My patient showed up for his appointment in very good form today. He was clean-shaven and wearing a new set of clothes. He said he’d been interviewing for jobs. His past still haunts him, but he’s trying to move beyond it, to see what the world has to offer. He seems eager for the next step – something I haven’t seen in my entire time since he began therapy with me. It’s good to see that he’s finally taken our conversations to heart and has decided to give life a second chance. I was concerned for awhile, about his safety and, quite frankly, mine, but I am now very encouraged.

He has reconnected with his protesting friends and seems to be developing positive relationships now that he’s broken through the wall of his grief. But he did make a few worrying comments about how he’s started to notice strange people following him and strange messages that seem to keep appearing.

Despite the additional layer of mystery, I do think we have reached a milestone in his treatment. This seemed to be confirmed by the report I received from the detective who was following my patient. The detective told me that BB did nothing suspicious under his observation. However, he confirmed several of the comments you all made – namely, that my patient’s story seems to reflect that of an old English ghost tale concerning a man called Sweeney Todd. Even the details of his answers under hypnosis seem to fit this story. I wonder if this character is somehow embodying his delusions?

One of you also mentioned that perhaps dissociative personality disorder is playing a role in his condition. DID is not universally accepted as a legitimate diagnosis, but it seems worth exploring, at least as a thought experiment. Perhaps he uses “Sweeney Todd” as an outlet for his urges, a fantasy that allows him to imagine terrible acts without owning them himself.

This could be a fascinating new condition, or it could be a variant of one that’s been understood for around a decade. Believing that you are a part of a TV show is actually a documented delusion. It’s called the Truman Show Delusion, named after a film where this was the plot. Only, in this case, my patient thinks he’s part of (or comes from) a fictional story, not a reality TV show.

Personally, I doubt the film itself actually inspired people to become delusional in this particular manner. Delusional people in the Middle Ages saw themselves in personal battle with the Devil. Some delusional people today see believe they have been abducted by aliens. Our delusions are shaped by the society we inhabit, and ours is a very ego-oriented culture – one in which cameras, surveillance, and stories are everywhere. It makes sense to me that this sort of delusion would be possible now.

Of course, every time I thought I had a diagnosis so far, it’s turned out to be something else, but I may actually be getting somewhere this time! I’m glad things are settling down. The last week was pretty rough. Things seem to be returning to normal, and I can’t tell you how relieved I am. I have the well-being of my patients to worry about – I can’t spend so much time worrying about myself, too. But thank you all for your supportive comments! I am really enjoying this project, mostly because you all have been so friendly and helpful.