(A non-bizarre delusion would be believing that your guru was raised from the dead, the exception for “culturally accepted response pattern” isn’t for tulpa hallucinations, it is so that someone who feels the presence of god in the church, hopefully without actually seeing a god hallucination, isn’t diagnosed.)
Here’s the criteria for e.g. 295.40 Schizophreniform Disorder:
One of the following criteria, if delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other: Delusions, Hallucinations, (...)
Rule out of Schizoaffective or Mood Disorders
Disturbance not due to drugs, medication, or a general medical condition (e.g. delirium tremens)
Duration of an episode of the disorder (hallucinations) one to six months
Criteria for 298.80: Brief Psychotic Disorder
Presence of one (or more) of the following symptoms: hallucinations (...)
Duration between one day and one month
Hallucination not better accounted for by Schizoaffective Disorder, Mood Disorder With Psychotic Features, Schizophrenia
Criteria for 298.90: Psychotic Disorder NOS (Not Otherwise Specified):
Psychotic symptomatology (e.g. hallucinations) that do not meet the criteria for any specific Psychotic Disorder, Examples include persistent auditory hallucinations in the absence of any other features.
Where are the additional criteria for that? Wait, there are none!
In summary: You tell a professional about that “friend” you’re seeing and hearing, you either get 295.40 Schizophreniform Disorder or 298.80: Brief Psychotic Disorder depending on the time frame, or 298.90: Psychotic Disorder NOS (Not Otherwise Specified) in any case. Congratulations!
Fair enough, if I had an imaginary friend I wouldn’t want to report it to a shrink. I got hung up on technicalities and the point I should have been focusing on is whether entertaining one specific delusion is likely to result in other symptoms of schizophrenia that are more directly harmful.
Many people suffering from hearing voices etc. do realize those “aren’t real”, which doesn’t in itself enable them to turn them off. If I were confident that you can untrain hallucinations (and strictly speaking thus get rid of a psychotic disorder NOS just by choosing to do so), switch them off with little effort, I would find tulpas to be harmless.
Not knowing much of anything about the tulpa community, a priori I would expect that a significant fraction of “imaginary friends” are more of a vivid imagination type of phenomenon, and not an actual visual and auditory hallucination, which may be more of an embellishment for group-identification purposes.
Well, if you insist, here goes:
(A non-bizarre delusion would be believing that your guru was raised from the dead, the exception for “culturally accepted response pattern” isn’t for tulpa hallucinations, it is so that someone who feels the presence of god in the church, hopefully without actually seeing a god hallucination, isn’t diagnosed.)
Here’s the criteria for e.g. 295.40 Schizophreniform Disorder:
One of the following criteria, if delusions are judged to be bizarre, or hallucinations consist of hearing one voice participating in a running commentary of the patient’s actions or of hearing two or more voices conversing with each other: Delusions, Hallucinations, (...)
Rule out of Schizoaffective or Mood Disorders
Disturbance not due to drugs, medication, or a general medical condition (e.g. delirium tremens)
Duration of an episode of the disorder (hallucinations) one to six months
Criteria for 298.80: Brief Psychotic Disorder
Presence of one (or more) of the following symptoms: hallucinations (...)
Duration between one day and one month
Hallucination not better accounted for by Schizoaffective Disorder, Mood Disorder With Psychotic Features, Schizophrenia
Criteria for 298.90: Psychotic Disorder NOS (Not Otherwise Specified):
Psychotic symptomatology (e.g. hallucinations) that do not meet the criteria for any specific Psychotic Disorder, Examples include persistent auditory hallucinations in the absence of any other features.
Where are the additional criteria for that? Wait, there are none!
In summary: You tell a professional about that “friend” you’re seeing and hearing, you either get 295.40 Schizophreniform Disorder or 298.80: Brief Psychotic Disorder depending on the time frame, or 298.90: Psychotic Disorder NOS (Not Otherwise Specified) in any case. Congratulations!
Fair enough, if I had an imaginary friend I wouldn’t want to report it to a shrink. I got hung up on technicalities and the point I should have been focusing on is whether entertaining one specific delusion is likely to result in other symptoms of schizophrenia that are more directly harmful.
See my take on that here.
Many people suffering from hearing voices etc. do realize those “aren’t real”, which doesn’t in itself enable them to turn them off. If I were confident that you can untrain hallucinations (and strictly speaking thus get rid of a psychotic disorder NOS just by choosing to do so), switch them off with little effort, I would find tulpas to be harmless.
Not knowing much of anything about the tulpa community, a priori I would expect that a significant fraction of “imaginary friends” are more of a vivid imagination type of phenomenon, and not an actual visual and auditory hallucination, which may be more of an embellishment for group-identification purposes.