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Paranoid protester in New York City
Tell me about
your mother

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For our next session...
Popping into your mind
'They' have invented something which doesn't exist — a real imagined disease and I know that they are trying to catch me out so that I can be locked inside an institution. But they won't catch me out because they do not know who I am today. And if I am not the same person as I was yesterday then they can't make it stick. They need a body, not just a mind to prefer charges, so my advice to all paranoiacs is to keep on the move. If you are a different person every day, no administration can keep up with you. If we all adopted this approach to life, society would be delightfully unmanageable but exquisitely euphoric, for it would release in all of us the imprisoned souls of our secret lives.
—Ralph Steadman[1]

Paranoia is a thought process characterized by excessive fear or anxiety, characteristically to the point where it would be considered irrational or delusional. Paranoid thinking typically includes persecutory beliefs concerning an obsession with a perceived threat.

Origin of the word "paranoia"[edit]

The word 'paranoia' originates from the Greek "παράνοια" meaning madness ("para" = beside, beyond; "noos" = mind).

Clinical indicators[edit]

Historically, this word was used to describe any delusional state of mind. In recent times the clinical use of the term is to describe delusions where the affected person believes they are being persecuted. Specifically, it is defined as containing two central elements:

  • The affected thinks that harm is occurring, or is going to occur, to them.
  • The affected thinks that the perceived persecutor has the intention to cause harm.

Paranoid Personality Disorder is defined in the American Psychiatric Association's DSM-5, primarily based upon a person having "a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent."[2]

The World Health Organization's ICD-10[3] characterizes Paranoid Personality Disorder as having at least 3 of the following:

  1. excessive sensitivity to setbacks and rebuffs;
  2. tendency to bear grudges persistently, i.e. refusal to forgive insults and injuries or slights;
  3. suspiciousness and a pervasive tendency to distort experience by misconstruing the neutral or friendly actions of others as hostile or contemptuous;
  4. a combative and tenacious sense of personal rights out of keeping with the actual situation;
  5. recurrent suspicions, without justification, regarding sexual fidelity of spouse or sexual partner;
  6. tendency to experience excessive self-importance, manifest in a persistent self-referential attitude;
  7. preoccupation with unsubstantiated "conspiratorial" explanations of events both immediate to the patient and in the world at large.


Paranoia is often a symptom of a psychotic illness (mainly schizophrenia) although attenuated features may be present in other non-psychotic diagnoses, such as paranoid personality disorder. Paranoia can also be a side effect of medication or recreational drugs.

Informal definition[edit]

"Paranoia is the delusion that your enemies are organized." — William S. Burroughs
"Paranoia is awareness." — Charles Manson


"Pronoia" was coined by Dr. Fred H. Goldner of Queens College describing a phenomenon opposite to paranoia [4] Long before the term was coined, J.D. Salinger referred to the concept in his 1955 novella Raise High the Roof Beam, Carpenters. In it, the character Seymour Glass writes in his diary, “Oh, God, if I'm anything by a clinical name, I'm a kind of paranoiac in reverse. I suspect people of plotting to make me happy." Science fiction author Philip K Dick referred to pronoia as an antidote to paranoia in his private work, Exegesis, in which it is mentioned in relation to his perceived protection by an entity he called V.A.L.I.S. (Vast Active Living Intelligence System); an ancient alien satellite he believed was the biblical god. [5]


"Narapoia" is a short story by Alan Nelson that originally appeared in The Magazine of Fantasy and Science Fiction, April 1951. In it, the protagonist says to his psychiatrist, "… while I’m walking along the street, suddenly I have this feeling there is somebody just ahead of me. Somebody I’m after. Someone I’m following." He also has non-hallucinations in which a bizarre bird creature he dreams about is real and sitting on top of his radio when he wakes up. Finally all this sends his psychiatrist round the bend, which suggests that the protagonist was really a Scientologist in deep cover.[6]

See also[edit]


  1. Paranoids by Ralph Steadman, Harrap, 1986, p. 104.
  2. [DSM-5. Arlington, VA: American Psychiatric Association. p. 649. ISBN 9780890425541.]
  3. Paranoid personality disorder ‐ International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
  4. Goldner, Fred (1982). "Pronoia". Social Problems (University of California Press) 30(1): 82–91.
  5. Dick, Philip K (2011). Exegesis. (p568, p931). Jackson, Pamela; Lethem, Jonathan, eds. Houghton Mifflin Harcourt.
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