Unreality TV and the culture of delusions

Today’s New York Times has an interesting article on the tug-of-war over the cultural influence on paranoid delusions and whether contemporary-themed psychosis is a new form of mental illness or just a modern colouring of an old disorder.

The article focuses on the recent interest in the ‘Truman Show delusion’, splashed over the media by two Canadian psychiatrists.

It’s quite hard to judge what they’re aiming to do as they’ve not published a scientific paper, and the article suggests they’re writing a book (is that the sounds of alarm bells I hear?), so I’m solely going on secondary sources.

But if they’re saying that delusions specifically about being in the Truman Show are somehow new and interesting, then they’re right in a way. Popular culture often turns up in paranoid beliefs – I worked with a gentleman once who believed he was in The Matrix – but its not earth shattering. It happens all the time.

If they’re saying that the general experience of The Truman Show – feeling that the world is being controlled, is unexplainably altered, or is uncannily mysterious – is somehow new, then they’re wrong by a good 100 years.

This was described by the German psychiatrist Karl Jaspers in the early part of the 20th century who called it Wahnstimmung, which is translated in the modern English literature as delusional mood or delusional atmosphere.

This is the description from Andrew Sims’ book on descriptive psychopathology Symptoms in the Mind:

“For the patient experiencing delusional atmosphere, his world has been subtly altered ‘Something funny is going on’; ‘I have been offered a whole new world of meaning’. He experiences everything around him as sinister, portentous, uncanny, peculiar in an undefinable way. He knows that he is personally involved but cannot tell how. He has the feeling of anticipation, sometimes even of excitement, that soon all the separate parts of his experience will to reveal something immensely significant.”

Actually, the article has a quote from me, although miscasts my view a little. I’m quoted as saying:

“Cultural influences don’t tell us anything fundamental about delusion,” said Vaughan Bell, a psychologist at the Institute of Psychiatry at King’s College in London, who has studied Internet delusion.

“We can look at the influence of television, computer games, rock ’n’ roll, but these things don’t tell us about new forms of being mentally ill,” said Dr. Bell, who said he had also treated patients who believed they were part of a reality television show.

Actually, I do think that cultural influences are fundamental in understanding delusions, but not in themselves. [Squiggly sound of tape rewinding] It seems the crucial qualification “in themselves” was missed off the quote.

In fact, in the paper I wrote on delusions about the internet I concluded by saying “The extent of influence may not be equal for all aspects of society and culture, although the fact that there is an influence at all, suggests that psychosis is only fully understandable in light of the wider social context.”

To quote John Donne, “no man is an island” and we can only fully understand or thoughts and behaviour, either everyday or pathological, with reference to the cultures we live in. But this doesn’t mean that each aspect of cultural influences us equally on all levels.

Link to NYT article ‘Look Closely, Doctor: See the Camera?’.

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