The psalmists sometimes wrote about the ‘enemies’ and the ‘evil-doers’ who sought their destruction. However, a close reading of these verses suggests that at least in some instances the psalmist is describing his own paranoid ideation or possibly even paranoid delusions rather than real enemies. Thus, in Psalm 31 there is a description of paranoia, threats conspiracy, fears of being killed and auditory hallucinations.

Ps. 31:13 ‘For I hear whispering threats from roundabouts while they conspire against me. They scheme to take my life.’

Malign thoughts attributed to others, combined with fears of being killed and a feeling of being watched are described in Psalm 56.

Ps. 56:5 ‘All day long they seek to injure my cause, All their thoughts are against me for evil, They stir up strife, they watch my steps, as they hoped to have my life’.

Such thoughts may have occurred in the context of a depression because a few verses later on the psalmist writes: 56:8 ‘You have kept count of my tossings, put my tears in your bottle, Are they not in your records?’ The combination of a paranoid illness and depressive symptoms suggest this writer might have been suffering from a psychotic depression. Paranoid ideas of reference with feelings that others are talking about them are given in Psalms 22 and 69.

Ps. 22:7 ‘All who see me mock at me, they make mouths at me, they shake their heads.’ Ps. 69:12 ‘I am the subject of gossip for those who sit in the gates, and drunkards make songs about me.’ A little further on in Psalm 69 there is a description of delusions of being poisoned, combined with a rare psychotic symptom of gustatory hallucinations where the person complains of an altered sense of taste.

Ps. 69:21 ‘They gave me poison for my food, and for my thirst they gave me vinegar to drink.’ It is of course possible that the author was given vinegar to drink, but unlikely that he was given poison for his food because he would have been dead or too ill to write about it. An altered sense of taste is often combined with delusions of being poisoned and this particular combination occurs in paranoid illnesses, especially among the elderly.

Theologians have usually considered that the persecution described by the psalmists was real but have been puzzled by who might lie behind it, as well as what its sociocultural significance might have been. Yet the thoughts and actual words used in these verses echo strongly the sentiments expressed by patients with paranoia and delusions.