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Paranoid
Exploring Suspicion from the Dubious to the Delusional (No, This Book is Not About You)
By David J. Laporte Prometheus Books
Copyright © 2015 David J. LaPorte
All rights reserved.
ISBN: 978-1-63388-069-6
CHAPTER 1
MEET PARANOIA
The content of the 911 call was not remarkable for a large metropolitan area. A man reported that someone had been killed in a drug-related shooting. What the operator found unusual was his calm, matter-of-fact manner.
When the police arrived at the scene that afternoon, they, too, were struck by the serious but strangely composed demeanor of the middle-aged man who answered the door. He escorted them to an upstairs bathroom where the body of a young woman lay slumped next to the tub, and provided details of what had happened and why.
Without any discernible change in expression, the man explained that the woman, who had been renting a room in his large Victorian home, had recently fallen in with what he called "the wrong crowd." According to the homeowner, she and her drug-dealer friends had been planning to murder him, so he had simply killed her first.
When an officer asked what led him to conclude that his life was at risk, the self-confessed killer provided a litany of "facts." For instance, he had overheard the muffled, one-sided telephone conversations in which the woman was surely plotting his death. She had also received suspicious letters cleverly disguised to look like ordinary advertisements for magazines or credit cards. "But what proof was there that your life was in imminent danger?" the incredulous policeman asked. Smiling slightly for the first time he motioned for the officers to follow him into the young woman's bedroom. There he showed them a hairbrush lying on the dresser.
"You see the position?" he asked. "It is usually placed with the handle pointing toward the front. Today, the handle was pointed away!" Seeing the quizzical looks on the officers' faces, he provided further explanation. "They positioned it that way last night to signal her that today would be the day."
He then offered the rest of his so-called proof: the garage door across the street had opened and closed twice that morning, indicating that the plan was in motion. Then there was the green minivan that had cruised slowly down the street.
Once the signs had become clear to him, the man retrieved the gun he kept between his mattress and box spring and calmly went to the woman's bathroom and shot her point-blank.
The police could perceive no hint that the man was putting them on. As bizarre as his story and explanations sounded, his delivery was utterly flat and straightforward, as if he were describing a mundane, everyday occurrence such as taking out the trash.
Finally one of the officers asked the obvious question. "If you thought your life was in danger, why didn't you just call the police?" A hint of a knowing smile crossed the man's face again as he replied, "The drug dealers have infiltrated the police department. I couldn't trust that anyone there would protect me."
An elderly woman believes that thieves enter her room every night to steal her possessions. A student, who had borrowed notes from a classmate for a lecture he missed, thinks that some of the pages have been removed purposely so he will fail the upcoming exam. A woman who recently emigrated from Afghanistan is certain that people are continually laughing at her and talking behind her back. A member of the Tea Party describes burying guns vertically in his backyard so they will be less easy to sense with metal detectors.
You may not be familiar with those particular cases, but what about these? Timothy McVeigh, a young Gulf War veteran, tells a friend that the army has implanted a computer chip in his buttock in order to keep track of his movements (no pun intended). Ted Kaczynski, a brilliant mathematician, conducts an eighteen-year vendetta against mere acquaintances and people he's never even met because he thinks he is being controlled and harmed by modern technology. John du Pont, a reclusive multimillionaire, has razor wire installed inside the walls of his mansion to prevent people he suspects are tunneling under his estate from reaching his living quarters. While we're at it, let's not forget Seung-Hui Cho or Jared Loughner, mentioned above.
What all these individuals have in common is paranoia: the topic of this book. Each of them is unduly suspicious about the intent and actions of others and feels that someone has it in for them.
As should be obvious from even the brief descriptions presented above, each of these people exhibited paranoia in somewhat different ways and, perhaps, for different reasons. The object of this book is to describe the many facets of paranoia, to provide explanations for how it comes about, and to address the potentially serious consequences of paranoid feelings and beliefs. To illustrate this information, I am including actual case examples I have personally seen, as well as cases provided by trusted colleagues (no paranoia here).
A primary assumption of this book is that most of us have experienced the feeling we commonly label paranoia at least once in our lives, and most of us have also known someone who was paranoid. In some of these cases, we may have had a legitimate reason to distrust the motives and intentions of others, but many of us will still question our assumptions before passing judgment. We often seek verification of our suspicions, sometimes by asking others whether their perceptions of a given situation are similar (Am I paranoid, or is Ray always smirking when I say something during meetings?). If the answer is yes, then we may conclude that our feelings of suspicion were justified because they were confirmed by another, possibly more objective, person.
