Mind and Body

Dr. Keith: Is Your Life Like a Reality TV Show?

Recently, two Montreal psychiatrists Drs. Ian and Joel Gold, who are also brothers, revealed the clinical histories of five patients they said suffered from a new condition: "The Truman Show Delusion." The patients believed their lives had ceased being spontaneous and were being scripted and broadcasted as reality TV shows to viewers around the world.

The name of this new condition derives from the 1998 movie starring Jim Carrey, "The Truman Show." In the film, Carrey's character, Truman Burbank is a happy-go-lucky guy - until he finds out his entire life is the subject of a reality TV show, his friends are actors and there are hidden cameras everywhere.

Psychiatrists have long known that psychosis can include "ideas of reference," in which patients believe they are the subjects of intense special interest by others, including strangers. But the Gold brothers correctly noted in their patients the belief had gone global and specifically involved the notion that others knew of them because they had essentially become stars of their own TV shows.

While these patients are the extreme, I've noticed elements of the same breaking with reality (in favor of TV-inspired fiction) in several patients, too. For example, a young man I recently treated dismissed my concern that his grades were plummeting, his family relationships were straining and he had been arrested for driving under the influence by stating, "Yeah, but I'm kind of like that guy in that show, the one who works in the restaurant, who's got his whole life coming down on him, but ends up making it all happen for himself, anyhow."

I actually had to remind him that that actor was playing a role, while on the other hand, he was living a real life. I reminded him of this many times during our work together.

In these cases, there has been a ceding of the person's own life story to the notion that it's all a drama, all entertainment. A DUI arrest thereby becomes an episode in a story that doesn't really touch its protagonist, because it's all part of an act, anyhow.

Perhaps the data suggesting that self-esteem in young people is increasing, as their performance levels on aptitude tests actually decline, is also linked to this phenomenon. The scores don't matter. Truth doesn't matter. Perception matters. And that detachment from oneself and others increasingly feels, to some of my patients, a lot like watching a reality TV show.

This concern about the bending of reality went national in this country in an unlikely place: Presidential politics. Senator John McCain's advertisement linking Barack Obama to Paris Hilton and Britney Spears (whether or not you agree with the idea) suggested that Obama is a candidate merely playing a candidate--like that Escher drawing of a disembodied hand drawing a hand, with no end to the fantasy.

McCain's assertion that Obama is "acting," not genuine, occurs against the backdrop of the mortgage bubble bursting and the banking crisis unfolding. That's why his advertisement may have hit home. We Americans are learning the hard way what happens when our institutions bend reality.

One thing is for certain: A delusion cannot be maintained forever. The truth always wins.

That's why the Gold brothers were talking about their patients, not fascinating, happy folks they had met on the street. Ultimately, the price of pretending is psychological pain. And, always, the road back to well-being is a road that ends in coping with reality and making one's life or one's nation everything it can truly - truthfully - be.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, "Living the Truth: Transform Your Life through the Power of Insight and Honesty" has launched a new self-help movement. Check out Dr. Ablow's website at livingthetruth.com.

Keith Ablow, MD is a psychiatrist, and was host of the nationally-syndicated "Dr. Keith Ablow Show." He is a former member of the Fox News Medical A Team.