New York, NY, USA. Several psychiatric patients think their lives are filmed and broadcast like The Truman Show. Three of them even refer to the movie by name.

Millions of words have been written about the effect of Reality TV on our cultural and social lives. Much less discussed are the possible interior ramifications such forms of broadcasting can have on our minds.


The Truman Show depicted Jim Carrey’s character as a man unaware that the intimate details of his life are being shown every day to a global audience of millions. As the realisation of his true predicament gradually dawns, he begins to exhibit symptoms and behaviors indistinguishable from what the real world would understand as a persecutory delusion. The closer to the truth he gets, the crazier he seems.

Joel Gold, M.D. is Clinical Assistant Professor of Psychiatry at the NYU School of Medicine and was an Attending Psychiatrist at Bellevue Hospital Center for nine years, where he continues to teach and supervise training psychiatrists.

He is a Research Fellow at the Center for Urban Epidemiologic Studies (CUES) of the New York Academy of Medicine and has a private practice in Manhattan.

Ian Gold, PhD, is the Canada Research Chair in Philosophy and Psychiatry at McGill University.

His research covers the philosophies of psychiatry and neuroscience, with current work on delusion in psychiatric and neurological illness.A new investigation into this subject by Joel and Ian Gold appears in the journal Cognitive Neuropsychiatry. Their paper describes several real-life patients engaged in a reversal of the movie’s plot — their symptoms recall Truman’s, without the knowledge that their attempts to understand the "truth" of their situation will afford them a happy, Hollywood ending.

The report looks at the phenomenon from three directions:

• the first describes and characterises The Truman Show delusion;
  
  
• the next looks at the role that cultural objects and influences can play in shaping clinical delusions; and
  
  
• the third discusses the implications of this cultural study of delusion, and how it effects our existing understand of how delusions work.

Although it might sometimes feel like it, it’s not the case that watching reality TV can trigger psychotic or delusional episodes. But underlying illnesses such as schizophrenia can react with "reality"-saturated TV schedules to shape and colour the nature of the delusion the patient experiences — sometimes creating forms that, observed from outside, seem curiously half-familiar.

The preliminary result of the investigation shows that while particular delusional ideas are culture-sensitive, the broader categories of the types of delusion people suffer from tend to remain the same across time and cultural influence.

The authors conclude that cultural studies of delusion are to become an essential part of understanding how such conditions actually operate.