You can hallucinate without being mentally ill
Thank you for clarifying, btg dad.
You haven’t asked what I think about that, but I hope you won’t mind me taking a chance and telling you anyway, for the benefit of others who might be interested in the matter.
The first point (and many people outside psychiatry healthcare don’t appreciate this) is that the idea that these people had psychotic episodes is not a generally accepted one, and for a simple reason: for something to earn categorisation as mental illness, not one but three things are required (I like to think of them as the 3Ds of mental illness).
It’s not enough that there’s a) disturbance in behaviour, emotions or thoughts—they must also be shown to produce b) significant dysfunction in the person and c) distress in them or those who know and care about them.
These 3 components are considered necessary in determining mental illnesses in both the ICD and the DSM (the two sets of guidelines in use by most mental health professionals).
And that’s not all: two caveats must also be considered…
- Expected responses (whether generally or for the person’s specific culture) for common stressors or loss (like losing a loved one) do not imply mental disorder.
- Socially deviant behavior (whether political, religious, or sexual) or conflicts between a person and society are not mental disorders unless they result from the kind of dysfunction already described.
The problem is that socially, people too often use disturbance in behaviour alone without considering the other two Ds or the two caveats.
The definition is certainly not perfect, but it’s very helpful for reminding us that mental illness is more than just unusual behaviour. And that’s an important point: God knows psychiatry has been used abusively enough in its history.
And it reminds us that we must take into account people’s culture, religion, and personal circumstances, before a diagnosis is made. All of which is why it’s best not to make these diagnoses without the necessary training.
So for the historical leaders: it’s easy to admit that they had hallucinations, but we can’t always say confidently that they had mental illnesses, except where we can establish the other factors.
And in case anyone is wondering: the two aren’t necessarily the same. Psychiatry recognises that hallucinations can occur in otherwise normal people. Hallucinations are after all, only sensory experiences imperceptible to others, and many otherwise well people get at least the common one of hearing your name called when you’re going to sleep or just waking up.
In fact, pretty much every symptom of mental illness can be found in otherwise non-ill people. Which raises my second point: it’s not single symptoms that matter: it’s the collection of symptoms into recognisable patterns.
The real training that we get as mental healthcare professionals is knowing and identifying the patterns.
And as someone who has been involved in training others, I can tell you: it takes at least a year (in most cases two) for most people to get competent at this on just a basic level.