Doctor... what if everything is fake?

Jim Carrey in The Truman Show

The Truman Show delusion, or Truman Syndrome, is a psychiatric condition where psychotic patients describe their lives similar to those of the main character in the 1998 film The Truman Show. Truman lived his entire life in a fake world for a reality TV show, constantly recorded by cameras.
"The Diagnostic and Statistical Manual of Mental Disorders defines a delusion, considered still to be little understood in psychiatry, as, essentially, a false belief that is not grounded in reality and that is held with absolute conviction despite proof to the contrary. The manual lists a caveat that a belief is not delusional if it is something widely accepted by other members of a person’s culture or subculture — for example, religious faith. But some psychiatrists say the exception is too vague.

Some experts studying conditions like Truman Show delusion and other culture-bound delusions, which are specific to a time or place, are questioning the premise that culture is only incidental to psychosis, even as a growing body of evidence has pointed to brain abnormalities and other biological causes for illnesses like schizophrenia."
How do patients know something is true "with absolute conviction"? Do they merely feel it being true? Do they have faith that it's true? I doubt that they somehow want it to be true, because many of these beliefs are painful and unproductive.

If people believe falsehoods based on faulty brain chemistry, can others who want us to believe access that same chemistry?

Look Closely, Doctor: See the Camera? - The New York Times>>

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