good idea.

It is a good read, describing a cognitive behavioural approach to understanding paranoid thinking and various ways of testing out suspicions to reduce their impact upon decision making and distress. Well-written for the general reader, the book also is useful for clinicians who want to discuss these concerns with clients, as it provides an example of describing paranoia and suspicion that is non-stigmatising and empathic in tone. Moreover the book’s contents represent the latest thinking in a cognitive behavioural approach to these concerns, with a number of exercises that can be used within therapy.

In the book the authors have detailed ways of coping with paranoid thoughts, which can be described in CBT terms as:

  • developing insight into the causes of suspicious thoughts (e.g., stress and major life changes, emotions, external and internal triggers, explanations for triggers, and reasoning);
  • becoming a detached observer of your fears;
  • practicing deliberately considering alternative explanations for suspicions and testing them out using behavioural experiments;
  • learning how to let go of suspicious thoughts when they come, and focus on what you are doing, not what you are thinking;
  • learning how to spend less time worrying about paranoid thoughts
  • deliberately thinking about positive aspects of your self

There is also a website, based upon the book, that is worth checking out.


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