“The Truman Show Delusion: Hell is other people.”

Delusions can be wildly irrational, and wildly interesting. Little is know about delusions, and much research focuses on how these thoughts arise and why they are so hard to abolish. But there are lots of interesting questions about delusions that get almost no attention. One of these is: Do delusions change over time and do they differ from culture to culture? Using case material, I describe a new delusional variant known as the Truman show delusion (TSD) which highlights the
question of culture in a particularly striking way. I sketch a theory according to which an evolutionary system used to assess social threat, the suspicion system, can give rise to TSD and other delusions. This theory posits that the social environment is powerful in the shaping of and perhaps even to the development of psychotic illness.