A Slew of Suspects

You walk into the conference room just as your coworkers halt their conversation: Were they talking about you? Or maybe you can't help but notice that the same car has been behind you on the highway for the past few miles. Are you being followed?

At one time or another, everyone experiences the kind of insecurity that can give rise to suspicious thoughts. But when thoughts consistently veer toward the perception of threats, you're not just being cautious—you may actually be paranoid.

Paranoia is a cognitive distortion, a consistent, unfounded view that others want to hurt us in some way. It's marked by a tendency to interpret neutral situations with a negative slant and then—even in the face of information to the contrary—to treat those fears as fact. It's a hallmark of severe mental illness, most notably schizophrenia.

But paranoia isn't limited to those with severe psycho-pathology; it exists on a spectrum, affecting plenty of otherwise healthy individuals. In fact, a mild—but still maladaptive—shade of this cognitive distortion, known as nonclinical or "everyday" paranoia, affects about a third of the population, research shows. For people with everyday paranoia, believing that friends, acquaintances, or strangers are hostile or critically focused on them is a daily occurrence.

What sets apart clinical from nonclinical paranoia is how strongly the ideas are held, how distressing they are, and how much they interfere with daily functioning. As with most other mental health problems, there is no clear cutoff between clinical and nonclinical paranoia; it's a judgment call reflecting how much distress and disability the problem causes.

Not only is everyday paranoia common, some experts believe it's on the rise. Our current media environment, with its endless repetition of scary news, has the effect of magnifying threats, which gives rise to paranoia in the susceptible. Now more than ever, the stage is set for suspicious thinking.

A little distrust is adaptive—it helps us detect danger in a person or scenario. Without it, you wouldn't notice the warning signs in an about-to-crack colleague or slip your iPad out of view in a crime-heavy area. But by definition, paranoia is maladaptive or unrealistic suspicion. Paranoia is not justified anxiety about others ("This poky waiter might ruin our dinner") but rather reflects fears for which there's no convincing (or even suggestive) evidence: "I bet this waiter thinks I'm fat—that's why she still hasn't offered us dessert."

True, it's not always easy to tell whether our worries are justified. But it's possible to identify when thoughts have slid into the swamp of paranoia: Would other people think my suspicions are realistic? Is there any indisputable evidence? "It's important to remember that paranoia isn't defined only by the content of the thoughts but whether they are exaggerated and unfounded," explains Daniel Freeman, a psychologist at Oxford University and author of Paranoia: The 21st Century Fear.

So "My friends aren't truly happy that I'm getting married" could be a paranoid thought for a bride-to-be—one whose loved ones have been nothing but supportive—and a reasonable anxiety for another, depending on the context.

It's possible not only to learn to identify paranoid thoughts but also to control them. By understanding the root causes of paranoia and learning what's behind their concerns, the paranoia-prone can reduce the frequency and intensity of suspicious thinking. It's important to do so. Failing to curb everyday paranoia can have snowballing repercussions.

Here's how to recognize irrational insecurities and keep them in check, no matter your place on the paranoia continuum.

Are you looking at me?

Paranoia is marked by a strong tendency to cast a negative light on ambiguous interactions—those that leave a lot of room for interpretation. Let's say you're walking down the hallway when a colleague passes by without saying hello. What runs through your head? If you're like most people, "you'll automatically run through a series of relatively neutral situational interpretations," explains psychologist Dennis Combs, director of the Psychotic Disorders Research Laboratory at the University of Texas in Tyler. Maybe your colleague was pulling out his Blackberry. Or the hall was crowded; perhaps he didn't notice you. Ultimately you shrug it off.

But those with everyday paranoia (occupying that higher-than-average but nonpsychotic spot on the spectrum) fail to appreciate social context. Like frank schizophrenics with more severe paranoia, they interpret ambiguity with a bias: the assumption of hostile intent, Combs says. The explanations they conjure up for a colleague's behavior will veer toward the negative: He's had it in for me since I got that promotion. "Instead of blaming the situation," says Combs, "people with paranoid tendencies will blame others. They're quick to assume that a person doesn't like them or has ill feelings toward them."

A key feature of paranoia is a cognitive defect: faulty people-reading skills, research suggests. The paranoia-prone demonstrate a reduced ability to recognize emotional expressions in others: Furious and distracted might look pretty much the same to them, for example.

As a result, they have poor theory-of-mind abilities; that is, they struggle to draw accurate inferences about what others are thinking or feeling. They default to a negative interpretation. Says Combs, "They jump to conclusions about the other person's intentions, and then make hasty, often poor, decisions based on little or no evidence."

