Review: Paranoia a 21st Century Fear

The world, say Freeman and Freeman, is a dangerous place.  Yet it has always been so.  Why then, they say, may paranoia be on the rise and why do one in four of us regularly have paranoid thoughts?*  ‘Paranoia the 21st Century Fear’ is a pocket sized book that seeks to answer these questions. 

Writing a book about a single psychiatric symptom is always going to be tricky, so perhaps I should be more generous than I am going to be about this reasonable attempt.  But for all the claims about this book’s wit and thought provocation, it reads more like an academic textbook that has had the word ‘lite’ placed after its title, and the pitch altered accordingly. 

A good deal of ‘Paranoia’ is taken up with the nature of paranoia and its identification, especially in the light of recent research.  Much of this has been undertaken at the IoP by Daniel Freeman himself where an interesting, and widely reported, study used virtual reality technology to place study participants in a tube train full of avatars.  The avatars have all been programmed to display neutral behaviour, yet many people experienced hostility.  Also interesting are the Freemans’ analyses of paranoid thought in The Winter’s Tale and the unforeseen consequences of submitting to paranoid thought patterns whereby many more children will die from road accidents than would otherwise have been the case as a result of paedophile-fearing parents driving them to school.

It is in these latter broadly societal factors where this book is the weakest.  Human society has changed much faster than the human mind.  Although there are informative pages on the effects of burgeoning urbanisation on mental health, little effort is made to construct a synthesis on wider causes of paranoid thought beyond that of simply discussing psychopathology.  For instance, people in developing countries may be less ‘paranoid’ but they also have fewer possessions to lose;  what connection then between increased material possessions and perceived vulnerability? And who stands to gain?  In this matter I direct curious readers towards the work of master documentary maker Adam Curtis

Most concerning, are the final paragraphs of the book where the authors sum up their position:

[Paranoia’s] amazingly widespread, resilient and creative – and it may well be on the rise.  But it can also be beaten.

To do so requires measures targeted at society as a whole, and at individuals.  Governments must play a major role with the former.  We need a ranger of policies to raise public awareness of paranoia; train therapists; and tackle the effects of potentially damaging social and economic trends. 

I’ve always hoped that tackling the effects of potentially damaging social and economic trends is what governments exist to do.  However well meaning, the Freemans thus seek to promote paranoia from a distressing symptom to a disease-in-the-making which may harm as many people as they seek to cure.  And, this aside, there can be almost nothing more guaranteed to send a vulnerable person into a spiral of suspiciousness than a poster reading ‘Don’t be paranoid: we’re here to help’. 

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* This, of course, is somewhat shaky:

The book lists five surveys (pg 9), of which one is:

‘A French survey of 462 adults found that 25% had, at some point in their lives, felt that they were being persecuted in some way.  10.4% had sometimes believed there was a conspiracy against them’.

Far from being an overestimate, I’m surprised that a survey asking such a broad question didn’t field a result closer to 100%.  Does this really mean anything? 

If you were to ask a cohort of patients ‘what bothers you the most in life?’ many of them will probably say things like ‘my boyfriend is really pissing me off’ or ‘I haven’t got any money’; quite a lot of people will frame things differently, and say they’re ‘depressed’.  This latter evaluation sounds simple, but actually involves a complex interaction of individual distress and societal values. 

I suspect it won’t be long before people are saying ‘it’s just that I’m so paranoid doctor’: you find the thing for which you seek….

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Sample of the first five pages

Article in the Guardian Suspicious Minds 10 March 2009

6 Responses to “Review: Paranoia a 21st Century Fear”

  1. Paul says:

    I have to agree that wider social and political factors weren’t discussed in great detail in that book. It has a distinct bottom-up feel to it. Although they are advocates of a continuum approach, Freeman and colleagues’ understanding of fear of harm from others in the general population seems more influenced by their understanding of the unrealistic fear of harm encountered in the clinic*.

    I’d also agree that turning fear of harm from others into a psychological phenomena can have adverse and regrettable consequences, including those you mention. I also think more needs to be done to assess the actual harm people have experienced or will experience. Apart from Freemans’ virtual reality experiment, most studies of paranoid thinking in the population have not controlled for actual threat, which is somewhat problematic.

  2. It’s interesting to think on the question ‘how scared should we be’. I remember reading an article by pseudophilospher Alain de Botton following the 9/11 attacks where he advocated considering all the things that might go wrong in a day in order to foster preparedness (I can’t find it online alas). On 9/12 being seriously concerned about nuclear war, which seems like an over reaction seven years later.

    I feel that in the review above I did Freeman and Freeman a disservice by not mentioning that I have tried to read a book on the history of paranoia, Joanna Bourke’s Fear: Cultural History but it was something of an anti-page-turner. to the best of my knowledge no one has written any sort of thesis on current cultural forces.

  3. Paul says:

    I came across another relevant book in Waterstones – recently published it’s called ‘A Philosophy of Fear’ by Lars Svendsen – a Norwegian philosopher. Review in the Guardian

    It’s quite a slim volume and looks interesting. Not quite sure if he gets out of his armchair and does any actual research though!

    On a marginally related subject I note none of the theory of mind studies in people with a schizophrenia diagnosis have controlled for levels of fear or anxiety experienced by this group, despite Frith, Corcoran, and others suggesting this might play a role in persecutory delusions and psychosis more generally. In fact very few studies have looked at affect and theory of mind. I’ve a hunch that regulating 2nd or 3rd order theory of mind skills is not particularly adaptive when faced with imminent threat, and that if they compared people classified as psychotic with, say, soldiers, prison inmates or refugees, then any difference might vanish.

  4. Frontier Psychiatrist says:

    As a final titbit on this subject, I’ve often found it interesting how people and therefore societies are often mutually antagonist towards ‘others’, which could be classified as a variety of paranoia.

    Consider for instance, the names that syphilis was given during its initial outbreaks:

    French disease in Italy and Germany
    Italian disease in France.
    Spanish disease in Holland
    Polish disease in Russia
    Christian disease” by the Turks and
    British disease by the Tahitians

    Source Wikipedia (of course)

    This in part reflects that it was spread by invaders, but does suggest a willingness to embrace the idea of threat from an outside agency.

  5. Declan Flynn says:

    The book Beyond Fear by Dorothy Rowe is about the best look at emotional and psychological distress which always involve fear and anxiety or defences against such. She is a psychologist of vast experience and wisdom who deserves to have more influence than she currently does. Her work is very interesting but has also been of considerable practicable use.

  6. [...] of the third chimpanzee is informative about hunter gatherers and is a generally excellent book Paranoia: a 21st century disease is informative about urban living and its effect on mental [...]

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