Ways to reduce paranoia in social environments?

Paranoid personality disorder, I'm thinking co workers are bashing me all day. I dread going to work every day strictly because of this. I have no friends and no desire to make any. Cannot trust most people. I have a horrible way of expressing my feelings and when I do I come off as aggressive. I can't seem to hold onto a conversation either, even if it is about a broad topic. Anxiety is present as well. I have a fear of the worst outcome happening in most situations.
Asked by J

Hi J! Thank you very much for asking this important question related to paranoid personality disorder on the BetterHelp platform! I appreciate you taking the time to explore your thoughts on this online forum. Thank you for providing me with more information about your personal experience coping with paranoia. I can tell that you are willing to put in the effort to make some positive changes and grow from your experience!

First off, I admire your ability to set the initial goal of trying to reduce your experience of paranoia in social settings. This goal is absolutely attainable and will require you to come up with a strategy that essentially measures your experience of paranoia. A traditional psychological tool for measurement is the Likert scale. This would require you to self report and measure your experience of paranoia on a scale of 1 to 10 or even on a scale of 1 to 5. A value of one would indicate only trace amounts of paranoia, whereas a value of five or ten would indicate severely feeling paranoid.

Realistically, you could be able to drive down your rating of paranoia through behavioral health interventions, including systematically changing your thoughts through behavioral modification. I recommend cognitive behavioral therapy for that. Perhaps you can start by bringing down your score a few points at first and eventually be able to notice a larger difference over the course of time.

A variation on this idea that I can offer to you is to construct a timeline. You can incorporate a Likert scale in this exercise, as well. My thought is that it may be helpful for you to create a timeline as a means to address the paranoid thoughts that you have been having. This timeline can be utilized on a daily or weekly basis as a means to keep track of your experiences, thoughts, and feelings in relation to your social interactions.

In addition, you may want to utilize colors as a means to categorize paranoid thoughts into sub categories. This qualitative research method is known as coding. Seeing your thoughts on paper and how they change or stay consistent over time will likely grant you greater insight into your experience.

It sounds like your symptoms of paranoid personality disorder include feelings of paranoia and thinking that people at work are talking about you. What do you imagine that other individuals are saying about you? Based on your question, it seems like you suspect that your co workers may be critical of your performance at work. Given the nature of your experience, it makes sense that these symptoms would be more persistent and prevalent in a social environment. Developing your interpersonal skills through therapeutic interventions may be useful for you as you learn to understand and navigate your experiences.

I would be interested in hearing more about the origin of your experience with paranoia. When exactly did the paranoia start for you? Recalling the "touchstone" experience, or the first time you remember feeling paranoid in a social setting, may be an avenue for you to explore in order to gain more insight into your experience. This is an EMDR technique.

At what point were you diagnosed with paranoid personality disorder? If you haven't already, I definitely recommend participacting in psycho education on the topic of paranoid personality disorder during the course of your therapy services. Learning more about symptom presentation, causal relationships, geneic factors, prevalence and treatment is the first step in understanding your own personal situation and diagnosis. For example, did you know that paranoid personality disorder is considered to be part of the cluster A personality disorders?

It sounds like lately you have been struggling in the moment with managing social situations. Have you ever tried mindfulness techniques in the past? I recommend exploring mindfulness techniques, such as grounding exercises, guided meditation, deep breathing, positive self affirming statements and relaxation techniques. I definitely want to recognize the challenges that you have been facing. It would be great if you could begin to explore a variety of mindfulness exercises in order to decide which strategies work best for you.

You mentioned that you have not been able to trust other people. It is okay to identify this as a possible barrier to your therapy treatment. Being aware and consciously acknowledging barriers is the first step to overcoming them. I would be interested in hearing more about your experiences with trust and mistrust in the past. In what ways are you struggling to trust other people? What have you done to establish trust with other people in the past?

Lastly, I would like to offer an open ended art therapy directive for you to utilize. As a provisionally licensed art therapist, I view art making as fuel for healing. Any creative activity that you can participate in would be beneficial for you to channel your inner thoughts and express your feelings. Take some time to create a collage and really allow your paranoia to be the energy and the driving force in your creation.

If you are willing, search for images in magazines, newspapers, online and in your junk mail. Take some time to cut the images with scissors, arrange the images that you have gathered and glue them on cardboard or watercolor paper. Essentially, this will be a bit more about the process than the look of the finished product. However it turns out, feel free to take pride in your creative work!

At this time, I recommend individual counseling for your current situation. The therapeutic process can be exceptionally healing and sometimes it can be enlightening and eye opening experience. The therapy room is an open space for you to bravely speak your mind, express your thoughts and explore your feelings. Therapy also offers a way for you to practice establishing trust through consistent communication as well as build rapport through the therapeutic alliance. I hope that the therapeutic journey is beneficial for you and that the therapist that you are matched with offers the helpful suggestions, insight and guidance that you have been searching for!

I truly appreciate you taking the time to reach out for support on BetterHelp. You deserve to feel better about your personal experience. You can certainly achieve the goals that you have set for yourself! I want to thank you so much for your time asking this valuable question on the "Ask a Licensed Therapist" forum. I wish you all the best in your future and on your therapeutic journey!