Coping techniques: Paranoid ideation

Please note that you should always consult with your physician before making any changes in your diet, your level of exercise and activity, medication or behaviors related to substance use.

The best way to make use of these techniques is to read through them, select three that stand out to you and practice them. I would be glad to hear from you on your responses.

  1. Paranoia, or a conviction that some individual or group is intending us harm, is a common phenomenon. In mild cases we might believe that someone in the environment is doing something to annoy us. For instance, a neighbor doesn’t quiet his dog from barking, and we think this is his way of being deliberately discourteous to us. Moderate levels of paranoia are characterized by more personalized beliefs, such as the thought that my cell phone activities are being monitored by someone. At severe levels paranoia might include the sense that there’s a widespread organized focus on me, which might include some government agency.  What characterizes paranoid ideation at all levels are the ideas that someone wants to do us some kind of harm, and, that we are important enough to warrant this kind of personal attention.
  2. Develop relaxation skills to practice in the presence of suspicious or fearful thoughts.
  3. Keep a journal. This can serve several purposes. It can be a way to track triggers for such thoughts so that you can increase your awareness of what stresses you. For instance, do you have suspicious thoughts when you have to go out into the public, or when you watch the news on television? Knowing where you are most likely to be triggered will support you in decreasing suspicious thinking. A journal can also help you notice the development of paranoid thinking. This can promote some detachment from the thought process, and an interest in it as a phenomenon.
  4. One possible pattern might be when you don’t get enough sleep. Sleep can be improved with sleep hygiene practices, such as limiting exposure to bright lights in the hour before bedtime (bright lights include computers and smart phones, which provide stimulation and a message to the brain that it’s daytime). For other sleep hygiene practices, please refer to the Coping Techniques: Sleep Disturbance page of this site.
  5. Another possible pattern might be the use of alcohol or drugs, both of which are associated to changes in thought patterns. Consider decreasing your use of them so that you can better determine the impact they might be having on your thought process. As with any change in levels of substance use, first consult with your doctor.
  6. Another pattern might be your exposure to certain triggers, such as entering a crowded environment or engaging with a particular person. If this is the case consider limiting your exposure to triggers. For instance, go grocery shopping at a smaller market during off hours rather than to a mall, or spend less time with people with whom you feel uncomfortable and more time with people you enjoy.
  7. Assess the content of your thoughts. First, note what you’re thinking about the situation. It can be useful to write this down. Write down, in a step-by-step format, what happened that led you to that conclusion. Observe how the thought developed in response to events and to your interpretation and conclusions about them. Next compose a list of evidence that supports your conclusion, and evidence that seems to go counter to your conclusion.
  8. Challenge your paranoid thoughts. If what you’re thinking was true, what else would you expect would be true? How would the world around you look?
  9. If these thoughts become intense practice distraction. This can include calling a friend, going for a walk, watching a movie, getting some exercise or cleaning your house.
  10. Interrupt yourself from acting on paranoid thoughts. Remind yourself that not every perceived insult or challenge needs to be met.
  11. Make use of reality checking. Sit down with someone you trust and describe what you’re thinking. See if they reach the same conclusions that you have.
  12. Because one of the implicit beliefs that supports paranoid ideation is that we’re special or important enough to warrant individualized negative attention, consider for a moment that there are now approximately seven billion people on the planet. Reflect on how anonymous you are in that vast population, and rest in this reflection.