"Only the severe end was even considered. There was no sense of spectrum. Paranoia was very much seen as inexplicable, un-understandable, if anything some kind of biological system that had gone wrong. I remember thinking that seemed very reductionalist, that there must be some kind of psychology to it. Once I started looking at it as a spectrum, once you make the connection to things such as depression and anxiety, it really opens it up. People with depression have higher levels of paranoia because of a sense of vulnerability and low self-esteem. Anxiety is linked too. But whereas anxiety may lead to fearing harm from a spider, or of being humiliated in a social situation, it doesn't lead to a belief that the spider or others intend to humiliate or hurt us. It's the attribution of intent that distinguishes paranoia."