Counseling the Paranoid by David Dunham

Counseling paranoid people can be so frustrating. I rub my eyes a lot. It’s a sign I am getting tired of listening. The guy sitting across from me doesn’t pick up on the visual cues, he just keeps talking. The person who struggles with paranoia lives in a world of their own making. It can be particularly difficult getting through to them, in any form. Offering them Biblical counsel can seem impossible because their legions of conspiracy theories have blinded them to even the possibility of truth. They have an incredibly strong skepticism. In order to be the best help that we can be to them, counselors often have to begin by pulling the rug out from under their skepticism. Counselors can help paranoid people by teaching them to be more skeptical of their skepticism.

Adrian (not his real name) has firm convictions about nearly everything. Most of these convictions are poorly developed; they contain citations from random articles on the web, and are supported by very lucid, if melodramatic, stories of bizarre personal experience. He’s a sweet guy, and he has had a host of rough life experiences. He certainly doesn’t think of himself as paranoid; it’s often all I can think of when we talk. The phrase “brainwashing” slides off his tongue like it were common parlance: “Did you catch the Tigers game the other night?” “I read a really good book this weekend.” “They were attempting to brainwash me at work today, but I refused to let them.” And it’s not just work that attempts to brainwash him, it’s the church, his parents, and sometimes even God himself is involved in the brainwashing. When he discusses various conspiracy theories it can be a real challenge calming him down, or reasoning with him. There are days where I have to cut our meetings short simply because of exhaustion. I rub my eyes a great deal more on those days. Recently, however, Adrian is making some progress. It’s small but it’s significant, and it all started when he learned to be more uncomfortable with his own certainty.

The paranoid person is skeptical of nearly everything and everyone. Those in authority are particularly suspect. But from where does the confidence to critique these individuals and institutions come? How are they able to be so certain of their skepticism? This is an important question to ask. The truth is that my friend has every reason to be skeptical, but I want him to see that his skepticism does not go nearly deep enough. He is quick to discredit the government, the media, and the church, but he shouldn’t be so confident in his own abilities to discern what is true and false. The prophet Jeremiah wisely said, “The heart is deceitful above all things, and desperately sick.” The heart is deceitful, that means it is untrustworthy. “Who can understand it?” The prophet asks. Adrian’s heart chooses to see and believe what it wants; he has no reason to trust its interpretation.

There is no basis for rational thought apart from God Himself. If there is no God, if the world is the result of random chance happenings then how can we believe the mind, the product of random chance, is capable of cogent, honest, and rational thought? How can we trust it? The non-theist claims that his reason is reliable, but he proves such arguments by appeals to reason. This is a circular argument of the narrowest kind. It’s the equivalent of saying, “I believe my mind is right, because my mind convinces me it is right.” But apart from a greater foundation for rational thought, reason simply isn’t reliable. Adrian needs to learn to distrust his mind.

For that matter, he should distrust his mind in so far as he is unwilling to submit to God too. For, the mind in rebellion against God is no more reliable than the mind that rejects Him. The noetic effects of sin reveal that the mind, like the heart, is deceitful. It plays tricks on us. Furthermore, the reality of our mental limitations requires us to seek out wisdom higher than our minds, to seek out a guide to help us navigate the world of sin and brokenness which would disturb, alter, and delude our thinking. This is not to say that Adrian can’t have any cogent thoughts, but only that he has no basis for believing those thoughts while he rebels against God. Adrian needs God to validate even his skepticism. To help my friend I will take him to the depths of his skepticism. As his foundation begins to dissolve he is becoming more open to hearing the Word of God.

The goal for my time with Adrian each week is not to pick apart every conspiracy theory he espouses. Not only would this be exhausting, but it would be counterproductive. At one level he will never trust my critiques, thinking that they too have been shaped by those who control the dominate narrative of the day. On another level, though, to pick apart his theories would be to suggest that they have some level of credibility. To spend all afternoon arguing with a man who is not thinking rationally would mean suggesting to him that he is in fact thinking rationally. Instead I want to expose his hubris and his inconsistency. Without God he has no reason for his certainty. Without a solid foundation and a touch more humility he is only deluding himself. Don’t waste your time picking apart the beliefs of paranoid people, rather in love go to the ground floor and blow up their foundation.

In the process of counseling my friend several keys have been vital in helping him to take even small incremental steps. First, I have been asking more questions instead of attempting to constantly rebuke his poor reasoning. I ask questions about how he knows what he knows. I ask questions about why he trusts those whom he trusts. I ask why he doubts those whom he doubts. He doesn’t, of course, always listen to the questions, and sometimes his answers are non-answers, but on occasion the questions have caught him off guard and he has been forced to admit, “I don’t know.” It’s a start. Secondly, I challenge him with the possibility of truth and of his own limitations. He has readily admitted to me that he can be wrong, so we talk about times when he has been wrong. What did that mean for him? How did he come to that conclusion? How did he respond? He also already accepts that others can be right, after all when they agree with his conclusions he embraces their reasoning. So we talk about what it might look like for someone to be right when they don’t agree with him. Slowly we are working through the challenges to his own acceptance of external truth. Finally, we discuss often who God is. The reason he has trouble believing in truth is fundamentally because he doesn’t realize that truth is a person. You cannot reason an irrational person to the knowledge of the truth, this takes more than competent philosophical or even counseling skill. To bring Adrian all the way I need the Spirit of God to awaken him. So no matter how many times he has heard it, rejected it, attempted to refute it, or simply ignored it, I keep telling him the gospel. I trust that the Spirit will use this to awaken him to truth. It’s truly his only hope.

Adrian still struggles, but over time I am seeing improvement. He may pause now after he starts to say something. He thinks about it. On occasion he recognizes his arrogance. “I know, I need to be more humble,” he says after making a bold and fanatical claim. He has allowed me on several occasions to speak to him about the whole and complete Gospel message without shutting down or tuning out. He asks more questions, himself. Sometimes even asking me what I think about a subject. That is something he has never done before. Over time he has lost some of his confidence. It’s still a fight, and most days we still end up talking about how everyone is out to get him. But even these little changes are significant for a man who has spent years deluding himself.

Sin does amazing things to the mind. As we counsel those who suffer from and indulge in paranoid beliefs we need to keep that truth before us. Apart from submission to God they have every reason to be skeptical, but we need to help them take their skepticism as far down as it will go. Help them to become skeptical of themselves. Only then will they start to listen for and hear the voice of truth again.


Though I am a trained counselor, I am not an expert in mental illness. In the above content I am offering suggestions based on both a particular philosophy of counseling and on practical experience in counseling paranoid people. It is important that we always seek wise counsel whenever trying to offer help to those with mental illnesses.

David Dunham is an associate pastor at Cornerstone Baptist Church in Roseville, Michigan. He is a graduate of Ohio University (BA) and Southern Baptist Theological Seminary (MDiv).

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