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The Truman Show Delusion: Real or Imagined?

A few delusional people are convinced they are stars of an imaginary reality show, but doctors disagree on whether it's only an act.


Ian Gold says that although TheTruman Show film was played as for laughs, “there was an undercurrent of horror that was really powerful, that captures something of what this artificial environment would be like. Imagine if nobody was authentic [in your life], if every encounter you had was watched and you were utterly alone. The emails I have received since the story broke have brought home to me how terrifying this experience is.”

His brother concurs with the seriousness of the subject matter. Joel Gold has been bothered by some bloggers who have dismissed the Truman Show delusion as frivolous.

“This is a serious mental illness, it’s not silly or a form of narcissism. It’s a severe and persisting mental illness and we don’t want to make light of it. If you think the entire world is fraudulent, that is incredibly distressing.”

Is Pop Culture to Blame?

Does the pervasiveness of reality TV and cultural phenomena like YouTube predict more Truman Show delusion diagnoses in the future? Joel Gold thinks so.

“We’ve got the ‘perfect storm’ of reality TV and the Internet. These are powerful influences in the culture we live in and for some people who are predisposed, it might be overwhelming and trigger a [psychotic] episode. The pressure of living in a large, connected community can bring out the unstable side of more vulnerable people.”

Both doctors deny seeking “fame or glory” and say they are a bit overwhelmed by the media attention. They have been inundated with “wonderful and unexpected” emails and calls from clinicians, patients, and colleagues who are willing to share their stories. They now have worked on about 20 cases.

“The upside of publicity is the chance to study this properly and learn something about it,” Ian Gold says. His brother adds, “The Truman Show delusion asks more questions than it answers.”

The Golds are working on a medical paper that will provide a series of illustrative cases. “Given the recent feedback about our work, Truman Show delusion may be more widespread than we know,” Joel Gold says.

Ian Gold adds, “Reality TV doesn’t cause delusion, but is there something about reality TV that is particularly appropriate for expressing delusion once it has developed? We don’t know yet, but it’s fascinating to explore. There’s something about fame that people respond to. My hypothesis is that delusions have to do with our relationships with other people and the new media creates a larger community with more threats and opportunities.”

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Reviewed on August 06, 2008

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