It is difficult to have a discussion about paranoia. If you tell a person they are paranoid, they respond by documenting actual trauma and experiences that have happened. You are then implicated as being naïve. In day-to-day functioning, we constantly have an internal dialogue about whether we are lacking trust or being paranoid about a person or situation. Or, as the saying goes—we all have good reasons to be paranoid. Didn’t you hear about that kid who was kidnapped yesterday? Data shows this likelihood is low and has not become a greater possibility, but 24/7 and instant media makes it seem like a common occurrence which we need to fear, so we drive our kids to school only 3 blocks away from home. Race and historical prejudice, as encountered by black athletes like Paige, would be logical reasons to be paranoid.
Like many factors, we can describe paranoia on a continuum. Paranoid features can occur in anyone as symptoms that are mild and passing. Without evidence or cause, once in a while Joe checks his wife’s computer for amorous messages. Others may have paranoid episodes that are stronger and last longer. In this case Joe will check his wife’s computer for a week or so and may add a few other paranoid types of searches in other matters during this longer paranoid phase. Still some others have paranoid traits that are fixed and are a part of one’s ongoing personality and character. In this case, Joe, observing natural occurring behaviors he perceives as suspicious, becomes convinced his wife is having an affair. His actions and style cannot be controlled. His wife at first is irritated, then makes verbal efforts to allay his paranoid thoughts, then gives up. They argue frequently and loudly. Eventually, she leaves. At work, Joe is also convinced his co-workers have gone behind his back to tell his boss that he cuts corners and sometimes leaves early. His relationships at work are distant and strained. He has trouble holding a job. Soon, he quits and forms his own company and works out of an office at home by himself. (Only an example—not true of all who work at home). The worst symptoms of paranoia are obviously clinical and rise to the severity of delusions and hallucinations. A clear issue of mental health, there are symptoms now considered schizophrenic: the distortion of reality. The paranoid schizophrenic can also be violent.
It is always a difficult requirement to separate clinical from cultural, and group from individual influences. As a culture, and as a group, Americans are well known for individualism, mistrust and paranoia. As an individual trait, paranoia has characteristics such as suspiciousness, pervasive mistrust, hypervigilance, and guarded and secretive patterns of behavior. More subtle but influential patterns include a readiness to feel offended or transgressed upon and even then a tendency to collect these perceived transgressions into a built upon grudge followed by vindictiveness. These characteristics can be assessed in individuals, though their assessment requires time spent and clinical skills due to the underlying thought patterns not always obvious or evident. However, paranoid patterns in a group or culture are readily observed and experienced. The paranoid patterns can evolve and collect into group action and even a movement. This becomes observed in the pervasive social paranoia evident in daily life and politics. The ordinary and evolutionary cultural paranoia is greatly multiplied by the media and the speed of technology. The paranoia is expressed with accusing projections of anger and mistrust upon others with lightning speed. This comes with accompanying interpersonal violence, now the foundation of American politics.
He Who Protests Too Much
The association of paranoia with the defense mechanism of projection is a link familiar to clinicians. Projection was initially posited by Freud as a defense mechanism. Projection is defined as when a person is unable to accept or acknowledge their unacceptable impulses, such as hate and strong aggression, and gets rid of these intense feelings by putting them on others. As a milder example, someone who is miserly and cheap, always complains about how cheap others are. Freud felt that the paranoid defense mechanism was in place to ward off unconscious homosexual feelings. A major criticism of Freud is that his theory cannot be proven. In this case there is some evidence. Henry Adams and colleagues from the University of Georgia published results in 1996 showing that men who were homophobic showed a higher sexual response to homosexual pornography than non-homophobic men. In this study, 64 heterosexual men were given an index that measured homophobia. The pre-screening instrument separated thesubjects into two groups—a high scorer group and a low scorer group. Then, a penile plethysmography measured their response to heterosexual, lesbian and male homosexual pornography. There was no difference in the response of the two groups to heterosexual and lesbian pornography. However, there was a difference when the men were exposed to male homosexual porn, as the high homophobic group had a stronger response. Day to day evidence is certainly in play—all the loud and vociferous preachers who publicly and morally denounce homosexuality are then caught having homosexual relationships.
Later and modern day emphasis of the paranoid defense mechanism is on extreme hostility and murderous rage. Thus, a person who has vulnerability to paranoia with paranoid personality traits can have these impulses triggered by a stressful event and act out with aggression—usually verbal in today’s media and political arena. What are today’s stressful events? Well—things like the budget deficit, terrorism, job loss and threat of losing one’s status. Don’t forget the paranoid response comes dramatically from the vulnerability and the projection becomes an attack in order to defend oneself. After all, the best defense is a good offense. The defense mechanism of projection is described as a defense mechanism of disavowal—of one’s uncomfortable and overwhelming internal feelings. What is especially notable is the intensity of the paranoid style response; its strength and vitriol and its ongoing continuous nature.
