Truman Show delusion

The Truman Show delusion 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. It is not officially recognized and is not separately listed in the Diagnostic and Statistical Manual of the American Psychiatric Association, but could be classified as a "Delusional Disorder, Persecutory Type". Truman Syndrome may be a related condition.

Background

The Truman Show is a 1998 comedy-drama film directed by Peter Weir and written by Andrew Niccol. Actor Jim Carrey plays Truman Burbank, 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. As he discovers the truth about his existence, Burbank fights to find an escape from those that have controlled him his entire life.

The concept predates this particular film. Author Philip K. Dick has written short stories and, most notably, a 1959 novel, Time Out of Joint, where the protagonist lives in a created world in which his 'family' and 'friends' are paid to maintain the delusions. Later science fiction novels repeat the theme. While neither of these books shares the reality-show aspects of The Truman Show, they certainly share the concept of a world constructed, by others, around one's personal aspects.

Delusions

Main article: Delusion

Delusions – fixed, fallacious beliefs – are symptoms that, in the absence of organic disease, indicate psychiatric disease. The content of delusions varies considerably (literally only limited by the imagination of the delusional person), but certain themes have been identified – among others, persecution. These themes have diagnostic importance in that they point to certain diagnoses. Persecutory delusions are, for instance, classically linked to psychosis.

Cultural impact

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 showed how 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.

Joseph Weiner, the chief of consultation psychiatry at North Shore University Hospital in Manhasset, New York and associate professor of clinical psychiatry and medicine at Albert Einstein College of Medicine, 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.

Reported cases

There have been over 40 recorded instances of people suffering from the Truman Show Delusion in the U.S., the U.K. and elsewhere. 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 2001 terrorist attacks were not a plot twist in his personal Truman Show, while another traveled to a downtown 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 Bush was a "Judas" brought him to Bellevue 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.

The choice of the name "Truman Show Delusion" by the Golds was influenced by the fact that three of the five patients Joel Gold initially treated for the syndrome explicitly linked their perceived experiences to the film.

Truman Syndrome

In the U.K., psychiatrists Paolo Fusar-Poli, Oliver Howes, Lucia Valmaggia and Philip McGuire of the Institute of Psychiatry in London described in the British Journal of Psychiatry what they referred to as the "Truman Syndrome":

[A] preoccupying belief that the world had changed in some way that other people were aware of, which he interpreted as indicating he was the subject of a film and living in a film set (a ‘fabricated world’). This cluster of symptoms ... is a common presenting complaint in individuals ... who may be in the prodromal phase of schizophrenia.

The authors suggest that the "Truman explanation" is a result of the patients' search for meaning in their perception that the ordinary world has changed in some significant but inexplicable way.

Medical relevance

Despite the cases reported by the Golds, psychiatrists are still hesitant to consider the phenomenon a distinct mental disorder. It is not yet officially recognized and is not a part of the Diagnostic and Statistical Manual of the American Psychiatric Association. The Golds do not say that it is a new diagnosis but refer to it as "a variance on known persecutory and grandiose delusions."

Similar show concepts found in other media and literature

Various BCE/BC:

• Various ancient literature has god-like beings and other beings affecting humans, their affairs, and the world in which they live.
• An ancient prayer/song says "we spend our years as a tale [that is told]." Psalms 90:9b KJV. (Bold added.)
• An ancient proverb says "... and he will direct your paths." Proverbs 3:6b NKJV. (Bold added.)

Various CE/AD:

• c. 27 – 66 AD: Petronius is credited as writing "quod fere totus mundus exerceat histrionem": "because almost the whole world are actors".
• 1599-1600: As You Like It, a William Shakespeare play, has a line in it that begins "All the world's a stage, And all the men and women merely players". See also the "Origins", at the latter's link, for similar works that predate this.
• 2003: "Cancelled" is an episode of the South Park TV series in which aliens make a reality show called Earth.
• 2006: Stranger Than Fiction is a film in which in which a character named Harold Crick finds his life affected by "a disembodied voice narrating events as they happen".
• 2011: The Adjustment Bureau film plot has men making sure that people's lives "proceed as determined by "the plan"", a document attributed to a mysterious character called "the Chairman". The way they do this can be severe at times, causing "accidents" to happen, causing people to have or miss opportunities, freezing people in place, erasing people's memories, implanting various ideas into people's minds in order to sway their decisions, etc. The film does not appear particularly religious in nature, and does not refer to "the Chairman" as a deity.

Similar concepts that can affect a person's view of themselves and the world:

Dreams – Several works play upon the idea that human reality is actually a dream or dream-like experience. For Example:

• "Row, Row, Row Your Boat" (c. 1800s) is a well-known song that says "Life is but a dream".
• "Shadow Play", a 1961 episode of The Twilight Zone in which the main character believes that "all people he has known in his past ... are playing parts in his dream".
• The film Vanilla Sky (2001). And
• The 2010 film Inception, in which people invade another person's mind, and partially control the person's dream state.

Computer simulation – The idea that human reality is actually some kind of simulation, generated by computer. For Example:

• The Matrix film (and series of films), wherein the entire world is a simulation, with some people being real persons plugged into it; while others are computer programs within the Matrix itself.
• The holodeck in Star Trek (The Next Generation and following), where scenes and people can be generated by a computer.

See also "Reality" article.

References

Notes