The sociocultural context of racism influences the behaviors of Black men and may reflect healthy paranoia (Sue, Capodilupo, & Holder, 2008). No published studies however, have directly examined the sociocultural experiences that influence Black men’s endorsement of paranoid-like behaviors. An online study was conducted with a nonclinical sample of Black men (N = 104) who completed the Millon Clinical Multiaxial Inventory–III (MCMI-III) Paranoid scale (Millon, Millon, Davis, & Grossman, 1994) and reported why they endorsed certain items. Responses to weighted items on this scale were analyzed using modified consensual qualitative research (CQR) procedures (Spangler, Liu, & Hill, 2012). The results indicated that this sample of Black men endorsed items reflective of clinical paranoia because they have life experiences that make them mistrustful. Their item responses were systematically categorized into the following categories: (a) life lessons learned in close relationships, (b) negative experiences at work or school, and (c) experiences living in oppressive contexts. Participant responses also reflected coping strategies categorized as: (d) personal coping (through awareness, acceptance, and meaning-making), (e) relational coping (through analysis and boundary enforcement), and (f) coping with systemic oppression. These results suggest that adaptive coping with life experiences may be misinterpreted as paranoia when the sociocultural context is not carefully considered.