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Key points
- Listening to people with unusual beliefs can alleviate stigma and promote healing.
- Often the best strategy is not to try to get rid of the beliefs but help people live well in spite of them.
- It may be useful to look for a history of trauma, abuse, or neglect that the beliefs might be a response to.
Paranoia is often defined as the delusional belief that one is being persecuted or harassed by others. It’s often seen as a symptom of a serious mental disorder such as schizophrenia, delusional disorder, or sometimes bipolar disorder. The mainstream psychiatric approach is to diagnose and medicate it, often with antipsychotic drugs.
A problem with the mainstream approach is that people who have these unusual beliefs often feel unheard, despite the fact that psychiatrists are trained “not to argue” with the patient. The feeling that they’re not being listened to can, in turn, increase social isolation, frustration, and paranoia.
It was precisely this feeling of not being listened to that led Peter Bullimore, who himself has a history of paranoia, to try a new approach—a non-judgmental support group that would give people practical tools to live well. That support group turned into an organization, the National Paranoia Network. I interviewed Peter about his own history and why it's time for a new approach.
Justin Garson (JG): What led you to think there was something fundamentally wrong with the status quo?
Peter Bullimore (PB): I spent quite a lot of years in psychiatric care. And for me, everybody focused on the voices. It wasn't the voices, it was the paranoia behind the voices that caused me problems because I was sexually, physically, and emotionally abused by three people in authority for eight years when I was a child. Eventually I had a breakdown and went into psychiatric care.
But the problem was, everybody was focused on the voices, not my belief system. My belief was that I can't trust people in authority, but all the staff on the wards were authoritarian to me. Every time I tried to talk about my experiences, they said, “No, Peter, I've heard all this before. It's part of your illness.” I was being ignored and nobody was getting to the root cause of the problem. I stopped talking about it because I felt no one would listen.
So, you need to listen to what the person's saying. Without a comprehensive narrative, you will never, ever understand people's experiences with paranoia and beliefs. What the system's got to start to do is see it through the person's eyes. If you try and see through your own eyes, you just won’t understand it. [Peter’s testimony and that of many others can be found in a recent anthology he co-edited, Making Sense of Paranoia.]
JG: How did you start the support network?
PB: It started in 2004. I received a phone call from a community psychiatric nurse, and he told me he was working with a guy, and he said he just doesn’t know what to do with him. I said, give him the office address. About a week later, a very big guy turned up. Disheveled, very suspicious, we were chatting for about an hour. I said to him, “What are your interests?” He said paranoia. “Pete, I know I'm paranoid. I don't know why.” I said, “Why don't we set up a paranoia support group and we'll learn from others?”
We found a room in an old school, so it's not medicalized. We put a flyer together, and flooded Sheffield with it. The criticisms we received were absolutely unbelievable. We got the old cliche, that people would be so paranoid they wouldn’t attend, or that we shouldn't use the word “paranoid” and pathologize people.
I didn't think anyone would come. The first meeting, 15 people walked through the door. One guy hadn’t left his apartment for five years, and he made a 45-minute journey on his own across the city to be there. I said to him, “Do you mind me asking why you've come?” He said: “I thought there was only me.”
People don't realize people have similar experiences. It just broke down so much social isolation. But the more the stories people were telling, you could see the seed of truth in their beliefs. This is not a “mental illness.” This is a perfectly normal reaction to difficult life experiences.
JG: If somebody has paranoid thoughts, how do you get them to change their mind? How would you try to get someone to switch belief systems?
PB: We wouldn't try and get rid of them. We try and make them secondary. I think the important thing is, if you don't understand a belief system, don't collude to get drawn into a world you don't understand. But don't dismiss either. Be honest and say, “I don't share your beliefs, but what do they mean to you?” It's what we call the fit. It’s making sense of what can be a very confusing reality.
A lot of people think of paranoid beliefs as symptom of a disease. They don't realize that they can have a protective function. Sometimes they are ways of coping with a difficult situation or past trauma. So, we're not going to try and get rid of those beliefs. We're going to make them secondary so the person can function in this world.
JG: What kind of services do you provide to mental health professionals?
PB: Along with Sandra Escher and Marius Romme [founders of the Hearing Voices Network], I developed the Maastricht Interview with a Person who Experiences Paranoia. [This is a structured interview to help understand a person’s distressing paranoia or beliefs, what sort of experiences trigger them, and some of the deeper problems that may have prompted the paranoia or beliefs, such as abuse or other trauma.] We've trained nearly 15,000 people now in this new approach. We've actually got specialist centers set up now, in America and Australia, that use this approach.
JG: Anything else you’d like to leave us with?
PB: My friend John Read, professor of psychology at the University of East London, has shown how important the link is between childhood trauma (or other adverse experiences) and getting a diagnosis of schizophrenia. The evidence that paranoid thoughts can be a protective response to childhood trauma is out there, but we're hiding behind a biogenetic model. That's why we should be saying to people: What's happened to you? Not: What's wrong with you?
