Outline the details of the story. Include the main plot, the central themes and events, the time frame and location and the list of characters.
Select a narrative voice for the story. Writers utilize a variety of narrative styles to enhance and create a paranoid mood or environment. Adopting a subjective voice allows the reader to experience the story and events from the point of view of the main character or protagonist. This helps to blur the line between the psychological state of the character and reality, making it unclear what is real and what is delusional. The subjective voice is often used in the noir films from the 1940s and 1950s. Writing in the objective voice places the characters in a paranoid world. The distinction between reality and delusion still exists but the delusional world is shared by the majority of characters rather than the individual protagonist. The dystopian novels of George Orwell and Phillip K. Dick are examples of this approach. Franz Kakfa's works represents a third approach. He uses an objective narrative voice but the reader is unable to determine if the individual character is delusional or experiencing reality as it is.
Create a list of symbols, allegories and similar techniques to tell the story. One of the essential characteristics of paranoid fiction is that things are not what they seem to be. The world is often experienced as dream-like and confusing. The characters have the feeling that the world is different than it appears to be. An example of allegory is Plato's "Myth of the Cave." In the myth, individuals are chained in a cave and are only able to see the wall directly in front of them. They see shadows of people, animals and trees cast on the wall in front of them and they understand the shadows to be reality. One of of the inhabitants escapes the cave and sees the world outside. He returns to the cave to share his knowledge of reality. The other inhabitants assume he is crazy.
Bring the story to a conclusion. The conclusion of a paranoid story may resolve the delusions or leave them hanging. For example, we may find that the narrator is unreliable. The story he has been narrating is not true at all and we have been deceived. On the other hand, perhaps the story is resolved. The main character comes to see that his delusions are in fact delusions.