In an individual who becomes paranoid schizophrenic, the paranoid projection is completely out of control. Delusions and hallucinations distort reality and the anger and rage are murderous. The young Arizona man, Jared Loughner, who shot Representative Giffords and others was recently evaluated as incompetent to stand trial with the report indicating he suffers from delusional and hallucinatory symptoms. The result of these types of serious paranoid symptoms is the person who holes up from fear of everyone, or attacks someone first because they believe they will be attacked by them. Imagine the paranoid who hunkers down and then gets out the guns to defend against perceived attacks from others. SWAT teams know all about this. Imagine the person who climbs on the overpass to throw rocks at passing cars who are coming to attack him. Treatment issues are another matter, by the nature of paranoid symptoms and the avoidance and mistrust of others, they often discontinue medication and establishing a therapeutic relationship is not easy.
Delusions & Paranoia
There is a more specific subtype that is also more related to current cultural factors. This brings in the more specific contributory factor of delusions. Delusional Paranoid Disorder refers to situations involved in day to day life. That can include: being followed, poisoned, infected or deception from a spouse or lover—the latter a constant media event in political news. Or even a delusion that one is “loved at a distance”. Now we enter the realm of possibility and probability and where the rubber meets the road. Am I being followed? Is my spouse cheating? Or am I just being paranoid? It is especially significant that the Diagnostic and Statistical Manual of Mental Disorders (DSM) describes these as “non bizarre delusions”.
Non bizarre delusions come with another criterion. It is not a delusion if a belief is “ordinarily accepted by other members of the person’s culture.” At what point does a belief become a delusion? A poll in 2011 showed that 17% of Americans still believe Barack Obama was not born in the United States. Therefore, this erroneous belief does NOT constitute a delusion. As a Catholic growing up, every Mass I attended changed the bread and wine into the body and blood of Christ. This is the zenith of the Mass—when the altar boy rings the bells and we bow our heads in devout reverence. But this is not a delusion, and within the culture I grew up in, not a question you would raise. Other delusions may involve imitation and obsession. For example, the story of the Octamom, Nadya Suleman, the California woman who had 8 children at one time through medical technology seems to most as bizarre. She looks almost exactly like Angelina Jolie, who is well known for adopting many small children. (Jolie was reportedly “totally creeped out” in responding to a report that Suleman even had cosmetic surgery in order to look like her.) This example may fit one of the six subtypes of Delusional Paranoid Disorder in DSM, described as “grandiose type”—a belief that one has a “special relationship with a deity or a famous person.” An idolization or obsession with someone may be creepy but not harmful to the object fixated on, but examples show us this can continue and ruminate until it does become aggressive. Yet as a culture we are obsessed with following media reports of famous people. How many of us are sick of hearing “news” about Charlie Sheen and Britney Spears? Our culture and today’s technology encourages delusional paranoid disorder—grandiose type.
The distinction seems to be separating an intense exaggerated belief and fixation with a loved one or a distant admired other—from a belief that becomes acceptable by group and cultural forces. Another way of putting this may be separating a personal belief and attachment from a group or cultural belief or fixation. There is safety from craziness in numbers. In the end, fixed and even bizarre beliefs that are shared by others allow the belief to be normalized.
So if you can influence someone else to believe what you do you may not be considered delusional and paranoid. Again, to the personal realm, suppose the belief is so obviously not true, but the person’s spouse or loved one adopts the delusionary system. Consider the DSM category of Shared Paranoid delusion-derived from French Psychiatry or described as folie-a-deux. Translated as “folly of two” or “madness shared by two”, this occurs when person one transmits the delusional belief to person two. Now they both believe the same delusion. If Mr. Jones believes the government will take his guns and stockpiles more and more weapons, he wins his wife over who helps him build his arsenal. Your appeal to her for some reasonableness about all the guns is not considered. In the clinical diagnostic category, it is noted that if we remove person two from person one, the delusions for person two will go away.
Historically, emotional closeness or even genetic factors seem to be the core of folie-a-deux. The original example from 19th century France involved twins who both killed themselves in identical fashion. (Where have we seen this before—mass cult like killings.) Today, in modern society we have the technological capability of spreading any type of belief with the speed of light. Folie-a deux goes way beyond two persons and no longer may need the emotional familial closeness as a foundation.
Madness shared by many sure seems to be a dominant theme today. Whether it is what has been referenced as “Obama derangement syndrome” or weapons of mass destruction or that the world will end tomorrow at 6pm, we thrive on an incredible pace of instantaneous false images and messages. Additional synonyms that come to mind are emotional contagion and mass hysteria, both profoundly enhanced by the speed of technology.
Yet there is a strong cultural genetic to our paranoia. Politics provides one consistent arena for historical observation. With all the craziness and hypocrisy in politics today, many writers have frequently but only obliquely referenced historian Richard Hofstadter’s 1964 article, “The Paranoid Style in American Politics“. The seminal article provides example after example in which paranoia is linked to movements such as the anti-Masonist and anti-Catholic movements, and McCarthyism and fear of communism. Historical and early hatred and abhorrence towards the income tax shows the issue today is just a continued American belief. The United Nations, still much maligned by Americans today, posed a conspiratorial threat forcing United Airlines to take off a UN insignia on their planes in 1964. Eisenhower endured paranoid projections that he was a communist, and the effort to put fluoride in our water was viewed by many as a communist plot to take over the U.S.
