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Does the internet influence delusional thinking? From the perspective of psychiatry, the answer is without a doubt, yes. The internet, along with other technological developments, has clearly impacted the content of delusional beliefs among those with mental illness. A century ago, people suffering from psychosis often had delusions about being possessed by the devil or being the victims of witchcraft. Nowadays, it’s much more common to hear delusions centered on technological themes.1-4
A businessman complains of the government monitoring and controlling him through computer terminals. A college freshman finds secret messages discussing plots to kill her within the comments of articles she reads online. An aspiring writer says that he’s certain that his consciousness has somehow been uploaded onto the internet.
In recent years, a seemingly new phenomenon called the “Truman Show Delusion” has emerged. This delusion, consisting of the belief that one is constantly being filmed for a reality TV show, has received attention through psychiatrist Joe Gold’s book Suspicious Minds: How Culture Shapes Madness and his numerous interviews in the popular media including The New Yorker, New York Post, and This American Life.
And yet, the ubiquity of technological themes among delusions doesn’t necessarily mean that technology or the internet causes people to become delusional. Instead, it’s thought that delusions are merely drawn from and echo popular cultural themes. But if delusions are just byproducts of popular culture, what makes them pathological?
While we often use the term “delusion” casually in lay speech, its technical definition, according to the 5th Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is as follows:
Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. Their content may include a variety of themes (e.g., persecutory, referential, somatic, religious, grandiose)…The distinction between a delusion and a strongly held idea is sometimes difficult to make and depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity.
In clinical practice, it can sometimes be hard to determine what is or is not a delusion. This is in large part because normal human beings believe in all sorts of things for which evidence and counter-evidence are lacking, such as whether there’s a God or an afterlife.5 In the absence of objective evidence, psychiatrists therefore sometimes assess delusionality based on how much a belief differs from popular opinion. Accordingly, the most readily identifiable delusions are those that are the most preposterous, implausible, and unshareable, but held with extreme conviction nonetheless. Often such beliefs have a self-referential quality. For example, it might not be so hard to find those who agree that, hypothetically speaking, the devil can talk to people. But it’s probably going to be much harder to find anyone who would agree that they devil is actually talking to you, telling you to rob banks.
Only now, in the age of the internet, that may be less true. A hundred years ago, you might search an entire town and still not find anyone who buys into your unconventional belief. But these days you can search across the entire planet with the simple click of a button, vastly increasing your chances of finding support.
On the positive side, the internet’s reach offers us the chance to expose ourselves to different cultures and different ways of thinking that could foster creativity, critical thinking, and positive aspects of divergent non-conformity. But it also provides a potential source of danger, especially when people treat information online as fact, whereas in reality it conflicts with objective evidence. Let’s look at some examples outside the psychiatry of mental illness and delusions, focusing instead on the main theme of Psych Unseen—the psychiatry of everyday life and belief.
A few years ago, I served as an expert witness in a federal case involving a man charged with tax evasion. In talking with him, he espoused with great certainty the belief that he didn’t have to pay taxes because he didn’t believe that the U.S. Tax Code was actually law. While such an unusual belief raised the question of delusional thinking, he displayed no signs of mental illness and had received more than his share of advice from like-minded “tax deniers” through the years. A little online research revealed that there is in fact a sizeable “tax denier” or “tax protestor” movement in the U.S., with myriad websites, books, and in-person seminars providing ample “evidence” for his beliefs. Since his belief was widely shared, there was little basis to conclude that he was delusional. And yet, he was without question wrong (see here for an item-by-item rational rebuttal to typical tax denier claims) and in the end, he was found guilty and sentenced to a lengthy prison sentence.
Then there’s the tragic story of Heaven’s Gate, the religious group who believed that the key to ultimate spiritual transcendence meant casting off the material body and hitching a ride on a passing spaceship believed to be hiding in the tail of the Hale-Bopp comet. In 1997, 39 members of Heaven’s Gate formed an “away team,” taking a lethal overdose of barbiturates to complete their ascension. Lest we dismiss this as delusional thinking or cultish nonsense, consider that the rumor of a UFO trailing Hale-Bopp didn’t emerge within Heaven’s Gate as a part of their religious dogma. Instead, it had been popularized in the late night paranormal radio show Coast to Coast AM with Art Bell, with actual photographs of the UFO (appearing as a amorphous white spot; see above) on several different websites. In short time, analysts debunked the rumor and the photographs as a hoax, but perhaps the damage had already been done. In an article in Skeptical Inquirer, Thomas Genoni Jr. suggested that fraudulent evidence and lack of journalistic integrity contributed to mass suicide within Heaven’s Gate, while quoting Bell as saying, “I’m not going to stop presenting my material because there are unstable people.”
On the one hand then, for a belief to be sharable detracts from its delusionality, especially when objective evidence is lacking. But on the other hand, the internet seems to have created a space for false information and unsubstantiated opinion to masquerade as objective evidence, even when good evidence to the contrary exists. Internet hoaxes abound, online information is replete with subjective bias and incendiary commentaries, and often what we read on the web is just plain wrong. Sometimes buying into such information can get us into real trouble.
