Excessive mistrust has become ubiquitous. The stakes are high: when mistrust gets out of hand the consequences — both for individuals’ mental and physical wellbeing and for society in general — can be catastrophic. Yet, though we are increasingly willing to discuss our depression or anxiety problems, paranoia is rarely discussed and, as such, generally little understood. In this talk Prof Freeman will describe his advances in understanding and treating severe paranoia. This will include the development of the Feeling Safe programme, the most effective treatment for persecutory delusions, and the use of immersive virtual reality (VR) to help patients relearn safety, overcome mistrust, and reengage with activities.