Separate from Hofstadter’s historical brilliance are his simple and direct descriptions of paranoia. He describes the paranoid style as a “style of mind”, defining style as a “way ideas are believed”. The way the ideas are believed is distinct from whether the content is true or false. This is a key point, as it is easy to get quite upset when the content is false and publically injurious to one or all. By viewing paranoia as a style of mind related to historical movements, we have a more objective framework for talking about and understanding paranoia. His description of the paranoid style is succinct: “heated exaggerations, suspiciousness, and conspiratorial fantasy.” He continues noting these are “modes of expression by normal people.” Hofstadter’s objective framework and reference to normal people hits home—it is hard for many to call the Tea Party a group of normal people. Instead, they are just another historical American movement that will pass on. That is, another normal paranoid movement in our great country’s history- one that again focuses on government forces taking over our lives or dooming us into the depths of hell. Hofstadter points out we all suffer from our history, but the paranoid adds their own fantasies from their traits and disposition. He calls the paranoid a Double Sufferer.
But Hofstadter’s analysis does involve judgment and conclusion. He notes the paranoid style has an “affinity to bad causes”. He describes the consequences of apocalyptic language and the implied message that “time is running out”. He points out the position does not allow us to resolve social conflicts as the “demand for total triumph” has no compromise. How appropo for today. If we don’t completely solve the budget deficit today we are doomed. Reducing spending by a few trillion is not enough—and there can be no compromises as the Tea Party loudly argues. Yet Hofstadter’s conclusion is clear– as another paranoid movement evolves today, it disables our democratic process.
Can we survive another cultural evolutionary paranoid assault without looking back? The problem is the frustration and anger we can have towards the intense Tea Party position and the desire to confront them. Traditional treatment indicates that confrontation of the paranoid just leads to loud and ugly arguments. This is what is so difficult if your loved one is paranoid. Attempts to try for a connection or emotional response will induce more paranoia. If a paranoid patient improves and is less paranoid, a therapist’s effort to express or indicate a closer emotional connection disrupts the stability and paranoid symptoms remerge. Both human responses of confrontation and emotional connection will fail.
So, let the paranoid movement define itself. Put another way, as expressed by experienced politicians, if your opponent is self destructing—don’t get in their way. As the Tea Party defines its own policies, they will exhibit the underlying rigidity of their paranoid position. Their paranoid position response to other proposed policies from their perceived “enemies” is an automatic no. In fact, the Tea Party and Republicans can be defined as the party of not just no but to use Sarah Palin’s famous words—“Hell No”. When the party of Hell No does state a position, it is an effort out of their comfortable inner realm of just saying no and usually poorly thought through. The much hailed economic plan proposed by Congressman Ryan is unable to be presented as anything positive– a no like response to Medicare from the business party that apparently doesn’t even understand risk management and believes the for profit insurance companies actually want to cover seniors. Forcing the Tea Party to define its positions on specific issues (for example, what are their opinions on foreign policy?) also takes away from what Hofstadter notes is a “heroic striving” of the paranoid. The details of a Ryan Plan may be presented as heroic, but the impact jolts people into reality that suggests a destructive force.
Normally, we would expect the movement to pass, though this can be facilitated by forcing the movement to define itself. But besides the social economic conditions, there are equally worrisome cultural factors. Our culture of 24/7 media and constant immediate technological developments are frightening. The fast paced technological immediacy of screen media breeds and plants a very rich soil for growing paranoia. For the paranoid, modern day technology may make them a Triple Sufferer. We can respond to some of this– President Obama released his original birth certificate because polls showed that the anti-born in the U.S. paranoid movement was growing in strength. It seemed to help. Still, the modern day factors of economic decline—perceived and real—and the technological screen media speed make today’s paranoid movement unique and potentially more destructive.
The technology of digital permanence affects day to day activity, as cameras are everywhere and with everybody. All digital photos have a permanent memory. New cars may soon have cameras to help you watch those corners and curbs and serve as an airplane black box does to record accidents. Insurance companies and law enforcement are thrilled. Privacy may go the way of the typewriter. Everything is recorded, everything can be observed and then measured. Realizing this, its easy then to become paranoid, about even our basic self. Less seriously afflicted may be able to obtain relief—like when you realize that noise that wakes you up at night is your cat knocking something over. Or maybe to have enough awareness to laugh about it-like the joke Woody Allen would tell that he thought everyone was calling him a Jew. He would ask someone: “hey did you have lunch?” Answer: “No—dyou? dJew?”
Today’s digital advancement of historical archetype paranoia creates images and sounds. The theme is reflected by the popular lilting rock song by The Police:
“I’ll be watching you… every move you make every step you take…I’ll be watching you.”
When you are on the internet, someone is watching you—every stroke you make. Still, like with Satchell Paige—performance matters. You should try not to look back.