The Truman Show Syndrome

Imagine a typical day in someone’s life today: you wake up to stories that disappear in 24 hours on WhatsApp, Instagram, and Facebook. CCTVs and sometimes security drones are a normal part of your daily life; you are under surveillance wherever you go. GPS tracking is something that is as common as asking someone the way on the street. You have accepted this as a part of your life. Now, imagine something similar yet very intimidating: someone living with the belief that their daily lives are being monitored and telecast or broadcast for the entertainment of others. Every moment, every move, every action of theirs is out there for people to see, inspite of them being unwilling to have their lives being subjected to such scrutiny.

But the catch here is, in addition to being something that is not what they signed up for, it is also a delusion that although not formally a part of the DSM, is being observed at alarming levels. The Truman Show Delusion (that has been named after the movie, The Truman Show) is a phenomenon that has, therefore, earned a place in the scientific literature. It was first described in 2006, written up in academic journals in 2012, and now is the subject of a fascinating new book called “Suspicious Minds” by NYU psychiatrist Joel Gold and his brother Ian Gold. In the words of Gold and Gold, “…a novel delusion, primarily persecutory in form, in which the patient believes that he is being filmed, and that the films are being broadcast for the entertainment of others. We describe a series of patients who presented with a delusional system according to which they were the subjects of something akin to a reality television show that was broadcasting their daily life for the entertainment of others”

Dr. Joel Gold met Albert, his first “Truman patient” in 2003 while working as an attending psychiatrist at Bellevue Hospital. Brian, a visual artist, who was admitted soon after, believed that he was living a secretly taped life. There was a computer engineer, an MIT professor, a lawyer — all of whom believed the same thing: They were on camera. Gold, as of 2014, had collected over 100 cases. “I started to think: There’s something really going on here,” he said. “What struck me was how all-encompassing the Truman Show Delusion is.”

Ever wondered what are the factors that might lead someone to experience this delusion? There are speculations that researchers make. “It’s important to state that Truman Show delusion is a symptom of psychosis,” Joel Gold says. “People who choose to be the centre of attention, have concerns about social standing, or who may fear being in public eye or seek it out, may be more drawn to identify with this delusion. I don’t think people are making it up or choosing it.” Both Golds are careful to say that the Truman Show delusion is not a new diagnosis, but rather, as Ian Gold says, “A variance on known persecutory and grandiose delusions.” Although some psychologists scoff at the notion that cultural Zeitgeist can shape delusions, the phenomenon has precedence. In the era of technology not existing, people’s delusions were shaped by factors such as people physically following them, people stalking them, watching their post and mail services. Now with progress in technology, it is implanted brain chips, video stalking and location tracking. With the advent of Reality TV and internet, such delusions don’t seem out of the ordinary (case in point, Bigg Boss).

There are other reasons as well. A suggestion by Dr. Max Coltheard really helps to put things in perspective in the present context. He claims that people who have been part of or experienced strange or stressful personal or social experiences and have no way to find a logical explanation for them may reach illogical conclusions about what’s happened with their lives. The death of a loved one affecting someone so much so that they cannot grieve, the 9/11 attacks are some such events that can trigger the Truman Show Delusion. Dr. Joel Gold, meanwhile, posits that the human brain is armed with a “suspicion system” that warns us when people nearby harbor malevolent intentions toward us. All of us have had experiences with this system. Under the right circumstances, this system might go off when it is required. But sometimes it goes off when it shouldn’t, so people begin to see deceitfulness where there is none in people’s expressions, movements, or words. And it builds up conspiracy theories and games akin to today’s reality shows. However, it is very interesting to note that if a person has never seen The Truman Show or experienced reality television or ubiquitous surveillance cameras, they are effectively immunized against Truman Syndrome. They may have other psychoses and paranoia, but to an incredible extent, certain manifestations of mental disease occur only or primarily in specific cultural contexts, and the Truman Show Delusion is definitely one of them. Gold and Gold concluded that cultural insights into delusions are an essential part of understanding how phenomena like the Truman Show Delusion operate.

Life for such individuals is never easy. And as there is no formal diagnosis, treatment options are limited. So, what can be done for these individuals who think they are trapped inside a reality show and can’t escape? It seems that the treatment is similar to the treatment for schizophrenia or other chronic paranoid disorders – hospitalization, medication and being kept under close supervision of a psychiatrist. Many of the Truman Syndrome patients do make significant recoveries and nothing seems to explain why some snap back to reality and others persist in madness—performing for an imaginary audience that never tires of persecuting them, and waiting for a season finale or a movie premiere that never comes up, ensuring their freedom from the performance.

Priya Baid