Their rush to judgment will stick, even if evidence to the contrary arises; the paranoia-prone mistakenly treat their thoughts as facts. Even if they later overhear that coworker from the hallway admitting he misplaced his glasses and can't see very well, they tend to remain unconvinced, at least a little. That's because everyday paranoia isn't based on concrete data; it's based on unwarranted feelings and thoughts.

The anatomy of a threat

Under the best of circumstances, our brains are always on alert for any whiff of danger. Anticipating threats serves an important evolutionary need. After all, if Stone Age homo sapiens thought saber-toothed tigers were lunging toward them because they just wanted a good scratch behind the ears, we humans wouldn't have lasted very long.

Threat evaluation originates in the brain's amygdala, which constantly scans the environment for potential danger and, finding it, triggers the body's fight-or-flight response. Assessments ("Danger! Snake!") are made in milliseconds, without our awareness. Then the more highly developed prefrontal cortex kicks in to refine and interpret that rough assessment ("Nah, it's just a stick") and calm the alarm response if need be.

This neurocognitive system is subject to subtle disturbances stemming from anxiety, depression, marijuana use, or even lack of sleep, factors that can transform stimuli from harmless to panic-inducing. First the threshold for the alarm system plummets so that the amygdala pipes up in response to ambiguous or low-level threats—that coworker's silence sets off the "I've been blown off!" sirens, for example. Then the brain ignores whatever attempts the prefrontal cortex makes to evaluate the situation and issue a soothing "You're fine" message.

"We're left in a state of increased vigilance and hyper-sensitivity to danger," explains Melissa Green, a psychologist at the University of New South Wales in Australia. "We may perceive threats where none exist." That stick still looks like a snake. And so does that stick, and that stick, and that stick way over there.

We humans pay special attention to social information; as historically tribal creatures, we've evolved to panic about social rejection as well as saber-toothed tigers and snakes. Individuals with everyday paranoia have a hard time processing the actual threat level of social exchanges. The prefrontal cortex fails to moderate fear as ambiguous social input trips the amygdala again and again.

Wired for wariness

In 2008, Oxford's Freeman took 200 fellow British citizens for a virtual ride on the London Underground. Each participant donned a head-mounted device that featured a 3-D view of a train car in London's tube. Inside the car were computer-generated passengers exchanging snippets of neutral conversation.

Afterward, participants relayed their experiences with the "passengers" they'd encountered. While the majority had neutral or positive experiences, 40 percent reported paranoid thoughts: "A girl looked like a pickpocket," for example, or "There was a guy spooking me out."

Participants who experienced paranoid thoughts were those who had previously reported worry, loneliness, or lack of social support, all known anxiety inducers. "Undoubtedly, the more anxious we are, the more likely suspicious thoughts are to occur," Freeman says. "Worry leads us to thinking only about bad outcomes and inflating our estimates of how likely they are to occur."

Worry and isolation are not the only pathways to paranoia. A genetic predisposition to anxiety also might make someone susceptible to paranoid thoughts, experts note.

Everyday paranoia is also related to self-esteem. In one study, researchers at Maastricht University in the Netherlands asked 158 individuals (some healthy, some previously diagnosed with psychosis) to keep a diary of their thoughts and moods for one week. Across the board, an increase in anxiety and a decrease in self-esteem predicted the onset of paranoid thoughts. Anger and irritability also produced suspicion, but those states were fleeting.

Depression is also linked to paranoia. Among those who are depressed, suspicious thoughts last longer and are more intense. "Depression is associated with low self-worth, so depressed individuals who are prone to paranoia may perceive themselves negatively and in turn believe others share their negative thoughts," says study coauthor Viviane Thewissen, who's now at Open University in the Netherlands. Paranoid thoughts may stick around longer as a dysfunctional effort to regulate self-esteem. Instead of thinking, "What a crazy economy! It's been five months and I still haven't found a new job," someone prone to paranoia might question whether a former boss is really providing the glowing recommendation she promised.

Whether chronic anxiety, depression, or low self-esteem leaves someone prone to paranoia, it still usually takes a stressful environment to bring it out. Consider contestants on Survivor, deprived of food and sleep and forced to compete in grueling physical competitions. Is it any wonder that even the most easygoing tribe members so rapidly turn shifty-eyed and mistrustful?

Few of us will find ourselves competing on that reality show, but Freeman believes we now live in an era that brings out the paranoia in us. "More than ever, we're reminded through newspapers, magazines, and television shows of all the threats facing us, from terrorists to criminals to pedophiles," says Freeman. "This overreporting leads us to overestimate the likelihood of the occurrence of these dangers." Perils are exaggerated; threats, magnified. View enough coverage of a child abduction case and you'll begin to wonder whether your neighborhood isn't crawling with kidnappers too. "It's hard to stay cool when everyone else is panicking," Freeman adds.

