In 1877, French psychiatrists Charles Lasègue and Jules Falret introduced the concept of folie à deux, a condition in which two people share a delusional belief system. The French term translates loosely to "madness for two" and eventually became known as shared psychotic disorder. Although it no longer exists as a standalone diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the concept remains relevant to understanding how two people can reinforce a distorted perception of reality.
It also feels remarkably relevant while attempting to unpack Nathan Fielder and Lance Oppenheim's brilliant documentary, You Can See Everything, about Elizabeth Holmes and her partner, Billy Evans.
The film opens just over a month before Holmes is scheduled to begin a multi-year prison sentence for defrauding investors in Theranos, the blood-testing company she founded after dropping out of Stanford. Once celebrated as the world's youngest self-made female billionaire, Holmes now faces enormous financial liabilities and an 11-year prison sentence. Yet she remains adamant that she did absolutely nothing wrong.
Her devoted and bewildering partner, Billy Evans, wholeheartedly supports her version of events. Together, they invite Fielder into their home, apparently hoping to demonstrate both Holmes's innocence and, perhaps even more importantly, the extraordinary nature of their love.
The more directly Fielder confronts Holmes with uncomfortable questions, the clearer it becomes that the couple appears to inhabit a reality of their own construction. Any suggestion of wrongdoing is met with deflection, often giving way to elaborate descriptions or performances of their unusually profound mutual devotion. The self-described mythical nature of their love for one another seems to become a defense mechanism proving their innocence.
Fielder, known for his fascination with simulated realities in shows like The Rehearsal, seems particularly well suited to explore this psychological terrain. He is direct but nuanced. His questions are no-nonsense but he becomes deeply engaged. The harder he tries to understand Holmes and Evans, the more elusive their reality becomes.
What emerges is a portrait of two people who appear to have become lost in each other, using the intensity of their emotional connection as a refuge from the painful realities surrounding them. Their shared conviction in the extraordinary nature of both Holmes's professional mission and their romantic relationship seems to serve a powerful psychological purpose.
Holmes has been convicted of defrauding investors, yet Evans appears unwavering in his acceptance of her claims of complete innocence. Meanwhile, Evans engages in behavior that appears to violate Holmes's trust in ways that are difficult to comprehend. Yet she seems remarkably untroubled by these apparent betrayals.
Perhaps this is because acknowledging either partner's troubling behavior would threaten the emotional refuge they have constructed together. The grand nature of their love becomes an apt metaphor for the majestic mission of Theranos. Their devotion appears to depend, at least in part, on a mutual willingness to look away.
The Psychology of Distorted Relationship Patterns
From a psychological perspective, relationships develop their own equilibrium, and couples can become deeply invested in maintaining familiar patterns, even when those patterns distort their understanding of themselves and the world around them. For Holmes and Evans, their shared insistence on the exceptional nature of their love may serve to protect them from a myriad of painful truths.
Consider an important distinction between intimacy and fusion. Genuine intimacy allows two people to remain connected while recognizing each other as separate individuals, capable of mistakes, contradictions, and disappointments. Fusion, by contrast, can make acknowledging those differences feel intolerable. When a couple becomes emotionally fused, protecting the relationship can begin to take precedence over confronting reality.
Relationships Essential Reads
The question is not whether Holmes and Evans meet the clinical criteria for a dual delusional disorder. The more relevant question is what it looks like when two people become so invested in protecting their emotional connection that acknowledging reality begins to feel like a threat to the relationship itself.
The very relationship that seems to offer them safety may also prevent them from inhabiting any semblance of reality.
We see everything and know nothing.