Developments in cognitive therapies and theories for paranoid psychosi
s have constituted a significant breakthrough in our understanding of
this disorder, offering a valid psychological alternative to biomedica
l approaches, which have been criticized on scientific, pragmatic, and
ethical grounds. However, we have recently found evidence for two typ
es of paranoia which, together with other conceptual and empirical wor
k, show these cognitive theories to be insufficient. We propose an int
erpersonal theory of the self, which places the cognitive, emotional,
and behavioral aspects of paranoia within a broader context of the per
ron. In this article, we (a) survey cognitive theories and the alterna
tive interventions they imply; (b) describe new findings on two types
of paranoia, which imply the need for significant theoretical adjustme
nts; and (c) propose and describe a modified theory of paranoid threat
and defense of the self, which, we argue, more adequately explains th
e phenomena.