Paranoia is a mixture of anxiety, hypervigilance, catastrophizing, an internalized bad object, referential ideation, and grandiosity. It involves Anxiety, Splitting, and Misattribution. The world is a hostile and dangerous place: Hypervigilance. I need to be on my guard because I am targeted.

Reactive paranoia: mortification, gaslighting, alloplastic defenses, conspiracism. Catastrophizing: Something really bad is going to happen. Internalized bad object: I am bad or I did something wrong and I deserve to be punished. Guilt often leads to paranoid ideation.

Grandiosity: I am sufficiently important, envied, or interesting to be the target of a malevolent conspiracy with malign intent. Grandiosity can be charismatic - or contemptuous. Charismatic grandiosity is misperceived by others as vision and self-confidence and is attractive. Contemptuous, haughty grandiosity - holding all people in contempt as completely inferior to you - is rejected and hated by people, especially people whose own grandiose or narcissistic defenses are triggered by it.

Sometimes paranoid ideation is an outcome of deepset insecurities and social anxiety and referential ideation (ideas of reference).

Sam Vaknin is a former Visiting Professor of Psychology, Southern Federal University, Rostov-on-Don, Russia and a professor of clinical psychology and business management in CIAPS (Commonwealth Institute of Advanced Professional Studies), Cambridge and Birmingham, UK; Ontario, Canada; and Lagos, Nigeria. Sam Vaknin is the author of Malignant Self-love: Narcissism Revisited and other books about personality disorders. His work is cited in hundreds of books and dozens of academic papers.