I'm a psychotherapist with a new client who was referred to me by an institution that diagnosed him as paranoid. But I don't quite trust them. Their staff is all-white and my client's black.

He does seem shy, cold and wary to me, but I'm black too, and I've seen snap judgments of black patients way too often...

So I check first for physical causes, and find the man has good reason to be a bit cold. He's part reptile! Part snake. Scaly skin, forked tongue, slit-pupil eyes...

He knows he's reptilian. Knows more than that: says "I know I'm evil, because I'm part snake." Naturally, he was raised among good Christians. Their culturally sanctioned ophidiophobia (gotta love that word!) has messed with his self-image!

Suddenly I see that paranoia is not a disease. Paranoia is a role--a social relationship. You can't be paranoid without people to mistrust! And he's not the paranoid here. They mistrusted him.

His problem isn't paranoia. It's just the opposite. He trusted them too much; he bought their ophidiophobic judgments.

My patient isn't crazy. Just scaly. In a world of fundamentalist mammals who freak at the sight of him.

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