Research suggests that interpersonal difficulties are reported by those who experience grandiose beliefs, however the processes and the relationship with the belief have seen limited exploration and are poorly understood. The present study aimed to explore the perceptions of interpersonal relationships and self-esteem of people who have grandiose beliefs and to explore if these accounts are consistent with existing theory. A qualitative design was employed using interpretative phenomenological analysis (IPA) to explore participants' subjective understanding of experiences. Semi-structured interviews were carried out with eight individuals who were purposively sampled. Transcripts were analysed using IPA. Four superordinate themes emerged: ‘Others as disregarding’; ‘Fragile sense of self’; ‘Lost in a frightening world’ and ‘Surviving’. The study found that participants' accounts were characterised by difficult interpersonal relationships in both early and adult life. The participants' sense of self was complex and lacking in coherence, thus previously used measures of “self-esteem” may not adequately capture the subtleties of the experiences. The sense of self was set in a social context characterised by feelings of powerlessness isolation and lack of trust. In the context of limited resources the results suggest the beliefs function to make sense of experiences and to help the participants survive. These findings confirm that the belief may, in part, serve to protect participants from poor “social self-esteem”. These findings provide avenues to further exploration of processes and provide recommendations for clinicians and services.