How to Respond to Paranoid Accusations

Co-authored by Hyungbum Kang, MA, MSW, LCSW, MAC and Nihal Shetty

Last Updated: April 4, 2022 References

When a loved one or friend makes paranoid accusations, it can feel difficult, scary, and confusing. There are several different mental health conditions that can cause paranoia, including schizophrenia, paranoid personality disorder, borderline personality disorder, or Alzheimer’s. A lack of sleep or the effects of recreational drugs can also result in someone making paranoid accusations.^{[1]
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Trustworthy Source
Mind
U.K.-based mental health charity focused on providing advice and resources to anyone facing mental health problems.
Go to source} No matter the cause, there are several important things to keep in mind when dealing with paranoia. We’re here to help with this guide on how to respond to paranoid accusations.

1

Treat them with empathy.

Arguing with paranoia can make things worse. No matter how many rational arguments you might have for why someone’s paranoid thinking doesn’t make sense, it’s best to put these aside for the time being. Reasoning with upset individuals is not reasonable.^{[2]
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Expert Source

Hyungbum Kang, MA, MSW, LCSW, MAC
Licensed Clinical Social Worker
Expert Interview. 22 July 2021.} Trying to prove them wrong can make someone experiencing paranoia feel attacked. Instead, empathize with their experience of fear and uncertainty.^{[3]
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Expert Source

Hyungbum Kang, MA, MSW, LCSW, MAC
Licensed Clinical Social Worker
Expert Interview. 22 July 2021.} You can say something like:^{[4]
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- “I can understand why you’re upset. If I thought that my neighbors were planning to hurt me, I’d feel a lot of fear too.”
- “I know that it must be scary to feel like you can’t trust anyone around you.”

2

Speak slowly and with simple language.

Paranoia can make people feel confused, so be clear and direct. Someone experiencing paranoia may be feeling like their thoughts are moving too quickly and out of their control. When speaking to someone who is going through this experience, it’s important that you try and make sure that your language is as unambiguous as possible. Speak in short, direct sentences, and be prepared to repeat yourself calmly if necessary.^{[5]
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- For example, you might say something like, “Would you like to take a seat? I think we might feel more comfortable if we sit down.”

3

Validate and redirect their fears.

Put them at ease by explaining you understand their accusations. Then, point out to them why you don’t see things the same way in as friendly a tone as possible. By both validating their fears and providing an alternative explanation, you may be able to help someone with paranoia adopt an alternative point of view. Try saying something like:^{[6]
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- “I know that your husband not returning your calls makes you worried. I think that it could be the case that he really has been busy at work and hasn’t been able to reach you—I know I ignore my phone when this happens to me.”
- “I can see why all of the houses having their lights off might be unnerving. The way I see it, I feel like most people in the neighborhood decided to get away for the long weekend.”

4

Tell them what you’re going to do before you do it.

Narrating your actions can calm a paranoid person. Someone experiencing paranoia might feel suspicious about all of your actions, so by addressing them explicitly, you can help assure the paranoid person that you aren’t doing anything behind their back. For example, you might say something like:^{[7]
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- “I’m going to open the door now. There’s no need to be alarmed when I come in—I don’t mean to cause you any harm.”
- “I’m going to use my phone to call your sister. You can watch me do this if you want to.”

5

Give them personal space.

Paranoia can cause people to distance themselves. Respect this distance, and avoid coming close to them unless they specifically request it. Giving someone experiencing paranoia their personal space can keep them from feeling threatened by you. Stand or sit at a respectful distance from them, without blocking any exits.^{[8]
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PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}

6

Keep the environment as calm as possible.

Loud noises or too many people can be very stressful. If someone is experiencing paranoia, it’s a good idea to try and reduce the amount of things in the environment that could be adding to their stress. This might mean turning on the lights, moving them into a place with fewer people, or turning down any music playing in the background.^{[9]
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7

Switch their focus to another activity.

Help someone with paranoia not dwell in it for too long. Giving them an activity to do, if they’re up for it, can take their focus off of their paranoid thinking. Paranoid people can feel isolated and distant from everyone else, so offering them an opportunity to help out with simple chores can give them a feeling of belonging. For example, you might say something like:^{[10]
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Trustworthy Source
Alzheimer's Association
Nonprofit organizaton focused on supporting those affected by Alzheimer's and promoting research on the disease
Go to source}
- “I know that your mind must be racing with all kinds of thoughts right now. How about if we clean some dishes together, then come back to this conversation?”
- “You’re going through a hard time right now. Maybe you would want to spend some time with me in the garden? I saw some weeds out there that need to be pulled.”

8

Talk to them about their episode when they’re calmer.