By providing us with a daily dose of potentially unreliable information, the internet lays the groundwork for delusional thinking. But recalling the DSM-5 definition, a delusion must not only be “false”—as much as it can be falsified—but also held with extreme conviction. Recent research suggests that beyond the unreliability of online information, the way we consume information from the internet can also lead to unwarranted levels of conviction associated with our beliefs.
For example, Michela Del Vicario and colleagues analyzed Facebook data and found that people tend click on information that conforms to their own belief systems, while ignoring the rest. This is an online demonstration of our brain’s inherent tendency for “confirmation bias.”6 Furthermore, sharing posts tends to occur among homogenous groups of like-minded individuals, effectively creating online “echo chambers.” In other words, when digesting information on the internet, we tend to read things that support what we already believe. We then preferentially share this information with those who are most likely to agree with us. This suggests that when we’re online, we avoid exposing ourselves to different viewpoints, limiting our learning potential along with the opportunity for critical feedback that might temper unrealistic beliefs.
In a similar vein, Yale psychologist Matthew Fisher and colleagues have recently demonstrated that searching for information on the internet inappropriately boosts “cognitive self-esteem,” inflating our confidence about what we think we know well beyond what we do actually know.7 We also seem to use the internet as a “one-way transactive memory partner”—a kind of portable memory bank—giving us the false impression that we possess information in our minds, whereas the information is actually only accessible online. The internet therefore seems to “blur the line between what we know and what we think we know,” an effect an article in Wired magazine labeled “the Google delusion.”
To make matters worse, these biases aren’t just the fault of our brains. It turns out, they’re also built into the programs that we use online everyday. Eli Pariser, author of The Filter Bubble: How the New Personalized Web is Changing What We Read and How We Think, has called attention to the fact that our Google searches, Facebook feeds, and Amazon recommendations all tailor information to our perceived personal preferences. They effectively “showing us what we want to see, but not necessarily what we need to see.” Pariser likens this narrowing of exposure to online information to being trapped inside a “filter bubble” and in a 2011 TED Talk, noted that:
“…we’ve actually been here before as a society. In 1915…you couldn’t have a functioning democracy if citizens didn’t get a good flow of information…newspapers were critical because they were acting as a filter, and then journalistic ethics developed. It wasn’t perfect, but it got us through the last century. And so now, we’re kind of back in 1915 on the Web. And we need the new gatekeepers to encode that kind of responsibility into the code that they’re writing…we really need…to make sure that these algorithms have encoded in them a sense of the public life, a sense of civic responsibility…Because I think we really need the Internet to be that thing that we all dreamed of it being. We need it to connect us all together. We need it to introduce us to new ideas and new people and different perspectives. And it's not going to do that if it leaves us all isolated in a Web of one.”
And so, in the final analysis, does the internet promote delusional thinking? No and yes. We’re not really talking about true delusions in the clinical sense of the word. The internet doesn’t make us mentally ill or psychotic—it’s normal, and often healthy, to have unconventional beliefs. But our brains already shut out conflicting evidence and with the internet, we amplify this process on a daily basis as we’re navigating information online. On top of that, the internet itself is wired to make confirmation bias even more likely, potentially hiding information that might dampen our convictions and give us a healthy dose of cognitive flexibility—the ability to take on other people’s viewpoints.
A recent Washington Post article claimed that Donald Trump is responsible for bringing “fringe news” into the mainstream. But it’s not really Trump’s doing—the shift of news and media to the internet years ago widened the river of accessible information. This created muddied waters that contain unconventional beliefs based on little evidence right alongside more reliable, fact-checked information. With biased brains operating in online echo chambers and filter bubbles, our convictions about our personal ideas, which have always included a range of unconventional and false beliefs, have soared. We’re not delusional exactly, but our internet-influenced way of thinking these days has resulted in a kind of folie à mille that may be the worst possible way to “make American great again.”
Dr. Joe Pierre and Psych Unseen can be followed on Facebook and on Twitter.
To check out some of my fiction, click here to read the short story "Thermidor," published in Westwind earlier this year.
References
1. Compton MT. Internet delusions. Southern Medical Journal 2003; 96:61-63.
2. Bell V, Grech E, Maiden C, et al. ‘Internet delusion’: A case series and theoretical integration. Psychopathology 2005; 38:144-150.
3. Lerner V, Libov I, Witzum E. “Internet delusions”: The impact of technoolocal developments on the content of psychiatric symptoms. The Israel Journal of Psychaitry and Related Science 2006; 43:47-51.
4. Nitzan U, Shoshan E, Lev-Ran S, et al. Internet-related psychosis – A sign of the times? The Israel Journal of Psychiatry and Related Science 2011; 48:207-211.
5. Pierre JM. Faith or delusion: At the crossroads of religion and psychosis. Journal of Psychiatric Practice 2001, 7:163-172.
6. Del Vicario M, Bessi A, Zollo F, et al. The spreading of misinformation online. Proceedings of the National Academy of Science 2015; 113:554-559.
7. Fisher M, Goddu MK, Keil FC. Searching for explanations: How the internet inflates estimates of internal knowledge. Journal of Experimental Psychology 2015; 144:674-687.
