Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Professor Daniel Freeman, clinical psychologist, explains how delusions may be unfounded but they cause real distress and misery for sufferers - who feel constantly unsafe. He set himself the challenge of finding an effective treatment, a decade later he and colleagues have unveiled Feeling Safe, which shows real benefits for trial participants and, he hopes, a step change in the treatment of severe paranoia.

Professor Daniel Freeman
'I was too paranoid about going out. Thinking someone's going to stab me. I was housebound. Purely just paranoia. I missed out on so many things in life. I'd lie in bed, and I'd be thinking that tomorrow something's going to happen, something's going to happen. It would play on my mind 24/7.'

This fear of other people is common among people diagnosed with severe mental health disorders such as schizophrenia. Largely unfounded, often unrelenting, and wearyingly upsetting, these intensely paranoid thoughts are known as persecutory delusions. People feel very unsafe. Also typical is the response: when being out and about is so frightening, staying at home can seem the only way to cope. But there are consequences for both mental and physical health. For example, three quarters of patients with severe paranoia have suicidal thoughts. Life expectancy is on average 14.5 years shorter, due to conditions such as high blood pressure, diabetes and heart disease - illnesses to which inactivity is likely a significant contributory factor.

Given the distress caused by persecutory delusions, treatment is critically important. Usually, people are prescribed anti-psychotic medications. They certainly can help, but only about a quarter of patients have a good response. Moreover, these drugs can trigger unwelcome side-effects. Sometimes medication is combined with psychological treatment – specifically something called cognitive behaviour therapy (CBT) for psychosis. Again, some people get real additional benefit, but all too often the paranoia persists.

There has been, then, plenty of scope for improvement in the treatment of persecutory delusions. So, I set myself an ambitious target: to produce a psychological therapy that would lead to recovery in persecutory delusions for 50% of patients for whom anti-psychotic medication had not succeeded. That half of patients would no longer believe that their fears were true. The Feeling Safe programme, developed with colleagues over the past decade, is the result of that effort.

Read the full story on the University of Oxford website.

Similar stories

PhD Student of the Year 2022 Winner!

Congratulations to Nuffield Department of Women's & Reproductive Health DPhil student Josephine Agyeman-Duah on being named winner of PhD Student of the Year at the Postgrad Awards 2022.

Ethics at Westminster: A Workshop on Public Values and the Pandemic

At an event organised by the UK Pandemic Ethics Accelerator at the House of Commons on 18 May 2022, parliamentarians, policy makers and academics joined together to discuss how to bring ethical thinking and debate into public policy on pandemic recovery and preparedness, and how to involve the public.

Student Prizes for Biomedical Sciences and Medicine 2021-2022

Congratulations to all our Biomedical Sciences students and Medicine students who have been awarded prizes during the 2021-2022 academic year.

New study finds that politicians typically enjoy longer lives than general populations

New data show politicians have a considerable survival advantage over general populations, based on information from 11 countries and over 57,500 politicians. In some countries this survival advantage is at the highest level for 150 years, and life expectancy at age 45 was found to be around seven years higher for politicians compared to general populations in certain countries.

Five ways the pandemic has affected routine medical care

Since the beginning of the pandemic, COVID has infected at least a third of the UK population and is estimated to have factored in the deaths of almost 200,000 people in the UK. But critically, COVID has also had a devastating impact on our healthcare systems. While this was expected, new evidence is beginning to reveal the scope of the issue – in particular the effects for people living with long-term health conditions.