When Life Is Like a TV Show

As a director of psychiatrics at New York's Bellevue Hospital Center, Joel Gold has seen thousands of delusional patients. But a few years ago, he began noticing a different sort of paranoia: young white men who believed they were the subjects of their own reality-TV shows. Some, says Gold, who with his brother has written a preliminary paper and hopes to author a larger study, seemed pleased by their roles—excited by the anticipated million-dollar payout. Others were tormented. One came to New York to check whether the World Trade Center had actually fallen—believing 9/11 to be an elaborate plot twist in his personal storyline. Another came to climb the Statue of Liberty, believing that he'd be reunited with his high-school girlfriend at the top, and finally be released from the "show."

Grandiose, paranoid delusions are a staple among schizophrenics and psychopaths. Typically, they apply to one aspect of a patient's life—say, irrationally believing a spouse is cheating. But these patients, much like Jim Carrey's character in the 1998 film "The Truman Show," believe their entire lives are being broadcast, and that everyone is in on the joke. The numbers are small—Gold has observed only five firsthand and has heard from or about more than a dozen since—but he and others think "The Truman Show Delusion," as Gold now calls it, is the pathological product of our insatiable appetite for self-exposure. Delusions are often related to the larger cultural and political climate: during the cold war some people thought they were being monitored by the KGB. Today, some might think Al Qaeda is after them. When all it takes is a Webcam and the click of a mouse to be seen and heard by millions, and with hundreds of surveillance cameras capturing our movements each day, it's not necessary to go on "Big Brother" to feel like you're in the public eye. "If you have a predisposition to paranoia, going on YouTube and seeing some guy doing something can really shake you up," says Gold. You could think, "Is the world watching me?" Perhaps the key to sanity is knowing that while the whole world isn't watching, someone probably is.

© 2008