Dr Monica Sood

2024

Paranoia describes beliefs that others are a threat to us, with limited or no evidence of this. Paranoia is common in people with a psychosis diagnosis (e.g., schizophrenia) and also common in the general population. People in the general population are more likely to experience mild forms of paranoia, for example worrying that “people are talking about me”, whereas people with psychosis often experience more severe paranoia, for example believing that “there is a conspiracy against me”.

There is lots of evidence showing that people with paranoia tend to have insecure attachment styles, meaning that they may not feel comfortable or safe with others, and therefore struggle to manage close relationships. By contrast, people with a secure attachment style feel safe and secure around others and are less likely to have paranoia.

While we know that attachment styles are linked to paranoia, we do not know if attachment styles cause paranoia. My research tests this by looking at whether people with paranoia benefit from a secure attachment visualisation task that aims to bring about feelings of safety and security. In my research, participants listen to a secure attachment visualisation task (to bring about feelings of safety and security) or insecure attachment visualisation tasks (to bring about feelings of insecurity). The results show that, compared to the insecure attachment visualisation tasks, the secure attachment task reduces paranoia.

My research also tests how the secure attachment visualisation task works – how is the visualisation task changing paranoia levels? I found that the task works by changing both what we think (our beliefs about ourselves and others) and how we think (the extent to which we can ‘step back’ from our thoughts and beliefs). More specifically, the secure attachment task reduces our negative beliefs about self and others (what we think) and cognitive fusion levels (how we think) – cognitive fusion describes the extent to which people believe their thoughts as literally true and allow these thoughts to take control of their actions. Some people have high cognitive fusion, meaning that they believe their thoughts are true and therefore may act on them. Other people have low cognitive fusion (termed cognitive defusion), meaning that they can understand that their thoughts are not true and therefore do not need to act on them – they can let their thoughts come and go more easily. My research shows that the secure attachment visualisation task reduces both cognitive fusion and negative beliefs about self and others, leading to lower paranoia levels.

The secure attachment visualisation task can easily be used in psychological treatments (and as a stand-alone tool) to support people’s recovery by fostering a sense of felt security at times of threat. Cognitive defusion exercises that help people to ‘step back’ from unhelpful thoughts and beliefs are likely to be a useful addition to treatments for psychosis to help people feel less paranoid.

This blog is based on the following scientific publication:  Sood, M., Carnelley, K.B., & Newman-Taylor, K. (2021). How does attachment imagery for paranoia work? Cognitive fusion and beliefs about self and others mediate the impact on paranoia and anxiety. Psychology and Psychotherapy: Theory, Research, and Practice, 94(4), 973–993. https://doi.org/10.1111/papt.12354

Dr. Monica Sood, PhD is a Postdoctoral Research Fellow in the School of Psychology, Centre for Innovation in Mental Health and Centre for Research on Self and Identity. Her research is funded by the Economic and Social Research Council, South Coast DTP.