The Truman Show Delusion

truman by Gary Neill

The Truman Show delusion, informally known as Truman Syndrome, is a type of persecutory/grandiose delusion in which patients believe their lives are staged plays or reality television shows. The term was coined in 2008 by brothers Joel and Ian Gold, a psychiatrist and a neurophilosopher, respectively, after the 1998 film ‘The Truman Show,’ about a man who discovers he is living in a constructed reality televised globally around the clock. Since he was in the womb, all the people in Burbank’s life have been paid actors.

The concept predates this particular film. It was based on a 1989 episode of the ‘Twilight Zone,’ ‘Special Service,’ which begins with the protagonist discovering a camera in his bathroom mirror. This man soon learns that his life is being broadcast 24/7 on TV. Author Philip K. Dick has also written short stories and, most notably, a novel, ‘Time Out of Joint’ (1959), in which the protagonist lives in a created world in which his ‘family’ and ‘friends’ are paid to maintain the delusions.

Delusions – fixed, fallacious beliefs – are symptoms that, in the absence of organic disease, indicate psychiatric disease. The content of delusions varies considerably (limited by the imagination of the delusional person), but certain themes have been identified, for example, persecution. These themes have diagnostic importance in that they point to certain diagnoses. Persecutory delusions are, for instance, classically linked to psychosis. The content of delusions are invariably tied to a person’s life experience, and contemporary culture seems to play an important role. A retrospective study conducted in 2008 indicated that delusional content has evolved over time from religious/magical, to political and eventually to technically themed. The authors concluded that: ‘sociopolitical changes and scientific and technical developments have a marked influence on the delusional content in schizophrenia.’

Psychiatrist Joseph Weiner commented that: ‘…in the 1940s, psychotic patients would express delusions about their brains being controlled by radio waves; now delusional patients commonly complain about implanted computer chips.’ The Truman Show Delusion could represent a further evolution in the content of persecutory delusions in reaction to a changing pop culture. Because reality shows are so visible, it is an area that a patient can easily incorporate into a delusional system. Such a person would believe they are constantly being videotaped, watched, and commented upon by a large TV audience.

Joel Gold, a psychiatrist at Bellevue Hospital Center in New York City, and a clinical assistant professor of psychiatry at New York University, and his brother Ian, who holds a research chair in Philosophy and Psychiatry at Montreal’s McGill University, are the foremost researchers on the subject. They have met, since 2002, with over a dozen individuals, primarily white men between 25 and 34, suffering from the delusion. They have reported that one patient traveled to New York City after 9/11 to make sure that the terrorist attacks were not a plot twist in his personal ‘Truman Show,’ while another traveled to a Lower Manhattan federal building to seek asylum from his show. Another patient had worked as an intern on a reality TV program, and believed that he was secretly being tracked by cameras, even at the polls on Election Day in 2004. His shout that then-President George W. Bush was a ‘Judas’ brought him to Bellevue Hospital and Gold’s attention.

One of Gold’s patients, an upper-middle class Army veteran who wanted to climb the Statue of Liberty in the belief that doing so would release him from the ‘show,’ described his condition this way: ‘I realized that I was and am the center, the focus of attention by millions and millions of people … My family and everyone I knew were and are actors in a script, a charade whose entire purpose is to make me the focus of the world’s attention.’ It has been suggested that the delusion is a result of the patients’ search for meaning in their perception that the ordinary world has changed in some significant but inexplicable way. The Golds do not say that it is a new diagnosis but refer to it as ‘a variance on known persecutory and grandiose delusions.’ Additionally, the rapid expansion of technology raises questions about which delusions are possible and which ones are bizarre.

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