How To Help Someone With Paranoia: A Guide For Loved One

It can be common for people to occasionally experience varying degrees of paranoid thoughts and feelings. For example, we may believe that someone doesn’t like us even if we have no evidence to indicate that’s the case. Most people can weigh the variables, realize there are numerous ways they could have misinterpreted a situation, and go forth with the understanding that they may have an inaccurate or incomplete version of the story. But for some, it isn’t that simple. They may have persistent, overwhelming spells of paranoia that can make functioning in daily life extremely challenging and contribute to feelings of isolation, mistrust, and emotional pain. If you have a loved one experiencing paranoia, it can be natural to want to help them cope. Educating yourself and having a compassionate conversation with them in a comfortable environment can be helpful. You might encourage your loved one to seek the professional help they deserve through in-person or online therapy.

Helping someone with paranoia 

Due to the nature of paranoia, it can be challenging to help someone experiencing this symptom feel safe, supported, and heard. Here are a few tips that may help.

Educate yourself about paranoia

Learn about paranoia and its symptoms to better understand what your loved one may be experiencing. This knowledge can help you respond to them in a supportive and informed manner. 

Create a comfortable environment

Minimize environmental stressors that could contribute to the person's paranoia. Pick a place to speak where they won’t be afraid to be candid and talk openly. 

Listen empathetically and actively

It can be challenging to persuade someone with paranoia to open up and communicate. Attentive, non-judgmental listening can give them the confidence to feel comfortable talking about their experiences. Here are a few tips regarding how to listen effectively and create a safe space for sharing thoughts and feelings.

Employ engaging body language 

It is often easier to speak freely with someone who appears to be paying attention. Ensure you’re both in a comfortable position where you can stay relaxed and maintain an open posture. If you think it will be well-received, you might maintain casual eye contact and respond with physical gestures that show you’re listening, such as nodding. Stay mindful of your facial expressions throughout the conversation to avoid projecting expressions that could be interpreted as negative.  

Ask open-ended questions 

Asking questions requiring more than a yes or no answer may enable you to understand their point of view and show that you’re interested in hearing their perspective. You can also ask them to expand on their thoughts to provide more detail or better clarity.

Repeat back what they’ve said

Paraphrasing what you heard often shows you’re paying attention and allows you to gain perspective and process your thoughts in your own way. After they’ve expressed themselves, consider saying something like, “What I’m hearing you say is…” or, “If I understand you correctly, you’re saying….”

Don’t plan your response while they’re still talking

Try to avoid formulating a response to the conversation while they’re still communicating their thoughts. Give them plenty of time to express themself and make their point before you offer your opinion. Waiting until they’re finished talking and paraphrasing what they’ve said before you respond can go a long way toward establishing trust and understanding. 

Be strategic when you offer advice

Sometimes, unsolicited advice can seem insincere and put a damper on a previously bidirectional conversation. It may also be counterproductive if you offer up advice that sounds critical by prefacing it with “you should” or “you ought to.” Again, try to allow your loved one time to convey their thoughts entirely and verify that you understand by paraphrasing. Then, when it’s solicited or appropriate, you may offer your advice. 

Speak calmly and without judgment

Just as it can be crucial to create a calm, non-threatening environment with your body language, it can also be essential to maintain that atmosphere with your voice. Use clear and gentle language to respond to your loved one and express your point of view. 

Focus on and validate their feelings

Even if their thoughts and feelings seem irrational to you, it can be important to let them know their experience is valid. Instead of trying to convince them they aren’t thinking clearly or arguing that their thoughts are unfounded, try to focus on expressing empathy and understanding. 

Don’t reinforce their paranoia 

Offer reassurance and support

It can be helpful to encourage your loved one to share their experience and reassure them that they are safe talking to you. You might show you’re there to support them by offering to help them explore coping strategies and options for professional help. If you think they’d be receptive, you can contact trusted friends, family, or colleagues to cultivate a unified, supportive network around them. 

Respect their boundaries

Paranoia can make individuals feel vulnerable and threatened. Respect their need for personal space and boundary and avoid making assumptions about their needs. Pushing them into situations that may heighten their anxiety or make them uncomfortable will likely be counterproductive. 

Care for yourself 

Try to remember that supporting someone with paranoia can be challenging, so taking care of your own well-being can be crucial, too. Effective self-care tends to differ for each person, but try to engage in activities you enjoy and establish your own social support system of friends and family members to help you avoid burnout. Many people find that engaging in activities designed to provide relaxation helps. You can try mindfulness exercises, spending time in nature, meditation, and yoga. 

Caring for your physical well-being can also be vital. Try to get plenty of quality sleep, eat a balanced diet, and add movement to your day. If you feel overwhelmed, a licensed mental health professional can provide guidance, support, and coping techniques.

Signs of paranoia 

Paranoia is commonly defined as a persistent and irrational suspicion or mistrust of others, often accompanied by feeling threatened or persecuted. A person with paranoia can experience distrust toward anyone, from strangers to loved ones. Individuals with paranoia may interpret innocent comments or actions as personal attacks or evidence of a conspiracy against them. They may feel “singled out” or watched by others. 

Paranoia may also involve clinging to beliefs despite a lack of evidence to support them or even when presented with evidence showing otherwise. Mental health professionals often refer to these beliefs as “overvalued ideas” or OVIs. OVIs are usually fixed, and individuals may resist accepting changes to their beliefs. 

Individuals with paranoid thoughts and beliefs may experience an increased state of vigilance, constantly scanning their environment for potential dangers or signs of betrayal. Distortions in thinking patterns can also be common. These may involve jumping to conclusions, making unfounded assumptions, or thinking in absolutes. These patterns are often called “cognitive distortions” and tend to be a common symptom of several mental health conditions. 

Paranoia can cause much pain and stress for those who experience it. For example, perceived threats can sometimes cause an individual with paranoia to isolate themselves, potentially limiting contact with others and avoiding social gatherings. Heightened states of alertness and mistrust can be incredibly draining for the individual experiencing them, and anxiety, fear, anger, and irritability often accompany paranoia.

Benefits of online therapy

Online therapeutic interventions are often successful in treating individuals experiencing paranoia who might otherwise feel uncomfortable seeing a psychologist in a conventional setting. Platforms like BetterHelp can match individuals with licensed mental health professionals experienced in using CBT and other treatments. With online therapy, you can speak with a therapist via video conference, online chat, or phone call from the comfort of your home. 

Effectiveness of online therapy

A growing body of research indicates that online therapy can be just as effective as traditional in-office therapy. For instance, one randomized controlled trial measured the progress of online CBT for patients with disorders who experienced paranoia as a symptom. During the trial, subjects attended an eight-week intervention period with a follow-up six months later. Subjects were given self-assessment questionnaires and generally reported significant symptom improvement with greater adherence to treatment plans than conventional therapy.