Treat episodes of paranoia as learning experiences for you. For some people, paranoid accusations might be the result of an episode of psychosis, and once the episode ends, they'll return to being calmer and more rational. Although you’re probably feeling thankful just to be done with this stressful experience, revisiting what happened can help you understand what your loved one needs from you during future moments of paranoia.^{[11]
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- Say something like: “I’m glad you’re feeling calmer. How about if we talk about what happened?”
- If they falsely accused you of something, you can have an open discussion with them.^{[12]
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  Expert Source
  
  Hyungbum Kang, MA, MSW, LCSW, MAC
  Licensed Clinical Social Worker
  Expert Interview. 22 July 2021.}

9

Discuss treatment options with them.

Bring up treatment only when someone is calm. Being told that they need mental health treatment can create a lot of anxiety and fear in someone struggling with paranoia. Try not to use medicalizing terminology. Instead of saying things like “You’re paranoid” or “You have a mental health disorder,” tell them something like “I think you’re really struggling, and could use a stress-free conversation with a therapist. Could I help you find an appointment?”^{[13]
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- This might be a conversation that you have to revisit a number of times. Be persistent in offering help, but know that it might take time before they agree to seek it out themselves.^{[14]
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  National Alliance on Mental Illness
  Grassroots mental health-focused organization providing resources, support, and education for those affected by mental illness
  Go to source}

10

Try not to take their accusations personally.

Someone’s disordered thinking doesn’t say anything about you. When someone is experiencing paranoia, they might lash out at you in ways that can feel personal and damaging. It’s important to take a step back and have some perspective in moments like this. The person with paranoia is also in a great deal of suffering, so try to treat them with gentleness.^{[15]
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- If someone’s accusations have gone too far and they present a genuine threat to your physical safety, you may have to get emergency services involved.^{[16]
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  Trustworthy Source
  National Alliance on Mental Illness
  Grassroots mental health-focused organization providing resources, support, and education for those affected by mental illness
  Go to source}
- If you do call 911, tell the operator that you’re dealing with a psychiatric emergency and need someone trained in crisis intervention.^{[17]
  X
  Trustworthy Source
  National Alliance on Mental Illness
  Grassroots mental health-focused organization providing resources, support, and education for those affected by mental illness
  Go to source}

11

Forgive yourself for making mistakes.

You won’t always respond perfectly, and that’s okay. It’s natural to sometimes get too defensive when faced with hurtful accusations. But if this is something that you experience with this person on a regular basis, remember that you’ll get better at dealing with these episodes over time. Accept that you won’t always react with perfect calm and poise—you’re only human.^{[18]
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Trustworthy Source
National Alliance on Mental Illness
Grassroots mental health-focused organization providing resources, support, and education for those affected by mental illness
Go to source}
- Remember to take care of yourself and spend time away from the orbit of your loved one who experiences paranoia. Eating, sleeping, and exercising well is important to maintain your mental strength.
- If you feel a lot of stress from dealing with your loved one’s paranoia, this is completely understandable. It might be a good idea to talk to a therapist to process your emotions.

Expert Q&A

Question

How can I console a friend when they are upset?

Hyungbum Kang, MA, MSW, LCSW, MAC
Licensed Clinical Social Worker
Hyungbum Kang is a Licensed Clinical Social Worker based in Honolulu, Hawaii. With over a decade of experience, Hyungbum specializes in using an integrated therapeutic approach to treat ADHD, Anger Management, Depression, and other mental health and social work struggles. He received a Bachelor’s degree in English and Master’s degrees in Sociology and Social Work. Hyungbum earned an MBA from Hawaii Pacific University (HPU) and is working on his Doctor of Psychology from HPU. He is a member of the American Psychological Association, the International Honor Society in Psychology, the National Association of Social Workers, and the California Consortium of Addiction Programs and Professionals.

Hyungbum Kang, MA, MSW, LCSW, MAC

Licensed Clinical Social Worker

Expert Answer

Finding out why your friend is upset is not the first step. Staying with their feeling is the first step. You can say, " I am with you" or " I understand that you are upset." Reasoning with upset individuals is not reasonable.
Question

How can you deal with someone who falsely accuses you?

Hyungbum Kang, MA, MSW, LCSW, MAC
Licensed Clinical Social Worker
Hyungbum Kang is a Licensed Clinical Social Worker based in Honolulu, Hawaii. With over a decade of experience, Hyungbum specializes in using an integrated therapeutic approach to treat ADHD, Anger Management, Depression, and other mental health and social work struggles. He received a Bachelor’s degree in English and Master’s degrees in Sociology and Social Work. Hyungbum earned an MBA from Hawaii Pacific University (HPU) and is working on his Doctor of Psychology from HPU. He is a member of the American Psychological Association, the International Honor Society in Psychology, the National Association of Social Workers, and the California Consortium of Addiction Programs and Professionals.

Hyungbum Kang, MA, MSW, LCSW, MAC

Licensed Clinical Social Worker

Expert Answer

When someone falsely accuses you of something, you should have a reasonable open discussion with them. If you like, you can gather a few pieces of evidence to show that you are innocent.