Editor’s Note: Ellis Amdur, who runs Edgework Crisis Intervention Resources PLLC out of Shoreline (Wash.) partnered with Olympia (Wash.) Police Department Sergeant John Hutchings to co-author a book aimed at helping police officers become better prepared to handle incidents involving the mentally ill. Below, you will find an excerpt from the book— a full chapter — which focuses on tactics specific to paranoia. Click here to read the excellent book review by PoliceOne Columnist Ed Flosi, and click here to purchase a copy of the book.
Dealing with a paranoid individual can be surpassingly difficult. The person’s motto of life could be summed up in a phrase: “If there is a problem here, that would be your fault.”
The paranoid world is one of dominance and submission: the paranoid tries to dominate the other people in their lives, and is terrified or enraged at being forced to submit.
The paranoid individual (even without delusions) has a consistent attitude of blame, resentment of authority, fear of vulnerability, and an expectation of being betrayed by people they trust. Stimulant users, notably those addicted to methamphetamine and cocaine, frequently display these behaviors.
Book Review: The Thin Blue Lifeline
By Ed Flosi
Every working law enforcement officer has had to handle an event involving a person with a mental illness. With the closure of many mental health facilities and the reliance on the mentally ill patients to self-medicate in the real world, the handling of the patients suddenly became the responsibility of the first responders.
This defined number of “out patients” is only a part of the larger group that may one day snap and become the next call for service. Other people that contribute to this list would include:
1.) Long-term stimulant abusers, 2.) Persons yet to be diagnosed only because they have not been put into the system, and 3.) Returning soldiers with undiagnosed traumatic brain injuries.
The Thin Blue Lifeline: Verbal De-escalation of Mentally Ill and Emotionally Disturbed Individuals. It is one book in a series of eight similar books, each specific to a profession. The book and the series are available for purchase at www.edgework.info.
It is also a very common “solution” that criminals arrive at to excuse any failure. Paranoid people are, at core level, terrified that they will be made vulnerable, but they’re aggressive toward that of which they’re afraid. One helpful image of the paranoid person is an angry porcupine, all quills, with a soft underbelly, hunched over, ready to strike in hair-trigger reaction.
• Paranoid people interpret relaxation as vulnerability. Friendship means letting your guard down. Therefore, they become more paranoid when you begin to establish rapport with them. For this reason, paranoid people are particularly volatile within their families. With paranoid folks with whom you have frequent contact, such as some homeless mentally ill individuals who reside in a downtown core area, don’t be surprised if they suddenly flare up with suspicion or accusations during times that are uneventful or even, within professional limits, friendly.
• Being mistaken or wrong is another form of vulnerability. Rather than admitting wrongdoing or mistakes, paranoid individuals reflexively project negative feelings on the other person. If they feel hate, they believe you hate them. If they have difficulty with their family after you tried to resolve a potentially violent domestic issue, they will claim you set them up by planning this with their family.
• Paranoid people live like detectives. They continually search for evidence to prove what they already know is true. They have ideas of reference, in which they believe that other conversations, glances, or actions are directed at them. They assume that others are conspiring about them, talking about them, laughing at them. Ironically, their reactions, in response to these paranoid ideas often cause others to act in exactly the way the paranoid person expects and fears.
• Paranoid people make others uncomfortable and/or afraid. Because of their aggressive or standoffish behavior, they can make other people uncomfortable or afraid. If they sense fear in you, they expect you to attack, and they will then “attack you back first,” because fear drives their aggression. Even in situations when you do feel threatened, appear calm. (Chapter 8).
Try to Let Them Know What Is Going On • Because paranoid people are so suspicious, they will often quiz you concerning why you’re doing something. Whenever you can, tell them what you’re doing.
• At the same time, you shouldn’t accept being quizzed incessantly. You aren’t required to explain every action. In fact, it might be a tactic to throw you off guard or distract you.
• It often makes tactical sense to say what you’re going to do, so there is no ambiguity.
• Even when you place them into protective custody, explain what you’re doing and why — once they’re secure. You will be dealing with them again, and if they have a sense that you’ve treated them in good faith, things are more likely to go well next time as well.
Physical and Psychological Personal Space with the Paranoid Individual
Many paranoid people are preoccupied, even obsessed with fears that they will be invaded or controlled in some fashion. The more psychotic are often afraid that they will be molested or otherwise sexually violated. Some of the following are, of course, relevant when dealing with any individual, but they’re doubly important with the paranoid individual.
• Maintain the angle. Whether standing or sitting, turn your body at a slight angle, so that physical “confrontation” is a choice rather than a requirement. If you directly face a paranoid individual, you force that person to turn away if he/she doesn’t want to face you. This usually increases their agitation.
• Mindfulness. Never let down your own guard. You’re in an avalanche zone, and anything could set off another slide.
• Differentiate. Paranoid individuals feel safest when you differentiate yourself from them, so that you aren’t interwoven with their delusional fears. Therefore, it is better to be somewhat emotionally distant rather than too warm and friendly.
• Too friendly is as dangerous as a threat. Try to be aware when things are getting too relaxed. It isn’t only about you maintaining awareness. If the paranoid person relaxes, they may suddenly startle, realizing that for a brief moment, they let their guard down. They may respond by exploding to make sure you don’t “take them over.”
• Cover your triggers. Paranoid people may try to provoke you. If you lose your temper, they will feel justified in whatever they do to you as well as it keying into their terror-based aggression. A slang expression for this is “fear biters.” They bark and snarl and when you react, they attack as if you went after them first.
Is there a specific paranoid rage or violence?
There is no specific “paranoid rage.” Instead, paranoia is an “engine” that drives rage in all its various forms, so you will use all the tactics described in Section X. You’ll de-escalate the individual using tactics specific to the mode of rage they’re exhibiting rather than de-escalating “paranoia” itself. Paranoid individuals can exhibit traits of fear, frustration, intimidation, and manipulation. With their focus, however, they’re rarely disorganized. Even so, some disorganized people can experience an “omni-directional dread,” a pervasive terror that is inescapable.
Review: Paranoia and Persecution
The paranoid individual has an attitude that if anything is wrong it is another person’s fault. Whether delusional or not, they see others as conspiring against them or persecuting them.
• Depending on what will prove useful, use any of the standard tactics for delusional people when speaking with a person whose delusions are paranoid. • De-escalate based on the behavior, not the paranoia. • Let them know what’s going on. • Speak in formal tones. Don’t be too friendly. • They will try to provoke you so they can “hit you back first.” • Be aware of both physical and emotional spacing. Maintain a correct distancing, neither too close nor too far. • Differentiate by not being too friendly, and if they’re delusional, clearly separate yourself from their paranoid ideas without getting into an argument with them. • Maintain your calm. The paranoid individual is usually assaultive when they feel under attack, when they perceive you as controlling them, or when they perceive that you are afraid.
• If you do take them into custody, or otherwise control them, let them know what is going on and why. Paranoid individual are most likely to become dangerous when they base their actions on their imagination rather than on reality.