Paramount Pictures

Just when you thought those annoying Kardashians couldn’t mess with your head any more than they already do, consider “Mr. A.” When he first saw the psychiatrist, he demanded to speak to “the director” of the reality show in which he was starring.

When “Mr. B.” met psychiatric workers, he informed them that he was being continuously taped for national broadcast. “Mr. D.” really was working on a reality show -- until he came to believe that he was the actual star.

All these people, and others, suffered from the delusion that they were serving as entertainment for others. All of them specifically cited the 1998 movie “The Truman Show,” written by Andrew Niccol, directed by Peter Weir, and starring Jim Carrey. In the movie, Carrey plays an insurance man living in a town that’s actually a TV set and populated by actors he thinks are his friends, family and neighbors.

Psychiatrist Joel Gold, in private practice and a professor of psychiatry at New York University, and his brother Ian Gold, a philosopher of psychiatry at McGill University, writing in the most recent issue of the journal Cognitive Neuropsychiatry, dub this the "Truman Show" delusion. They ask “Can a case be made that the phenomenon of reality television might interact with the expression of psychotic symptoms?”

The answer, they argue, is most definitely yes.

They suggest that “reality television resonates with a common anxiety about one’s position in the social hierarchy…. Someone who is particularly anxious about their social status, therefore, might experience reality television as presenting a significant social threat, or a tantalizing possibility of success, or both. In the life of such a person, reality television might act as a significant stress, the effects of which might include a persecutory or grandiose delusion of the Truman Show type.”

It’s not that watching lots of reality TV causes a mental illness (believe it or not). Rather, an existing or nascent illness, like schizophrenia, interacts with the cultural pervasiveness of reality TV to give form to the delusion. It’s a little like those unstable people who go to Jerusalem and experience “Jerusalem Syndrome,” the belief that they’re characters from the Bible.

The Golds wrote the paper because they think the environmental associations with psychosis don’t get enough attention. “We think in North America that it’s overlooked,” he said in an interview.

“We are interested in the way society as a whole has changed,” he said, “With the advent of reality TV and closed circuit TVs in cities such as London where people are truly observed, and the Internet with YouTube, what impact might that have on people otherwise predisposed to grandiosity and paranoia?”

As the Golds point out, delusions fall into a limited number of standard types no matter where the sufferer lives. People from Saudi Arabia tend to have delusions about being covered in sand. People in the U.S. tend to have delusions about being followed by the CIA. The specific content of the delusion can be culturally based.

For example, in this month’s issue of the International Journal of Social Psychiatry, researchers from Maywood University studied records from a state psychiatric institution across the last century and found that while the categories of delusions were the same as today -- such as persecutory, religious or grandiose -- the content of the delusion depended on whatever was happening in the culture at the time.

At the moment, we’re steeped in “reality” television, so it’s no wonder, the Golds suggest, that people with a mental illness might get the idea they’re the next Bethenny Frankel.

Science has not yet pinned down the root biological causes of delusions. A leading theory involves the way the chemical dopamine activates motivational brain circuitry. A person suffering from a delusion may not just notice that there’s an anchorman on TV is wearing a yellow tie, he might attach enormous importance to that fact, and come to believe that the yellow tie is communicating some vital message. The social brain may also be impaired. What scientists call “Theory of Mind” -- the ability to figure out what others are thinking and feeling -- may be misfiring. The brains of the delusional may also be too quick to jump to conclusions about common experience.

“If a car is bearing down on you, you see it as a threat,” Gold explained. “You better get out of the way. Well, there are two blue cars parked outside my home, and two days ago, there was also a blue car. Is there something to that? Is it a threat? You could build a delusion around that.”

Brian Alexander (www.BrianRAlexander.com) is co-author, with Larry Young PhD., of "The Chemistry Between Us: Love Sex and the Science of Attraction," (www.TheChemistryBetweenUs.com)  to be published Sept. 13.

Want more weird health news? Find The Body Odd on Facebook.

NBC

Here's a scene from NBC's new show, "Awake," in which the protagonist, played by Jason Isaacs, experiences two alternate realities.

In the new TV series “Awake,” a detective, his wife, and son, suffer a severe car crash. The detective wakes up. But he seems to live in two realities: In one, his wife is dead and his son lives. In the other, his son is dead and his wife lives. Psychiatrists in each reality tell him the opposite existence is a dream. Yet clues from these parallel lives leak into crime investigations, helping the detective solve them.

Whoa.

But could any such thing happen in real life?

“My first suggestion is that the person who wrote this needs to get some counseling,” offered University of Florida neurologist Dr. Kenneth Heilman. 

That would be a “no.” But similar phenomenon do occur.

Heilman himself has a personal experience with something like it. When his mother was in the hospital after a severe heart attack that had restricted blood flow to her brain, she’d sometimes comment that she couldn’t tell if she was dreaming or was awake.

And he once had a patient with viral encephalitis, an inflammation of the brain, who said the same thing. Dreaming and waking life had become conflated.

Of course, all of us experience this phenomenon when we sleep and dream. In many, maybe most, dreams, we think what we’re experiencing is real because, as Heilman likes to describe it, we’ve engaged the clutch when sleeping and disconnected our reasoning, centered in the frontal cortices.

“That’s why, in the middle of a dream, you don’t think ‘OK, I can’t be hanging on to the top of a double decker bus feeling quite excited but not afraid as the bus charges around Edinburgh,” explained University of Cambridge professor Sue Llewellyn.

We also can have “lucid dreams,” those dreams that occur, often just before we wake, when our reasoning centers in the frontal lobes began to reengage. We’re asleep, and dreaming, but slightly aware. Also, drugs like LSD can induce hallucinations that blur the boundaries between dream and reality.   

Damage to the centers of reasoning and sensory input can create a variety of delusions. Reduplicative paramnesia, for example, was named in 1975 (though it was known as early as 1903) when a doctor realized that a few patients insisted, incorrectly, that the hospital was actually located at another location. Today it’s the insistence by suffers that places, people or events have been duplicated. Parkinson’s disease and strokes can cause the frontal brain lesions that lead to this syndrome, but so can severe trauma.

Like a car accident.  

Related: 

• Alien hand syndrome: When one hand develops a mind of its own
• Engineer lived with a bullet in his head for eight decades
• Un-paralyzed by a crash? Doctors say it's unlikely

Want more weird health news? Find The Body Odd on Facebook.