Clinical paranoia isn't simply a mistrust of others until or unless they are proven wrong; it is the extreme end on a trust continuum. Unfortunately, individuals who suffer from clinical paranoia feel that their conclusions are justified and will often point to confirming evidence that seems quite real to them although utterly erroneous to the rest of us. Therein lies part of the difference between what most of us may refer to as paranoia and the extreme versions that mental health professionals are trained to identify.
As this book will describe, responses to and consequences of paranoia can range from healthy situational adaptation to seemingly inexplicable and tragic violence as the case examples presented above demonstrate.
In this electronic age there is, arguably, good reason to feel paranoid. Indeed, if the cell phone conversations of the heir to the throne of England can be monitored relatively easily, what hope do us common folk have of maintaining our privacy? Thankfully, most people's lives are not considered interesting enough to warrant that kind of intrusion ... although the NSA may beg to differ.
The government has been monitoring our phone calls, e-mails, text messages, and web browsing. It can also tap into ATM systems around the country and know when and where we are withdrawing money and how much. Already unmanned drones are circling our skies; not to drop missiles but to engage in a variety of other purposes, one of which might be to monitor our activities.
Computer hackers have been able to break into sophisticated government and corporate computer systems, seemingly at will; never mind our less protected personal ones. Handheld recorders and cell phone cameras are now capturing much of our behavior on video, which can be shared immediately with the rest of the world. At any moment, something we do could "go viral" and be viewed by millions.
We are now able to place computer chips under the skin of our pets to protect against loss, so that all anyone has to do is pass Fido under a scanner — much like we do a box of cereal at the supermarket — and all the relevant information about the owner will pop up on a computer monitor. If they can do that to pets, what about us? Revelations about our government's past experiments with drugs on unsuspecting and nonvoluntary subjects certainly raise concerns in even the most trusting and naive of us. And these are just the things we know. What super-secret technology really exists that we don't know about?
One of the points made in this book is that this era, with all its sophisticated technology, is not responsible for paranoid disorders. People have likely suffered from paranoia since early in the history of human development. Whether all this electronic sophistication, with its ability to violate our privacy in novel ways, is increasing the number of people experiencing paranoia is a reasonable question. Might it be elevating the paranoia levels of all of us? Well, the answers are to be found in the following pages.
PARANOIA'S OPPOSITE: TRUST
A reasonable antonym for paranoia is trust. Because I focus on the former in this book, it is important to at least mention its opposite. Trust is essentially the expectation that you will receive from another person an expected outcome, usually a positive one. If you feel that you can rely on that person's word or promise, then you are willing to put yourself at risk. Trust develops based on past experiences and interactions with others. It produces a sense of predictability and dependability.
Yet not all our interactions with others result in that reliable outcome. So how is it that we all don't become paranoid as a result? Well, the notion of faith enters the picture. We're not guaranteed a certain outcome, but most of us have some degree of faith in the behaviors of others. The amount varies understandably from person to person and from situation to situation. The person selling a "genuine Rolex" on the street corner for $50 is probably not going to be trusted by most of us. On the other hand, most of us do trust that when we walk into an expensive jewelry store, the $5,000 Rolex in the display case is the genuine item. Again, we have faith that it is. The rest of the book will focus on why some of us do not have that trust and faith.
A BIT OF BACKGROUND
The position of paranoia in psychology is much like that of depression. Depression is a word that has leaked into our common language and is now synonymous with sadness (Mari looks depressed today.). At the same time it is also a major psychiatric disorder and a prominent feature of a variety of clinical disorders, such as bipolar disorder. Further, depressive features are also commonly found in a variety of other psychiatric disturbances. The majority of individuals suffering from bulimia nervosa or panic attacks, for instance, have depression.
Similarly, paranoia and paranoid are terms that have crept into our everyday vocabularies. They refer to someone who feels excessively suspicious, typically with little or no reason to feel so, and who has a firm belief in the malevolent intentions of others. It, too, takes the form of major mental illnesses such as paranoid schizophrenia and delusional disorder. Paranoid symptoms are also commonly found in other disorders such as alcoholism or Alzheimer's, even though they are not the essential or defining feature of them.