Across a lifetime, one person could even temporarily slide up the paranoia scale, experiencing more suspiciousness while unusually stressed, anxious, or depressed—say, during a period of unemployment. After losing a job, struggling to find health care, and missing payments on a credit card, student loans, and condo fees, someone who's never suffered from regular paranoid thoughts may suddenly spiral into worrying that her friends hate her, her boyfriend is losing interest, and the man across the street wants to steal her dog.

Paranoid thoughts have also been linked to stressors such as racial discrimination (perceived or real), childhood trauma, and bullying, all of which give rise to a painful sense of outsider status. Learning to view the world as threatening—and threatening to you, in particular—can prompt a person to see potential harm or humiliation anywhere, even when those thoughts aren't warranted, says Thewissen.

Perhaps because they may feel lonely more often, single people are also more likely to be paranoid than their married counterparts, Freeman found. Just as social isolation breeds everyday paranoia, relationships tend to be a natural corrective. The casual back-and-forth communication that distinguishes them serves as a subtle, nonthreatening check on baseless ideas. ("You don't really believe that TV pundit, do you? I'll send you this great article refuting his main points.")

The paranoia profile

Susceptibility to suspiciousness not only reflects our emotional state, but also has developmental links. We are most at risk in our late teens and early 20s, Freeman finds. "Arguably, that is the time we feel most vulnerable in our lives," he suggests. "We're becoming independent and establishing our identity and lifestyle, so our relationships with others may be at their greatest stage of flux."

Having low socioeconomic status also primes people to go on high alert. The powerlessness that poverty evokes may lead some to feel persecuted on an individual level.

Surprisingly, it's a toss-up as to whether women or men are more likely to feel the need to watch their back. Freeman's studies indicate that more women experience low levels of paranoia (answering yes to the question "Over the past year, have there been times when you felt that people were against you?"), while men are more likely to experience intense levels of suspicion (believing others are plotting to cause them serious harm). Even so, women are more ill at ease about their suspicion. The reasons for the gender discrepancy are unclear, says Freeman, but "women generally have higher levels of worry than men, and worry does make paranoid thinking more distressful."

The real threat of distrust

The negative effects of everyday paranoia are potent. Paranoid thinking reduces happiness and calm and magnifies social isolation. It leads people to withdraw from neighbors, coworkers, and friends. Why venture out in the world when we're bombarded with reasons to hide from it? But isolation only exacerbates paranoid thinking.

Most people who experience paranoid thoughts remain at the mild end of the paranoia spectrum. But for some, severe delusional thoughts develop over time. As with anxiety or depression, milder bouts of paranoid thinking put a person at greater risk of developing the clinical form, says Freeman. Not surprisingly, then, paranoid thinking is also associated with an increased risk of suicide.

There are effective treatments for everyday paranoia. Research suggests that gaining distance from suspicious thoughts and evaluating them reduces both the distress they cause and their overall frequency. One particularly promising approach is cognitive behavior therapy, in which a patient is helped to identify anxiety-based thoughts and then test out their validity.

Directly tackling the underlying triggers of paranoid ideation—anxiety, depression, and a stressful environment—also helps diminish everyday paranoia. Increasing social activities is another important step. But many people shy away from such a remedy because of their low self-esteem and fears of being ridiculed or harmed, says Freeman. Failing to reverse isolation compounds paranoid thinking.

It's possible to combat intrusive suspicious feelings on one's own. First, says Freeman, it's valuable to "remember that such thoughts are very common." Expose them to daylight. Share them with others to get a check on how accurate they really are. Or try to imagine another person's perspective: What would your spouse or best friend do in the same situation? Would she consider your thought justified?

If you catch yourself ruminating on why that colleague ignored you in the hall, let it go. "You might never know the reason behind a person's laughter or his look in your direction, so why waste time trying to find an answer?" Freeman says. "Ambiguity is all around us. Don't let it keep you from doing the things you enjoy."

Trusting Too Much

Trusting others is a necessary part of everyday life. We trust that cars in oncoming traffic will stop at red lights. We trust that the novocaine will kick in before the dentist's drill does. We trust that the cook at the diner washed his hands before he prepared our salad, and that if we dial 911, help will be dispatched immediately.

"Trust reduces complexity and ensures that we can swiftly maneuver through the ambiguities of the day," says Reinhard Bachmann, professor of strategy at Surrey University's Business School in England and coeditor of the Handbook of Trust Research. In fact, because trust breeds efficiency, "people who trust easily are likely to experience more success and power," he says. "Trusting saves time and effort that would otherwise go into attempting to control everything all the time."

