My older brother suffers from schizophrenia and one of his recent positive symptoms included the Truman Show delusion, in which he believed people were covertly recording him, watching him when he was alone and broadcasting his actions to an unknown audience. The implications are extremely distressing. What was even more shocking to me was that this delusion isn’t uncommon.
While the “Truman Show delusion” doesn’t appear in the Diagnostic and Statistical Manual, research conducted on patients who have shared this belief suggests it has to do with the popularity of reality television shows. This is also an era of NSA surveillance and Edward Snowden. Googling “Am I being watched?” will easily turn up with conspiracy theories that are ready to confirm “You absolutely are.”
When I tell people about my brother Pat’s delusion, they usually ask what I said, what I told him to calm him down. At this point, I know enough not to try to talk him out of his delusions. It may make him stop talking about it, but it doesn’t set him at ease. He doesn’t know who is watching him or why. He doesn’t present much evidence, if any, to support his suspicions, but that doesn’t change anything. He still won’t go to bed; he still thinks an audience is watching him brush his teeth.
Articles on this delusion have recently appeared on WebMD, the New York Post, and Popular Science. Three patients in the WebMD article actually “specifically referenced the movie.” This article from BuzzFeed says a man named Nicholas Marzano sued HBO in federal court for allegedly making him the star of a secret reality show:
His suit, filed in April, alleges that HBO has hidden cameras throughout his home, installed controlling devices in his car, enlisted the help of local police, and recruited actors to portray “attorneys, government and law enforcement officials, physicians, employers, prospective employers, family, friends, neighbors, and co-workers,” all so that their show about his life can continue. Marzano also says HBO is keeping him from getting a job or paying his bills, so that he will be forced to remain on the show.
While I never successfully talked Pat out of a delusion (no one ever has), he no longer believes he is the subject of a hidden camera reality show.
“I don’t think that’s really an issue anymore,” he says.
It’s something that can always come back, in some form or another. All his delusions are persecutory and usually related to covert surveillance.
But since his recovery from active phase psychosis we have discussed the Truman Show delusion. He found it very interesting. He always loved that movie. But he doesn’t recognize that it has anything to do with something he was convinced of just a few months ago. He doesn’t identify with the syndrome.
Ironically, we both agreed that the Truman Show, realistically, is something that never would have worked. Truman Burbank would have been used to all the things that seemed weird to him in the movie. He’d experience strange occurrences his whole life and since he never knew any other way, he wouldn’t suspect anything was amiss. If he walked into something he thought was a bathroom but turned out to be a breakroom for the extras, it would just be one of many times something like that happened in his life.
He wouldn’t be shocked when a bus driver didn’t know how to drive the bus. He’d be used to things happening over and over again — a lady on a bike passes by and then a dented Volkswagen circling his block all evening. He’d think it was normal for someone to pop out of his birthday cake and shout “I’m on TV!” Strange noises, fortuitous timing and circumstances, drama, the same person passing by his house all day — these would be mundane to him. He’d be used to things going wonky every time he tried something spontaneous.
“If he never thought it was weird as a kid, he wouldn’t suddenly think it was weird when he was in his 20s,” Pat agreed.
But even though we can talk about this, it’s something that Pat could become convinced of at any time. Despite being on long-term injectable medication, Pat’s illness is treatment-resistant. He has always had breakthrough symptoms on medication.
If he experiences another persecutory delusion, he won’t be able to reason it out precisely like this. Like I tell our relatives: His mind isn’t broken, it’s just glitchy. So is mine. When I’m really anxious or suffering a depressive episode, I’m not being realistic at all and I’m sure anyone would consider my thoughts scary.
Pat’s delusions aren’t so scary when I think of them as common. From this framework you can see where popular culture influences delusions and maybe creates paranoid thinking to begin with. My brother’s thinking isn’t totally out of left field. All of us have felt a little exposed, a little invaded. Pat just feels it more deeply.