Schizophrenics used to see demons and spirits. Now they talk about actors and hidden cameras – and make a lot of sense
Clinical psychiatry papers rarely make much of a splash in the wider media, but it seems appropriate that a paper entitled ‘The Truman Show Delusion: Psychosis in the Global Village’, published in the May 2012 issue of Cognitive Neuropsychiatry, should have caused a global sensation. Its authors, the brothers Joel and Ian Gold, presented a striking series of cases in which individuals had become convinced that they were secretly being filmed for a reality TV show.
In one case, the subject travelled to New York, demanding to see the ‘director’ of the film of his life, and wishing to check whether the World Trade Centre had been destroyed in reality or merely in the movie that was being assembled for his benefit. In another, a journalist who had been hospitalised during a manic episode became convinced that the medical scenario was fake and that he would be awarded a prize for covering the story once the truth was revealed. Another subject was actually working on a reality TV series but came to believe that his fellow crew members were secretly filming him, and was constantly expecting the This-Is-Your-Life moment when the cameras would flip and reveal that he was the true star of the show.
Few commentators were able to resist the idea that these cases — all diagnosed with schizophrenia or bipolar disorder, and treated with antipsychotic medication — were in some sense the tip of the iceberg, exposing a pathology in our culture as a whole. They were taken as extreme examples of a wider modern malaise: an obsession with celebrity turning us all into narcissistic stars of our own lives, or a media-saturated culture warping our sense of reality and blurring the line between fact and fiction. They seemed to capture the zeitgeist perfectly: cautionary tales for an age in which our experience of reality is manicured and customised in subtle and insidious ways, and everything from our junk mail to our online searches discreetly encourages us in the assumption that we are the centre of the universe.
But part of the reason that the Truman Show delusion seems so uncannily in tune with the times is that Hollywood blockbusters now regularly present narratives that, until recently, were confined to psychiatrists’ case notes and the clinical literature on paranoid psychosis. Popular culture hums with stories about technology that secretly observes and controls our thoughts, or in which reality is simulated with virtual constructs or implanted memories, and where the truth can be glimpsed only in distorted dream sequences or chance moments when the mask slips. A couple of decades ago, such beliefs would mark out fictional characters as crazy, more often than not homicidal maniacs. Today, they are more likely to identify a protagonist who, like Jim Carrey’s Truman Burbank, genuinely has stumbled onto a carefully orchestrated secret of which those around him are blandly unaware. These stories obviously resonate with our technology-saturated modernity. What’s less clear is why they so readily adopt a perspective that was, until recently, a hallmark of radical estrangement from reality. Does this suggest that media technologies are making us all paranoid? Or that paranoid delusions suddenly make more sense than they used to?
The first person to examine the curiously symbiotic relationship between new technologies and the symptoms of psychosis was Victor Tausk, an early disciple of Sigmund Freud. In 1919, he published a paper on a phenomenon he called ‘the influencing machine’. Tausk had noticed that it was common for patients with the recently coined diagnosis of schizophrenia to be convinced that their minds and bodies were being controlled by advanced technologies invisible to everyone but them. These ‘influencing machines’ were often elaborately conceived and predicated on the new devices that were transforming modern life. Patients reported that they were receiving messages transmitted by hidden batteries, coils and electrical apparatus; voices in their heads were relayed by advanced forms of telephone or phonograph, and visual hallucinations by the covert operation of ‘a magic lantern or cinematograph’. Tausk’s most detailed case study was of a patient named ‘Natalija A’, who believed that her thoughts were being controlled and her body manipulated by an electrical apparatus secretly operated by doctors in Berlin. The device was shaped like her own body, its stomach a velvet-lined lid that could be opened to reveal batteries corresponding to her internal organs.
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