Healthy trust, Bachmann explains, is based on either having positive firsthand experiences with the potential "trustee" or knowing that a stranger in a given environment is likely to follow certain rules. Even if the restaurant valet is wearing a "Grand Theft Auto" T-shirt, you believe he'll park your car—not speed away in it.

Blind trust, on the other hand, is having faith "without any semiconscious assessment of what the maximum damage could be if you get it wrong," says Bachmann. Overtrusting folks don't just fail to weigh the risks of a situation—they neglect to see that risks exist. Children are classic overtrusters, since they lack the cognitive equipment to size up potential danger.

People are most likely to overtrust when they want a shortcut. It's simpler to give your money to an investment broker and trust he'll make you rich (hello, Bernie Madoff) than it is to interview several brokers, ask exactly what will be done with your money, and research investment funds. You don't want to lose out on potential gains—which others might already be making—so you take the short route and overtrust.

Finance is not the only popular arena for overtrust. "When a person continues to stay in a friendship or romantic relationship after their trust has been broken multiple times, they're also probably trusting too much," Cornell social psychologist David Dunning explains. If your partner admits to serial affairs or your best friend drives you crazy with gossip although you've begged her to stop, believing that either one will suddenly change bestows expectations that will never be reached. "What a person has done in the past is not a perfect indicator of their future actions," Dunning says, "but it's the best we have."

It's always smart to look for clear evidence that someone deserves your trust, Dunning suggests. Can several references give your new babysitter glowing reviews? Are other customers in the parking lot generously tipping the valet? Even in established relationships, trust needs assessment. Yes, give a person a chance to demonstrate his trustworthiness. But if he fails, rethink whether the relationship is worth continuing.

Conspiring for Answers

Conspiracy theorists appear to be the poster children for everyday paranoia. But don't point a finger just yet at the Birthers, the Truthers, or even those who insist man has yet to set foot on the moon. Experts are still on the fence about whether harboring suspicions about authorities qualifies as true-blue paranoid thinking.

Many studies have linked conspiratorial beliefs to a lack of trust, feelings of powerlessness, and a sense of alienation, "all of which are arguably elements of subclinical paranoia," says Karen Douglas, a psychologist at the University of Kent. "But not all alternative explanations people come up with to explain events are necessarily unrealistic." (Watergate, after all, was a mind-boggling accusation before it was a documented break-in.)

People who believe conspiracy theories might simply be more open-minded. British individuals who rated high in intellectual curiosity, an active imagination, and a proclivity for new ideas were more likely to endorse alternative explanations for the World Trade Center attacks (e.g., that it was an inside job), a University of Winchester study found. Researchers think a person's creativity may allow for greater openness to conspiracist ideas.

Our brains are actually set up quite nicely to buy into conspiracy theories. "We have a tendency to interpret new information in ways that confirm our preexisting beliefs and attitudes," says Ilan Shrira, a social psychologist at the University of Florida. "Then there's our default assumption of 'naive realism,' in which we feel we are able to remain objective while those around us are biased." In other words, conspiracy theorists believe that only they see the "obvious" truth.

There's no hard evidence that conspiracy theorists are growing in ranks, experts say. Still, many believe that the Internet facilitates the spread of conspiracy theories because it's so much easier to share information now than it ever has been before, Douglas adds.

Men and women are equally likely to believe conspiracy theories. One good indicator of susceptibility to conspiracy thinking is how Machiavellian a person is. According to Douglas's research, people are more prone to believe others conspire when they think they would too, if given the opportunity. They're projecting their moral qualities onto others.

A kinder, gentler explanation of why people subscribe to conspiracy theories? We live in an era when we're struggling to deal with frightening, complicated, and sometimes unanswerable questions. While people with nonclinical paranoia feel uncomfortable with ambiguity on a personal level ("I don't know why the cashier didn't say hello. Does she hate me?"), conspiracy theorists display discomfort with ambiguous Big Picture questions: Why did the towers fall on 9/11? What or who lives in outer space?

"People are constantly bombarded with often conflicting information and must decide for themselves what is the truth," Douglas says. Fox News and NPR tell very different versions of the same story, and sometimes it's difficult to distinguish between the truth and other explanations. People generally lack direct access to the facts that might help them distinguish correct from incorrect explanations. "They need to try to make sense of it all, and conspiracy theories may provide an easy way out of this complex task," she says.

When you're wondering, "When will the world end?" it's comforting to hear an answer—no matter how absurd.