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Book Review

‘Suspicious Minds’ by Joel Gold and Ian Gold

28book "Suspicious Minds" by Joel Gold and Ian Gold.

A growing number of people believe they are being watched. Some live in cities where surveillance cameras abound. Some have found their way into the National Security Agency’s databases. Some are members of the Kardashian family. Only a few are, in fact, delusional.

For these few, already prone to psychosis, the hypersurveillance of the digital age has become a hook on which to hang a set of false beliefs as old as madness itself: that external forces are influencing their thoughts and manipulating reality. Thematically, these delusions aren’t much different from those of an 18th-century Welshman who became famous for his conviction that he was being watched and controlled by spies using an “Air Loom,” which manipulated waves of animal magnetism using what was, at the time, the cutting-edge technology of pneumatic chemistry.


In our time, the Air Loom delusion has given way to what Joel and Ian Gold call “the Truman Show delusion”: the belief that one is the unwilling star of his own reality show, his every action filmed and broadcast to millions of viewers. In “Suspicious Minds,’’ their incisive, insightful new book, the brothers describe the disorder as both novel in content and ancient in form, and fundamentally illuminating of the way that culture can both contribute to mental illness and influence the shape it takes.

Joel, a psychiatrist, first encountered a patient suffering from the Truman Show delusion not long after the terrorist attacks of Sept. 11, 2001, when national tensions ran high and government surveillance reached unprecedented levels. The patient complained of an experience he compared to “The Truman Show,’’ the 1998 movie starring Jim Carrey as Truman Burbank, whose life is televised without his knowledge or consent until he realizes that his island home is a stage and the people on it merely players, paid to act as his friends and neighbors.


Like Truman, Gold’s patient believed that the events in his life — including the 9/11 attacks — were being staged to evoke ratings-worthy responses from him. In the years that followed, when a number of other patients reported similar beliefs, Joel and Ian, a professor of philosophy and psychiatry, began to ponder the implications of this increasingly common malady.

Through their collaboration, the two concluded that the accepted theory that psychosis boils down to the purely biological (so many misfiring neurons) was wrong and that culture (technology, ideas, and possibly the Kardashians) can do real mental harm. Interwoven with their theoretical discussions of mental illness are anecdotes about some of the many delusional patients Joel has treated. In both anecdote and argument, the voice is clear, witty, and engaging; the tone is by turns entertaining and alarming.

The book opens with a recounting of how psychosis has been explained and treated throughout history, from Galen to Freud to the dawn of the psychopharmacological era in the 1970s. While the biological model still predominates, the authors argue, it’s far from flawless. “Despite the tremendous advances that neuroscience and psychiatry have seen,” they write, “we still don’t have anything like a theory of mental illness that is good enough even to be wrong.”

After summarizing some well-established evidence for environmental influences on mental illness (higher schizophrenia rates have long been observed among immigrant groups, city dwellers, and victims of child abuse), the brothers Gold propose an intriguing new hypothesis to account for delusions: a malfunctioning “Suspicion System,” in which the cognitive system that has evolved to alert us to possible danger breaks down, becoming so overloaded by an abundance of real and perceived external threats that it can no longer discriminate between justifiable wariness and paranoia.


While this theory doesn’t discount neuroscience entirely, it does suggest that people with a genetic predisposition for illnesses such as schizophrenia and bipolar disorder may be at greater risk of developing psychosis now than ever before. Taken to its logical conclusion, the Golds’ hypothesis means that the Suspicion System is more likely to overload in the Internet age, as the boundary between public and private further erodes. Though careful to point out that almost no research has been done on the connection between the Internet and psychosis, they frame their own suspicion as a question, asking, “Can our culture be making us crazy?”

Jennifer Latson is writing a narrative nonfiction book about Williams syndrome. Follow her on Twitter @JennieLatson.