Paranoia shares another similarity with depression, as both terms are used clinically to define an essential feature of a disorder: prominent suspiciousness in the case of paranoia; a sad feeling state in depression. Yet in both paranoia and depression there are a number of clinical characteristics that actually comprise the syndrome of depression or paranoia. In the case of depression, sad mood is at the heart of the disorder. But typically depressed individuals will also commonly lose their appetite, have problems sleeping, have trouble making decisions, experience low energy, and lose their sex drive, among other things.
Excessive suspiciousness is at the heart of paranoia, yet characteristic features also include hostility, rigidity, and lack of trust.
A final commonality is that both depression and paranoia are dimensional in nature. We all experience degrees of paranoia or depression. Actually, it is probably more accurate to say that we all experience degrees of suspiciousness or sadness. For some — those featured in this book — the experience is rather severe and stable. Such is also the case for depression. Thus it is important to establish that paranoia is a pathological clinical state. Suspiciousness may not necessarily be abnormal. This theme will be developed more below.
THE PROBLEM WITH PARANOIA
One of the major differences between depression and paranoia is that volumes have been written about depression. Whole journals are devoted to the study of it. In contrast, the literature on paranoia is scant. There are four primary reasons for this disparity.
First, there is, presumably, a higher rate of depression in our society. This is a debatable point. Depression can easily be isolated from the many disorders and conditions in which it is found. For example, someone with cancer can easily be identified as suffering from depression. Hence the rate of "pure" depression and depression embedded within other disorders is relatively easy to determine. Moreover, its treatment is usually independent of the treatment of the other disorder it may be associated with. So the depressed cancer patient can receive chemotherapy and be treated separately for depression.
Not so with paranoia. Paranoid individuals don't tend to show up complaining of paranoia like depressed patients do of their condition. Moreover, the paranoia is frequently so embedded within the disorder it is associated with — alcoholism, for example — that it does not get diagnosed or counted. So we treat the alcoholism but not the paranoia per se.
Second, the ultimate consequence of depression is perceived to be more serious than any of paranoia: successful suicide. However, as the opening anecdote demonstrates, paranoia can lead to very serious and deadly consequences.
Third, little cross-talk exists between clinical researchers interested in paranoia. I attend conferences on Alzheimer's and usually find a talk or two related to paranoia in patients with Alzheimer's. A conference on schizophrenia will yield a great deal more discussion on paranoia within schizophrenia and even an occasional talk focusing just on paranoia.
But I have never encountered a conference devoted solely to paranoia, where researchers congregate and discuss such simple, and to date, unanswered questions, such as whether the presentation of paranoia is the same in other disorders. Do Alzheimer's paranoid patients tend to focus on family stealing from them because they fail to remember where they put or spent their money? Why do some paranoid individuals focus on government malfeasance, while others worry about their neighbors? What percentage of alcoholics, people with traumatic brain injuries, hypothyroidism, posttraumatic stress disorder, and so on have paranoia? There are dozens more of these basic questions, all with little data to address them. Similar questions about depression are easily answered.
The final reason so little has been published about paranoia is the nature of conducting research into mental illnesses; more specifically, studying actual people with the disorders.
FINDING PARANOID INDIVIDUALS
There is an inherent problem in the study of individuals with paranoia. If we want to study depression, for example, we would hang around in the waiting rooms of psychiatrists, psychologists, members of the clergy, psychiatric hospitals, general practitioners, and other places where depressed individuals will show up. Advertisements in local newspapers or TV commercials, often asking the reader/viewer if they "are suffering from depression" or "feeling afraid for no reason" are used and work well. Based on these and other sampling methods, we could gather data on a representative group of depressed individuals. Studying this group would yield results that would be generalizable to other depressed individuals.
Now imagine the same situation with paranoid individuals. First, they don't tend to come in asking for help or treatment. Unlike people with depression, or phobias, or sexual dysfunction, persons with paranoia don't necessarily think there is anything wrong with them. Thus there is little intrinsic motivation for them to seek help. From their perspective, it's the person out to get them (you) who has the problem, not them.
So going places where people with emotional/psychological problems seek help will not result in a large catch of paranoid individuals. Further, if patients in general are asked about paranoid issues, the truly paranoid are likely to deny such problems.
(Continues...)
Excerpted from Paranoid by David J. Laporte. Copyright © 2015 David J. LaPorte. Excerpted by permission of Prometheus Books.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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